Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women

DEFF Research Database (Denmark)

Benn, Marianne; Voss, Sidsel Skou; Holmegard, Haya N.

2015-01-01

OBJECTIVE - : Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk...... for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. CONCLUSIONS - : In women, extreme low concentrations of endogenous estradiol were associated...

Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease

Directory of Open Access Journals (Sweden)

Anna Weiss

2015-09-01

Full Text Available Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

Ultrasonographic findings of Kimura's disease presenting in the upper extremities.

Science.gov (United States)

Shin, Gi Won; Lee, Sun Joo; Choo, Hye Jung; Park, Young Mi; Jeong, Hae Woong; Lee, Sung-Moon; Suh, Jin-Suck; Jung, Soo-Jin

2014-12-01

To describe ultrasound findings of Kimura's disease arising in the upper extremities. Five patients with Kimura's disease confirmed by surgical resection were retrospectively reviewed by two musculoskeletal radiologists and a pathologist. All six lesions involved the epitrochlear area and appeared as partially (n = 5) or poorly (n = 1) marginated subcutaneous masses with the presence of curvilinear hyperechoic bands intermingled within the hypoechoic components by US. Moderate (n = 4) to severe (n = 2) vascular signals were observed in some proportion of the hyperechoic bands by color Doppler US. The associated findings were the increased echogenicity of surrounding subcutaneous fat (n = 6) and adjacent lymphadenopathy (n = 4). Microscopic examination showed proliferation of lymphoid follicles with prominent germinal centers and intervening fibrosis. In this study, Kimura's disease arising in the upper extremities showed a partially defined hypoechoic subcutaneous mass with internal hyperechoic bands and moderate-to-severe vascularities, increased echogenicity of the surrounding subcutaneous fat and adjacent lymphadenopathy on US. Thus, when these US features are observed in the typical epitrochlear region of an Asian individual, especially if accompanied by peripheral eosinophilia, Kimura's disease should be considered as a possible diagnosis.

Effects of extreme precipitation to the distribution of infectious diseases in Taiwan, 1994-2008.

Directory of Open Access Journals (Sweden)

Mu-Jean Chen

Full Text Available The incidence of extreme precipitation has increased with the exacerbation of worldwide climate disruption. We hypothesize an association between precipitation and the distribution patterns that would affect the endemic burden of 8 infectious diseases in Taiwan, including water- and vector-borne infectious diseases. A database integrating daily precipitation and temperature, along with the infectious disease case registry for all 352 townships in the main island of Taiwan was analysed for the period from 1994 to 2008. Four precipitation levels, 350 mm, were categorized to represent quantitative differences, and their associations with each specific disease was investigated using the Generalized Additive Mixed Model and afterwards mapped on to the Geographical Information System. Daily precipitation levels were significantly correlated with all 8 mandatory-notified infectious diseases in Taiwan. For water-borne infections, extreme torrential precipitation (>350 mm/day was found to result in the highest relative risk for bacillary dysentery and enterovirus infections when compared to ordinary rain (<130 mm/day. Yet, for vector-borne diseases, the relative risk of dengue fever and Japanese encephalitis increased with greater precipitation only up to 350 mm. Differential lag effects following precipitation were statistically associated with increased risk for contracting individual infectious diseases. This study's findings can help health resource sector management better allocate medical resources and be better prepared to deal with infectious disease outbreaks following future extreme precipitation events.

Lower extremity function in normal cognitive aging, mild cognitive impairment, and Alzheimer’s disease

NARCIS (Netherlands)

Eggermont, L.H.P.; Gavett, B.E.; Volkers, K.M.; Blankevoort, C.G.; Scherder, E.J.A.; Jefferson, A.L.; Steinberg, E.; Nair, A.; Green, R.C.; Stern, R.A.

2010-01-01

Eggermont LH, Gavett BE, Volkers KM, Blankevoort CG, Scherder EJ, Jefferson AL, Steinberg E, Nair A, Green RC, Stern RA. Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. Objective: To examine differences in lower-extremity function in

Understanding the Impacts of Climate and Hydrologic Extremes on Diarrheal Diseases in Southwestern Amazon

Science.gov (United States)

Fonseca, P. A. M.

2015-12-01

Bacterial diarrheal diseases have a high incidence rate during and after flooding episodes. In the Brazilian Amazon, flood extreme events have become more frequent, leading to high incidence rates for infant diarrhea. In this study we aimed to find a statistical association between rainfall, river levels and diarrheal diseases in children under 5, in the river Acre basin, in the State of Acre (Brazil). We also aimed to identify the time-lag and annual season of extreme rainfall and flooding in different cities in the water basin. The results using Tropical Rainfall Measuring Mission (TRMM) Satellite rainfall data show robustness of these estimates against observational stations on-ground. The Pearson coefficient correlation results (highest 0.35) indicate a time-lag, up to 4 days in three of the cities in the water-basin. In addition, a correlation was also tested between monthly accumulated rainfall and the diarrheal incidence during the rainy season (DJF). Correlation results were higher, especially in Acrelândia (0.7) and Brasiléia and Epitaciolândia (0.5). The correlation between water level monthly averages and diarrheal diseases incidence was 0.3 and 0.5 in Brasiléia and Epitaciolândia. The time-lag evidence found in this paper is critical to inform stakeholders, local populations and civil defense authorities about the time available for preventive and adaptation measures between extreme rainfall and flooding events in vulnerable cities. This study was part of a pilot application in the state of Acre of the PULSE-Brazil project (http://www.pulse-brasil.org/tool/), an interface of climate, environmental and health data to support climate adaptation. The next step of this research is to expand the analysis to other climate variables on diarrheal diseases across the whole Brazilian Amazon Basin and estimate the relative risk (RR) of a child getting sick. A statistical model will estimate RR based on the observed values and seasonal forecasts (higher

Sporadic lower motor neuron disease with a snake eyes appearance on the cervical anterior horns by MRI.

Science.gov (United States)

Sasaki, Shoichi

2015-09-01

Lower motor neuron disease (LMND) is the term generally used to describe diseases in which only lower motor neuron signs are detected. A snake eyes appearance on magnetic resonance imaging (MRI) is associated with a wide spectrum of neurological conditions including LMND. The author reports on three unique LMND patients with upper limb muscle weakness and atrophy who show a snake eyes appearance by MRI. The patients were aged 18, 40 and 52 years, respectively, at the onset of the disease and had a longstanding clinical course (more than 10 years for two patients and 8 years for one patient). They were followed up for more than 6 years. Clinical manifestations were characterized by (1) longstanding slow progression or delayed spontaneous arrest of asymmetric lower motor neuron signs localized exclusively in the upper extremities with unilateral predominance and distal or proximal preponderance; (2) the absence of upper motor neuron signs, bulbar signs, sensory disturbances and respiratory involvement; (3) a snake eyes appearance on the anterior horns of the cervical cord over more than 3 vertebrae by axial T2-weighted MRI and a longitudinal linear-shaped T2-signal hyperintensity by sagittal MRI; (4) neurogenic change with fasciculation and denervation potentials (fibrillation and a positive sharp wave) confined to the affected muscles by needle electromyogram; and (5) normal cerebrospinal fluid and a normal creatine kinase level. These cases did not fall into any existing category of LMND, such as progressive muscular atrophy, flail arm syndrome or Hirayama disease. These patients should be classified as sporadic LMND with snake eyes on MRI with a relatively benign prognosis. Copyright © 2015 Elsevier B.V. All rights reserved.

Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.

Science.gov (United States)

Davies, Grace I; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

2014-12-23

Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change

Directory of Open Access Journals (Sweden)

Grace I. Davies

2014-12-01

Full Text Available Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art.

Science.gov (United States)

Sista, Akhilesh K; Vedantham, Suresh; Kaufman, John A; Madoff, David C

2015-07-01

The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article.

Occupational exposure to extremely low-frequency magnetic fields and risk for central nervous system disease

DEFF Research Database (Denmark)

Pedersen, Camilla; Poulsen, Aslak Harbo; Rod, Naja Hulvej

2017-01-01

Purpose: Evidence of whether exposure to extremely low-frequency magnetic fields (ELF-MF) is related to central nervous system diseases is inconsistent. This study updates a previous study of the incidence of such diseases in a large cohort of Danish utility workers by almost doubling the period...

Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

International Nuclear Information System (INIS)

Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah

2009-01-01

To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease

Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

Energy Technology Data Exchange (ETDEWEB)

Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah [Chonnam National University Hospital, Gwangju (Korea, Republic of)

2009-07-15

To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease.

Lower-Extremity Function in Cognitively Healthy Aging, Mild Cognitive Impairment, and Alzheimer's Disease

NARCIS (Netherlands)

Eggermont, Laura H.; Gavett, Brandon E.; Volkers, Karin M.; Blankevoort, Christiaan G.; Scherder, Erik J.; Jefferson, Angela L.; Steinberg, Eric; Nair, Anil; Green, Robert C.; Stern, Robert A.

Eggermont LH, Gavett BE, Volkers KM, Blankevoort CG, Scherder EJ, Jefferson AL, Steinberg E, Nair A, Green RC, Stern RA. Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. Arch Phys Med Rehabil 2010;91:584-8. Objective: To examine differences

Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art

Science.gov (United States)

Sista, Akhilesh K.; Vedantham, Suresh; Kaufman, John A.

2015-01-01

The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article. © RSNA, 2015 PMID:26101920

Hepatic tuberculosis presenting with extreme hyperferritinemia masquerading as adult-onset Still’s disease: a case report

Directory of Open Access Journals (Sweden)

Manoj Edirisooriya

2012-07-01

Full Text Available Abstract Introduction Isolated hepatic tuberculosis is an uncommon manifestation of one of the most common infections worldwide, caused by Mycobacterium tuberculosis. Extremely high serum ferritin, which is regarded as a marker of adult onset Still’s disease, has not been observed in patients with tuberculosis of the liver. We report a case of hepatic tuberculosis who presented with clinical criteria of adult-onset Still’s disease and extreme hyperferritinemia, which posed a diagnostic confusion. Case presentation Our patient was a 48-year-old Sri Lankan man who presented with fever, polyarthralgia and a generalized skin rash of three months duration. He had marked constitutional symptoms, oral ulcers, hair loss, anemia and hepatomegaly. Laboratory investigations disclosed an inflammatory syndrome, evidence of hepatic dysfunction, bone marrow suppression and a raised serum ferritin level of 34,674 ng/ml. A rapidly deteriorating course of illness prompted treatment based on a presumptive diagnosis of adult-onset Still’s disease until liver histology was available. The patient died of sepsis followed by multi-organ dysfunction. Later, the liver histology revealed tuberculosis. Conclusion Extrapulmonary tuberculosis, although well known to present with peculiar manifestations, has not been reported to be associated with extremely high levels of serum ferritin in immunocompetent individuals. Isolated hepatic tuberculosis presenting with clinical criteria of adult-onset Still’s disease is remarkable. Since tuberculosis remains a potentially curable disease, an awareness of its’ protean manifestations is essential.

Recent Weather Extremes and Impacts on Agricultural Production and Vector-Borne Disease Outbreak Patterns

Science.gov (United States)

Anyamba, Assaf; Small, Jennifer L.; Britch, Seth C.; Tucker, Compton J.; Pak, Edwin W.; Reynolds, Curt A.; Crutchfield, James; Linthicum, Kenneth J.

2014-01-01

We document significant worldwide weather anomalies that affected agriculture and vector-borne disease outbreaks during the 2010-2012 period. We utilized 2000-2012 vegetation index and land surface temperature data from NASA's satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) to map the magnitude and extent of these anomalies for diverse regions including the continental United States, Russia, East Africa, Southern Africa, and Australia. We demonstrate that shifts in temperature and/or precipitation have significant impacts on vegetation patterns with attendant consequences for agriculture and public health. Weather extremes resulted in excessive rainfall and flooding as well as severe drought, which caused,10 to 80% variation in major agricultural commodity production (including wheat, corn, cotton, sorghum) and created exceptional conditions for extensive mosquito-borne disease outbreaks of dengue, Rift Valley fever, Murray Valley encephalitis, and West Nile virus disease. Analysis of MODIS data provided a standardized method for quantifying the extreme weather anomalies observed during this period. Assessments of land surface conditions from satellite-based systems such as MODIS can be a valuable tool in national, regional, and global weather impact determinations.

Comparative study of multi-slice spiral CT angiography and color doppler ultrasound in diagnosis of arteriosclerotic occlusive disease of lower extremity

International Nuclear Information System (INIS)

Li Wanjun; Lai Zhenhui; Cui Dong; Lin Xiupeng; Du Muxuan

2010-01-01

Objective: To compare the difference between multi-slice spiral CT angiography (MSCTA) and color doppler ultrasound in diagnosis of arteriosclerotic occlusive disease of lower extremity. Methods: Patients with arteriosclerosis occlusion were assessed by color doppler ultrasound, multi-slice spiral CT angiography and digital subtraction angiography (DSA). The image information of color doppler ultrasound and MSCTA were compared with that of DSA. Results: Color doppler ultrasound showed the anatomical shape and hemodynamics of the arteries of lower extremity. The sensitivity, specificity, and accuracy for diagnosis arteriosclerotic occlusive disease of lower extremity were 88.04%, 90.69% and 88.77% respectively. MSCTA showed the three dimensional structure of the arteries of lower extremity as well as the collateral arteries and the distal arterials. The sensitivity, specificity and accuracy of MSCTA were 97.69%, 96.90% and 97.66%, respectively. Conclusion: Multi-slice spiral CT angiography is an ideal imaging method for the diagnosis of arteriosclerotic occlusive disease of lower extremity. (authors)

Epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia: a systematic review protocol.

Science.gov (United States)

van Netten, Jaap J; Baba, Mendel; Lazzarini, Peter A

2017-05-18

Diabetic foot disease is associated with major morbidity, mortality, costs, and reduction of a person's quality of life. Investigating the epidemiology of diabetic foot disease is the backbone of diabetic foot research and clinical practice, yet the full burden of diabetic foot disease in Australia is unknown. This study aims to describe the protocol for a systematic review of the epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia. The systematic review will be performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed and EMBASE will be searched for publications in any language and without restrictions to date. Two independent investigators will screen publications for eligibility, with publications reporting Australian population-based incidence or prevalence of diabetic foot disease or diabetes-related lower-extremity amputation to be included. Additionally, a forward literature search will be performed in Google Scholar, and a grey literature search will be performed to identify government publications. Quality assessment will be performed using customised checklists. The summary statistic used for each study will be an incidence or prevalence proportion of diabetic foot disease or diabetes-related lower-extremity amputation. The standard error for each proportion will be calculated. A meta-analysis will be performed when three or more publications of adequate quality, reporting on similar outcomes and in similar populations, are identified. The results of this systematic review can be used to adequately inform stakeholders in the field of diabetic foot disease on the extent of the problem in incidence and prevalence of diabetic foot disease in Australia, and to help guide appropriate use of resources to reduce the burden of this disease. PROSPERO CRD42016050740.

Effects of interactive metronome training on postural stability and upper extremity function in Parkinson's disease: a case study.

Science.gov (United States)

Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

2017-01-01

[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson's disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson's disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient's static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson's disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson's disease.

Recent weather extremes and impacts on agricultural production and vector-borne disease outbreak patterns.

Directory of Open Access Journals (Sweden)

Assaf Anyamba

Full Text Available We document significant worldwide weather anomalies that affected agriculture and vector-borne disease outbreaks during the 2010-2012 period. We utilized 2000-2012 vegetation index and land surface temperature data from NASA's satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS to map the magnitude and extent of these anomalies for diverse regions including the continental United States, Russia, East Africa, Southern Africa, and Australia. We demonstrate that shifts in temperature and/or precipitation have significant impacts on vegetation patterns with attendant consequences for agriculture and public health. Weather extremes resulted in excessive rainfall and flooding as well as severe drought, which caused ∼10 to 80% variation in major agricultural commodity production (including wheat, corn, cotton, sorghum and created exceptional conditions for extensive mosquito-borne disease outbreaks of dengue, Rift Valley fever, Murray Valley encephalitis, and West Nile virus disease. Analysis of MODIS data provided a standardized method for quantifying the extreme weather anomalies observed during this period. Assessments of land surface conditions from satellite-based systems such as MODIS can be a valuable tool in national, regional, and global weather impact determinations.

Occupational exposure to electromagnetic fields (Emf) of extremely low frequency and Alzheimer disease

International Nuclear Information System (INIS)

Mir, L.

2008-01-01

Occupational exposure to extremely low frequency electromagnetic fields (between 3 and 3000 hz) is one potential risk factor for Alzheimer disease. this critical meta-analysis of the published epidemiologic work suggests the existence of an association in a very heterogeneous dataset. It looks for potential sources of error, examines the areas of uncertainty, and calls for the pursuit of further research. (author)

Effects of interactive metronome training on postural stability and upper extremity function in Parkinson’s disease: a case study

Science.gov (United States)

Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

2017-01-01

[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson’s disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson’s disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient’s static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson’s disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson’s disease. PMID:28210066

Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

Science.gov (United States)

Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew

2015-01-01

The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden. PMID:26633456

Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

Directory of Open Access Journals (Sweden)

Donna Green

2015-12-01

Full Text Available The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1 overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2 extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3 no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.

Agricultural Use of Burkholderia (Pseudomonas) Cepacia: A Threat to Human Health?

Science.gov (United States)

1998-06-01

against fungal diseases and has potential as a bioremediation agent for breaking down recalcitrant herbicides and pesticides. However, B. cepacia is...need for pesticides and its ability to degrade complex herbicides and pesticides is harnessed for bioremediation . Molecular Epidemiology of B... sunflower wilt fungus and role of antifungal compounds in controlling disease. Appl Environ Microbiol 1992;58:1760-3. 36. Homma Y, Sato Z, Hirayama F

Infection in the ischemic lower extremity.

Science.gov (United States)

Fry, D E; Marek, J M; Langsfeld, M

1998-06-01

Infections in the lower extremity of the patient with ischemia can cover a broad spectrum of different diseases. An understanding of the particular pathophysiologic circumstances in the ischemic extremity can be of great value in understanding the natural history of the disease and the potential complications that may occur. Optimizing blood flow to the extremity by using revascularization techniques is important for any patient with an ischemic lower extremity complicated by infection or ulceration. Infections in the ischemic lower extremity require local débridement and systemic antibiotics. For severe infections, such as necrotizing fasciitis or the fetid foot, more extensive local débridement and even amputation may be required. Fundamentals of managing prosthetic graft infection require removing the infected prosthesis, local wound débridement, and systemic antibiotics while attempting to preserve viability of the lower extremity using autogenous graft reconstruction.

Why do people buy dogs with potential welfare problems related to extreme conformation and inherited disease? A representative study of Danish owners of four small dog breeds

OpenAIRE

Sand?e, P.; Kondrup, S. V.; Bennett, P. C.; Forkman, B.; Meyer, I; Proschowsky, H. F.; Serpell, J. A.; Lund, T. B.

2017-01-01

number of dog breeds suffer from welfare problems due to extreme phenotypes and high levels of inherited diseases but the popularity of such breeds is not declining. Using a survey of owners of two popular breeds with extreme physical features (French Bulldog and Chihuahua), one with a high load of inherited diseases not directly related to conformation (Cavalier King Charles Spaniel), and one representing the same size range but without extreme conformation and with the same level of disease...

Lower Extremity Arterial Calcification as a Predictor of Coronary Atherosclerosis in Patients with Peripheral Arterial Disease

International Nuclear Information System (INIS)

Shin, Hwa Seon; Jung Park, Mi; Nyeo Jeon, Kyung; Min Cho, Jae; Soo Bae, Kyung; Seob Choi, Dae; Boem Na, Jae; Cheol Choi, Ho; Young Choi, Hye; Eun Kim, Ji; Bueum Cho, Soo; Eun Park, Sung

2016-01-01

Until now, there has been no study on the relationship between the calcification of the lower extremity arteries and significant coronary arterial disease (CAD). To evaluate whether lower extremity calcium scores (LECS) are associated with CAD and whether this can predict multivessel-CAD in patients with peripheral arterial disease (PAD). We retrospectively enrolled 103 PAD patients without cardiac symptoms or known CAD. All patients underwent cardiac computed tomography (CT) and lower extremity CT within 1 month and were categorized as nonsignificant CAD, single-CAD, or multivessel-CAD. The coronary calcium scores (CCS) were quantitatively measured according to the Agatston method and LECS were semi-quantitatively measured according to the presence of lower extremity calcification in the segment. The extent of CAD was evaluated according to the presence of ≥ 50% luminal diameter stenosis in the segment of CAD. LECS in multivessel-CAD were significantly higher than those in nonsignificant CAD (10.0 ± 5.8 versus 4.0 ± 3.1, P < 0.001). LECS significantly correlated with CCS (r = 0.831, P < 0.001) and the extent of CAD (r = 0.631, P < 0.001). Multivariate regression analysis demonstrated LECS and log-transformed CCS were independent predictors for multivessel-CAD. In receiver operating characteristic curve analysis, the diagnostic performance of LECS was 0.807 (95% confidence interval = 0.724-0.891, P < 0.001) for predicting multivessel-CAD. Peripheral arterial calcification is significantly correlated with CAD extent in patients with PAD. Peripheral arterial calcification can be a useful marker for predicting multivessel-CAD

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China.

Science.gov (United States)

Wang, Xuying; Li, Guoxing; Liu, Liqun; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan

2015-12-21

Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. We collected data from Beijing and Shanghai, China, during 2007-2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0-27, while the hot effects reached the strongest at lag 0-14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

Non-specific Inflammatory Disease Showed Abnormal FDG Uptake in Lower Extremities

International Nuclear Information System (INIS)

Chun, Kyung Ah; Kong, Eun Jung; Cho, Ihn Ho; Hong, Young Hoon; Lee, Choong Ki

2008-01-01

Including malignancy, various disease can show abnormal uptake in bone marrow. 1,2) We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent 18 F-FDG PET/CT to find out fever focus and unknown malignancy. 18 F-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA). 18 F-FDG PET/CT whole body image showed abnormal uptake in lower extremities. MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy, but biopsy result was non-specific inflammatory process. The patient was improved her clinical condition after antibiotics therapy

Teenager male with burning pain in extremities--suspect Fabry disease, 2 case reports.

Science.gov (United States)

Patil, Rajesh B; Joglekar, V K

2014-01-01

We present 2 cases of teenager males presented with burning pain in extremities and turned out to be cases of Fabry disease.The purpose of presenting this case is to highlight the fact that suspicion of Fabry disease in patients presenting with these symptoms will lead to early diagnosis and treatment of this condition before occurrences of complications. A 14-year-old male presented with severe burning pain in both hands and feet since last 4 yrs which persisted despite consumption of painkillers and becoming more disabling and without having any family history for such condition. On general examination patient had small reddish coloured lesions around the umbilicus, appearing like angiokeratomas. Skin biopsy confirmed the lesion. On enzyme assay his alpha galactosidase activity found to be '0' nmol/hr/mg of protein, confirming his diagnosis. Patient's creatinine and 2 D ECHO were normal and urine had 1+ proteinuria. Patient started on carbamazepine tablets for pain and referred to higher centre for genetic diagnosis and enzyme replacement therapy. CASE REPORT 2: An 18-year-old male referred to our hospital by general practitioner for fatigue and pedal oedema with deranged renal function tests. On history taking patient gave history of severe burning pain in both hands and feet since age of 9 yrs. Patient's general examination revealed hypertension with pallor, pedal oedema along with angiokeratomas in bathing suit distribution. Patient's ultrasonography of kidney revealed bilaterally normal sized kidneys with altered echotexture and urine examination showed fine granular foamy cells with sub nephrotic range proteinuria. 2 D ECHO revealed concentric left ventricular hypertrophy. Skin biopsy report supported the diagnosis of Fabry disease. Patient advised to undergo renal biopsy to confirm Fabry nephropathy but patient denied any further diagnostic workup for nephropathy or Fabry disease. Patient started on conservative treatment and carbamazepine in renal dose

[Effect of disease severity on upper extremity muscle strength, exercise capacity, and activities of daily living in individuals with pulmonary arterial hypertension].

Science.gov (United States)

Özcan Kahraman, Buse; Özsoy, İsmail; Acar, Serap; Özpelit, Ebru; Akdeniz, Bahri; Sevinç, Can; Savcı, Sema

2017-07-01

Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip strength were measured with dynamometer. There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05). Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China

Directory of Open Access Journals (Sweden)

Xuying Wang

2015-12-01

Full Text Available Objective: Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. Methods: We collected data from Beijing and Shanghai, China, during 2007–2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. Results: For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0–27, while the hot effects reached the strongest at lag 0–14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34 to extremely low temperature. Conclusion: People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

Spatial extreme learning machines: An application on prediction of disease counts.

Science.gov (United States)

Prates, Marcos O

2018-01-01

Extreme learning machines have gained a lot of attention by the machine learning community because of its interesting properties and computational advantages. With the increase in collection of information nowadays, many sources of data have missing information making statistical analysis harder or unfeasible. In this paper, we present a new model, coined spatial extreme learning machine, that combine spatial modeling with extreme learning machines keeping the nice properties of both methodologies and making it very flexible and robust. As explained throughout the text, the spatial extreme learning machines have many advantages in comparison with the traditional extreme learning machines. By a simulation study and a real data analysis we present how the spatial extreme learning machine can be used to improve imputation of missing data and uncertainty prediction estimation.

Stenting for peripheral artery disease of the lower extremities: an evidence-based analysis.

Science.gov (United States)

2010-01-01

In January 2010, the Medical Advisory Secretariat received an application from University Health Network to provide an evidentiary platform on stenting as a treatment management for peripheral artery disease. The purpose of this health technology assessment is to examine the effectiveness of primary stenting as a treatment management for peripheral artery disease of the lower extremities. CONDITION AND TARGET POPULATION Peripheral artery disease (PAD) is a progressive disease occurring as a result of plaque accumulation (atherosclerosis) in the arterial system that carries blood to the extremities (arms and legs) as well as vital organs. The vessels that are most affected by PAD are the arteries of the lower extremities, the aorta, the visceral arterial branches, the carotid arteries and the arteries of the upper limbs. In the lower extremities, PAD affects three major arterial segments i) aortic-iliac, ii) femoro-popliteal (FP) and iii) infra-popliteal (primarily tibial) arteries. The disease is commonly classified clinically as asymptomatic claudication, rest pain and critical ischemia. Although the prevalence of PAD in Canada is not known, it is estimated that 800,000 Canadians have PAD. The 2007 Trans Atlantic Intersociety Consensus (TASC) II Working Group for the Management of Peripheral Disease estimated that the prevalence of PAD in Europe and North America to be 27 million, of whom 88,000 are hospitalizations involving lower extremities. A higher prevalence of PAD among elderly individuals has been reported to range from 12% to 29%. The National Health and Nutrition Examination Survey (NHANES) estimated that the prevalence of PAD is 14.5% among individuals 70 years of age and over. Modifiable and non-modifiable risk factors associated with PAD include advanced age, male gender, family history, smoking, diabetes, hypertension and hyperlipidemia. PAD is a strong predictor of myocardial infarction (MI), stroke and cardiovascular death. Annually, approximately

Gadolinium-enhanced MR angiography of arterial occlusive disease in lower extremity : comparison with conventional digital subtraction angiography

International Nuclear Information System (INIS)

Shin, Sang June; Koh, Young Hwan; Cha, Joo Hee; Kim, Hyu Beom; Chung, Jin Wook; Park, Jae Hyung

2000-01-01

To compare the diagnostic value of gadolinium-enhanced MR angiography with that of conventional digital subtraction angiography for the evaluation of lower extremity arterial occlusive diseases. In 26 patients with symptomatic lower extremity arterial occlusive disease, both conventional digital subtraction angiography (DSA) and gadolinium-enhanced MR angiography (CE-MRA) were performed during the same week. MR angiography was performed using three-dimensional gradient-echo acquisition before, and two sequential acquisitions after, the administration of gadolinium (0.2 mmol/kg). In 23 patients, two separate, contiguous areas were scanned using additional doses. In three patients, only one field with a suspicious lesion was scanned. Three radiologists independently analyzed the CE-MRA and DSA findings of each vascular segment (20 segments per arterial tree) for the presence of obstructive lesions; the grade assigned was either mild or none (less than 50%), stenotic (50%-99%), or occlusion (100%). From among a total of 462 segments, DSA detected 99 which were significantly narrowed (stenosis, 33; occlusion, 66). Using MR angiography, 102 segments (stenosis 39; occlusion, 63) were identified, and 94 lesions (stenosis, 32; occlusion, 62) were graded correctly. Seven lesions were overestimated and four were underestimated. For the detection of hemodynamically significant stenosis or occlusions using MR angiography, sensitivity, specificity, and diagnostic accuracy were 95%, 98%, and 98% (G=3D0.995, P less than 0.001), respectively. To prove the absence of lesions, we repeated DSA in two patients with arterial spasm due to puncture. Three occluded segments seen on DSA, which revealed intact segments on MR angiography, suggested slow distal flow after reconstitution. For the evaluation of lower extremity arterial occlusive disease, the diagnostic value of gadolinium-enhanced MR angiography is comparable with that of digital subtraction angiography. The advantages of the

To evaluate the differences of risk factors in patients with lower extremity venous disease

International Nuclear Information System (INIS)

Sadikoglu, G.; Ozcakir, A.; Ercan, I.; Ozkaya, G.; Sadikoglu, Y.M.

2007-01-01

To determine whether there is difference between risk factors in patients diagnosed to have clinically documented lower extremity venous disease after confirming the diagnosis radiologically by ultrasonographic and venographic evaluation. This study was performed from January 2002 to January 2005 in Bursa, the fourth biggest city of Turkey situated in the west of country in the Marmara region. The study center is a private imaging center working in conjunction with the Department of Health, which performs diagnostic and therapeutic vascular protocols in the region. Five hundred and fifty-three cases with clinically and radiologically documented diagnoses were evaluated with Multi-Variate Statistical Package 3.13 for the presence of pre-defined clusters of 14 different variables. Other statistical analyses were performed by the Statistical Package for Social sciences, version 13.0. Three different clusters were defined. The variables used to define the clusters were: age, gender, educational level, presence of smoking, amount of smoking (pack/per year), disease symptoms, presence of heart disease and radiologically documented diagnosis. Chronic venous insufficiency and varicose veins are venous system diseases that are most commonly present in association with more than one concomitant risk factors. (author)

Ultrasonography of the lower extremity veins: Anatomy and basic approach

Energy Technology Data Exchange (ETDEWEB)

Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

2017-04-15

Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography.

Ultrasonography of the lower extremity veins: Anatomy and basic approach

International Nuclear Information System (INIS)

Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum

2017-01-01

Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography

Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic peripheral artery disease.

Directory of Open Access Journals (Sweden)

Chi-Lun Huang

Full Text Available OBJECTIVE: The clinical implication of the coronary artery calcium score (CS is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. METHODS AND RESULTS: Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03. During the follow-up period (21±11 months, 29 (35% patients underwent amputation, and 24 (29% patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18-12.72, p = 0.03 and a 5.16-fold (95% CI 1.13-21.61, p = 0.04 higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. CONCLUSION: Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies.

Guideline for the management of wounds in patients with lower-extremity venous disease: an executive summary.

Science.gov (United States)

Kelechi, Teresa J; Johnson, Jan J

2012-01-01

This article provides an executive summary of the lower extremity venous disease (LEVD) evidence-based guideline produced by the WOCN Wound Guidelines Task Force. The target audience for this guideline is health care professionals who specialize in, direct, or provide wound care for patients at risk for or with lower-extremity venous disease. The full guideline opens with an overview of definitions of LEVD, its prevalence, clinical relevance, etiology, related physiology and pathophysiology, and overall management goals for patients at risk for developing venous leg ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. Two approaches to interventions are provided: one addresses prevention strategies to reduce the risk of developing LEVD with ulcers. Methods to prevent ulcer recurrence are summarized including compression therapy, adjunctive therapies, medications, and patient education. A second approach presents treatment interventions including wound cleansing, debridement, infection control, antibiotic use, along with management of the periwound skin, nutrition, pain, and edema. This section also discusses limb elevation, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and appendices on cellulitis and venous eczema, types of edema, and compression therapy are available at the end of the guideline. This article provides an executive summary of the essential features of the guideline.

Endovascular management of deep venous thrombotic diseases of the lower extremity

International Nuclear Information System (INIS)

Roh, Byung Suk

2004-01-01

Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken

Endovascular management of deep venous thrombotic diseases of the lower extremity

Energy Technology Data Exchange (ETDEWEB)

Roh, Byung Suk [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

2004-07-01

Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken.

Application of DCE-MRI in evaluating lower extremity capillary endothelial function in patients with diabetes mellitus complicated by peripheral vascular disease after PTA

International Nuclear Information System (INIS)

Tian Hao; Zhao Jinli; Chen Xiaohua; Wu Xianhua; Li Yuehua

2014-01-01

Objective: To quantify endothelial function of lower extremity capillary in patients with peripheral vascular disease associated with diabetes mellitus by using DCE-MRI, and to explore the feasibility of DCE-MRI in predicting vascular restenosis in lower extremity after PTA. Methods: During the period form May 2009 to Jan. 2012, a total of 51 patients (study group) with diabetic lower extremity vascular diseases (77 diseased legs in total) were admitted to the hospital and were treated with PTA. Another 20 volunteers were used as control group. K-trans values were measured in soleus muscle using DCE-MRI. Based on the results after 6 months follow-up, the patients were classified into restenosis group and non-restenosis group. The K -trans values and others clinical data were compared between the two groups. Results: Although clinical symptoms and signs were improved in both groups after the treatment, K-trans value of restenosis group showed no obvious changes after PTA, while K-trans value of non-restenosis group was improved significantly. Before PTA, the difference in K -trans value between the two groups was not statistically significant, while K-trans values of the two groups were significantly lower than that of the control group (P<0.05). Conclusion: K-trans value can reflect the endothelial function in diabetes mellitus patients with peripheral vascular disease, and it can also predict the occurrence of restenosis, providing a useful evidence for clinical. therapy. (authors)

Upper Extremity Motor Learning among Individuals with Parkinson's Disease: A Meta-Analysis Evaluating Movement Time in Simple Tasks

Directory of Open Access Journals (Sweden)

K. Felix

2012-01-01

Full Text Available Motor learning has been found to occur in the rehabilitation of individuals with Parkinson's disease (PD. Through repetitive structured practice of motor tasks, individuals show improved performance, confirming that motor learning has probably taken place. Although a number of studies have been completed evaluating motor learning in people with PD, the sample sizes were small and the improvements were variable. The purpose of this meta-analysis was to determine the ability of people with PD to learn motor tasks. Studies which measured movement time in upper extremity reaching tasks and met the inclusion criteria were included in the analysis. Results of the meta-analysis indicated that people with PD and neurologically healthy controls both demonstrated motor learning, characterized by a decrease in movement time during upper extremity movements. Movement time improvements were greater in the control group than in individuals with PD. These results support the findings that the practice of upper extremity reaching tasks is beneficial in reducing movement time in persons with PD and has important implications for rehabilitation.

Roentgenological findings in muscular alterations of extremities

International Nuclear Information System (INIS)

Palvoelgyi, R.

1978-01-01

A survey of roentgenological findings in muscular alterations of extremities based on the author's experiences and on the literature is presented. Following a description of the normal roentgen anatomy, the alterations in different diseases of interstitial lipomatosis are demonstrated. By roentgenological examinations differt muscular lesions of the extremities can be differentiated and the clinical follow-up verified. (orig.) [de

A clinical study on chronic arterial occlusive diseases of the lower extremities by scintiangiography of the foot

International Nuclear Information System (INIS)

Oya, Yoshitaro

1981-01-01

Scintiangiography of the foot was performed on 210 limbs with peripheral vascular diseases of the lower extremities in comparison with 12 normal limbs. After an intravenous bolus of 10 to 20 mCi of sup(99m)Tc-human serum albumin, the arrival and distribution of activity in foot during reactive hyperemia were observed and photographed on the monitor scope of the gamma camera and recorded on video tape. The activity curve was obtained for several regions of interest and analysed to obtain the arrival time of activity Ta, the maximum counts time Tmax and the perfusion index. Those results were compared with angiography and the pressure index. The gamma camera image provided approximately the state of the peripheral circulation, and the defect or delay of the image was obtained on 93 per cent of the ischemic extremities. The pattern of the activity curves were classified into three types, I: rapid appearance with high activity peak, II: relatively rapid appearance with low activity peak, III: delayed appearance with the absence of the activity peak. In normal subjects and good run-off patients, the typical pattern of the activity curve was mainly observed being to I type, on the other hand, the pattern was generally being to III type in patients with ulcerated or cyanotic foot. The difference between the arrival time of activity of foot and toe under conditions of reactive hyperemia was longer evidently according to degree of arterial occlusion. The perfusion index was well correlated to the pressure index on foot and toe. In conclusion, scintiangiography of the foot is a simple and harmless procedure to evaluate the hemodynamic state of the lower extremities and is applicable for screening the peripheral vascular diseases and postoperative study. (author)

Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death.

Science.gov (United States)

Wukich, Dane K; Raspovic, Katherine M; Suder, Natalie C

2018-02-01

The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non-diabetes-related foot pathology. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis. Patients with diabetic foot disease (61 of 207, 31.9%) were 136% more likely (odds ratio [OR] = 2.36; 95% CI = 1.51-3.70; P = .002] to rank major LEA as their greatest fear when compared with diabetic patients without foot disease (42 of 254, 16.5%) and were 49% less likely (OR = 0.51; 95% CI = 0.34-0.79; P = .002) to rank death as their greatest fear compared with patients without diabetic foot disease. Patients with diabetic foot pathology fear major LEA more than death, foot infection, or ESRD. Variables that were associated with ranking LEA as the greatest fear were the presence of a diabetic-related foot complication, duration of DM ≥10 years, insulin use, and the presence of peripheral neuropathy. Level II: Prospective, Case controlled study.

The role of atherectomy in the treatment of lower extremity peripheral artery disease

Science.gov (United States)

2012-01-01

Background The incidence of lower extremity peripheral artery disease (LE-PAD) continues to increase and associated morbidity remains high. Despite the significant development of percutaneous revascularization strategies, over the past decade, LE-PAD still represents a unique challenge for interventional cardiologists and vascular surgeons. Method Typical features of atherosclerosis that affects peripheral vascular bed (diffuse nature, poor distal runoff, critical limb ischemia, chronic total occlusion) contribute to the disappointing results of traditional percutaneous transluminal angioplasty (PTA). New technologies have been developed in attempt to improve the safety and effectiveness of percutaneous revascularization. Among these, atherectomy, debulking and removing atherosclerotic plaque, offers the potential advantage of eliminating stretch on arterial walls and reducing rates of restenosis. Conclusions This review summarizes the features and the current applications of new debulking devices. PMID:23173800

Mortality impact of extreme winter temperatures

Science.gov (United States)

Díaz, Julio; García, Ricardo; López, César; Linares, Cristina; Tobías, Aurelio; Prieto, Luis

2005-01-01

During the last few years great attention has been paid to the evaluation of the impact of extreme temperatures on human health. This paper examines the effect of extreme winter temperature on mortality in Madrid for people older than 65, using ARIMA and GAM models. Data correspond to 1,815 winter days over the period 1986 1997, during which time a total of 133,000 deaths occurred. The daily maximum temperature (Tmax) was shown to be the best thermal indicator of the impact of climate on mortality. When total mortality was considered, the maximum impact occured 7 8 days after a temperature extreme; for circulatory diseases the lag was between 7 and 14 days. When respiratory causes were considered, two mortality peaks were evident at 4 5 and 11 days. When the impact of winter extreme temperatures was compared with that associated with summer extremes, it was found to occur over a longer term, and appeared to be more indirect.

Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population

DEFF Research Database (Denmark)

Varbo, Anette; Freiberg, Jacob J; Nordestgaard, Børge G

2015-01-01

BACKGROUND: Increased nonfasting remnant cholesterol, like increased LDL cholesterol, is causally associated with increased risk for ischemic heart disease (IHD). We tested the hypothesis that extreme concentrations of nonfasting remnant and LDL cholesterol are equal contributors to the risk of IHD......, myocardial infarction (MI), and all-cause mortality. METHODS: We compared stepwise increasing concentrations of nonfasting remnant and LDL cholesterol for association with risk of IHD, MI, and all-cause mortality in approximately 90 000 individuals from the Danish general population. During up to 22 years...... of complete follow-up, 4435 participants developed IHD, 1722 developed MI, and 8121 died. RESULTS: Compared with participants with nonfasting remnant cholesterol cholesterol of 0.5-0.99 mmol/L (19.3-38.2 mg/dL) to 2...

Global predictability of temperature extremes

Science.gov (United States)

Coughlan de Perez, Erin; van Aalst, Maarten; Bischiniotis, Konstantinos; Mason, Simon; Nissan, Hannah; Pappenberger, Florian; Stephens, Elisabeth; Zsoter, Ervin; van den Hurk, Bart

2018-05-01

Extreme temperatures are one of the leading causes of death and disease in both developed and developing countries, and heat extremes are projected to rise in many regions. To reduce risk, heatwave plans and cold weather plans have been effectively implemented around the world. However, much of the world’s population is not yet protected by such systems, including many data-scarce but also highly vulnerable regions. In this study, we assess at a global level where such systems have the potential to be effective at reducing risk from temperature extremes, characterizing (1) long-term average occurrence of heatwaves and coldwaves, (2) seasonality of these extremes, and (3) short-term predictability of these extreme events three to ten days in advance. Using both the NOAA and ECMWF weather forecast models, we develop global maps indicating a first approximation of the locations that are likely to benefit from the development of seasonal preparedness plans and/or short-term early warning systems for extreme temperature. The extratropics generally show both short-term skill as well as strong seasonality; in the tropics, most locations do also demonstrate one or both. In fact, almost 5 billion people live in regions that have seasonality and predictability of heatwaves and/or coldwaves. Climate adaptation investments in these regions can take advantage of seasonality and predictability to reduce risks to vulnerable populations.

Arterial diseases of lower extremities in diabetic patients: current state and prospects of therapy

Directory of Open Access Journals (Sweden)

Gagik Radikovich Galstyan

2011-03-01

Full Text Available Peripheral artery diseases (PAD are most serious diabetic complications responsible for the high risk of amputation of lower extremities. The occurrenceof PAD in diabetic patients is much higher than in subjects with undisturbed carbohydrate metabolism. PAD in diabetic patients is frequentlyan asymptomatic condition affecting distal portions of arterial segments and associated with pronounced mediacalcinosis. Standard diagnostic proceduresfor the screening of arterial lesions must be supplemented by non-invasive visualization and measurement of transcutaneous oxygen tensionin patients at risk of PAD and persisting foot ulcers. Of special importance is early diagnosis of critical limb ischemia and prevention of foot lesions.Combined treatment of diabetic foot syndrome in patients with critical limb ischemia includes normalization of foot circulation, surgical interventionand conservative therapy of the wound, monitoring concomitant micro- and macrovascular diabetic complications?

Diagnostic value of microRNA-143 in predicting in-stent restenosis for patients with lower extremity arterial occlusive disease

OpenAIRE

Yu, Zhi-Hai; Wang, Hai-Tao; Tu, Can

2017-01-01

Purpose This study was conducted to explore the diagnostic value of microRNA-143 (miRNA-143) in predicting in-stent restenosis (ISR) of lower extremity arterial occlusive disease (LEAOD). Methods From February 2012 to March 2015, 165 patients (112 males and 53 females) with LEAOD undergoing interventional treatment were enrolled in this study. Serum miRNA-143 expression was detected using quantitative real-time polymerase chain reaction (qRT-PCR). Patients were assigned into the restenosis an...

Type 2 diabetes risk alleles demonstrate extreme directional differentiation among human populations, compared to other diseases.

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Rong Chen

Full Text Available Many disease-susceptible SNPs exhibit significant disparity in ancestral and derived allele frequencies across worldwide populations. While previous studies have examined population differentiation of alleles at specific SNPs, global ethnic patterns of ensembles of disease risk alleles across human diseases are unexamined. To examine these patterns, we manually curated ethnic disease association data from 5,065 papers on human genetic studies representing 1,495 diseases, recording the precise risk alleles and their measured population frequencies and estimated effect sizes. We systematically compared the population frequencies of cross-ethnic risk alleles for each disease across 1,397 individuals from 11 HapMap populations, 1,064 individuals from 53 HGDP populations, and 49 individuals with whole-genome sequences from 10 populations. Type 2 diabetes (T2D demonstrated extreme directional differentiation of risk allele frequencies across human populations, compared with null distributions of European-frequency matched control genomic alleles and risk alleles for other diseases. Most T2D risk alleles share a consistent pattern of decreasing frequencies along human migration into East Asia. Furthermore, we show that these patterns contribute to disparities in predicted genetic risk across 1,397 HapMap individuals, T2D genetic risk being consistently higher for individuals in the African populations and lower in the Asian populations, irrespective of the ethnicity considered in the initial discovery of risk alleles. We observed a similar pattern in the distribution of T2D Genetic Risk Scores, which are associated with an increased risk of developing diabetes in the Diabetes Prevention Program cohort, for the same individuals. This disparity may be attributable to the promotion of energy storage and usage appropriate to environments and inconsistent energy intake. Our results indicate that the differential frequencies of T2D risk alleles may

Upper Extremity Freezing and Dyscoordination in Parkinson’s Disease: Effects of Amplitude and Cadence Manipulations

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April J. Williams

2013-01-01

Full Text Available Purpose. Motor freezing, the inability to produce effective movement, is associated with decreasing amplitude, hastening of movement, and poor coordination. We investigated how manipulations of movement amplitude and cadence affect upper extremity (UE coordination as measured by the phase coordination index (PCI—only previously measured in gait—and freezing of the upper extremity (FO-UE in people with Parkinson's disease (PD who experience freezing of gait (PD + FOG, do not experience FOG (PD-FOG, and healthy controls. Methods. Twenty-seven participants with PD and 18 healthy older adults made alternating bimanual movements between targets under four conditions: Baseline; Fast; Small; SmallFast. Kinematic data were recorded and analyzed for PCI and FO-UE events. PCI and FO-UE were compared across groups and conditions. Correlations between UE PCI, gait PCI, FO-UE, and Freezing of Gait Questionnaire (FOG-Q were determined. Results. PD + FOG had poorer coordination than healthy old during SmallFast. UE coordination correlated with number of FO-UE episodes in two conditions and FOG-Q score in one. No differences existed between PD−/+FOG in coordination or number of FO-UE episodes. Conclusions. Dyscoordination and FO-UE can be elicited by manipulating cadence and amplitude of an alternating bimanual task. It remains unclear whether FO-UE and FOG share common mechanisms.

QUALITY OF LIFE IN PATIENTS WITH HYPERTENSION, CORONARY HEART DISEASE, AND ATHEROSCLEROTIC LESION OF LOWER EXTREMITY ARTERIES IN THE SECONDARY PREVENTION OF COMPLICATIONS

Directory of Open Access Journals (Sweden)

A. A. Karlov

2014-07-01

Full Text Available Atherosclerotic lesion of lower extremity arteries frequently complicates the long-term course of hypertension and it is generally associated with coronary heart disease. Our study has attempted to evaluate the impact of combination antihypertensive therapy involving amlodipine, bisoprolol, and lisinopril on quality of life in this category of patients.

Does the anatomical localization of lower extremity venous diseases affect the quality of life?

Science.gov (United States)

Sadikoglu, Ganime; Ozcakir, Alis; Ercan, Ilker; Yildiz, Caner; Sadikoglu, Yurtkuran

2006-11-01

To investigate the effects of venous diseases at different anatomical localizations on the qualities of life of patients with varicose veins. The study included 354 cases, which was referred to a private vascular and interventional radiology center in Bursa, Turkey between January 2005 to January 2006. The cases were diagnosed with visual inspection and were clinically indicative of varicose veins. Color Doppler ultrasonography was used to radiologically examine the varicose veins. All cases were accepted as class II criteria according to the Clinical, Etiologic, Anatomic, Pathophysiologic classification. The generic Short Form Health Survey-36 (SF-36) was used to measure physical and mental quality of life (QOL). High scores indicated good QOL. The Statistical Package for Social Sciences version 13.0 program was used for the statistical evaluation. When the life SF-36 quality parameters of cases with different anatomical localizations of the varicose veins were examined, only the mental health scores were found to differ in different groups (pemotional role scores among the mental state determinants. When females and males with deep vein disease were compared, significant differences were found among both physical and mental health determinants. Anatomical localization of lower extremity varicose veins can be accepted as a predictive factor in determining the life qualities of patients with varicosities in their lower limb, and should be used to regulate their therapy and follow up protocols.

Extreme hyponatraemia with intact neurological outcome in a young child with Addison’s disease

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Smith, John-Paul; Burren, Christine; Cherinet, Yonas

2011-01-01

The authors present the case of a 6-year-old boy with a good neurological outcome from extreme hyponatraemia caused by autoimmune hypoadrenalism. He presented with 1 week of reduced appetite, lethargy, vomiting and one episode of diarrhoea. He was described as being slightly unsteady on his feet. Clinically he was alert, although intermittently confused, with dry mucous membranes and sunken eyes. Serum sodium was 96 mmol/l with normal serum potassium and renal function. He was initially treated with 3% saline intravenously, and his serum sodium increased to 128 mmol/l by day 3. He developed slurred speech and ataxia on day 4, although MRI brain showed no evidence of pontine myelinosis, and the symptoms resolved over 1 week. A Synacthen test on day 10 confirmed a diagnosis of Addison’s disease and he was commenced on hydrocortisone and fludrocortisone replacement therapy. At 5 months follow-up there are no obvious neurological or developmental sequelae. PMID:22679234

Rehabilitation Trends After Lower Extremity Amputations in Canada.

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Kayssi, Ahmed; Dilkas, Steven; Dance, Derry L; de Mestral, Charles; Forbes, Thomas L; Roche-Nagle, Graham

2017-05-01

The heterogeneity of medical complications that lead to amputation has resulted in a diverse patient population with differing rehabilitation needs; however, the rehabilitation trends for patients with lower extremity amputations across Canada have not been studied previously. To describe trends in rehabilitation after lower extremity amputations and the factors affecting rehabilitation length of stay in Canada. Retrospective cohort analysis. Canadian inpatient rehabilitation facilities that received persons with lower extremity amputations discharged from academic or community hospitals. Patients underwent lower extremity amputations between 2006 and 2009 for nontraumatic indications and were then discharged to a rehabilitation facility. Patients were identified from the Canadian Institute for Health Information's Discharge Abstract Database that includes hospital admissions across Canada except Quebec. Inpatient rehabilitation after lower extremity amputations. Length of stay, discharge destination, and change in total and motor function scores. The analysis included 5342 persons who underwent lower extremity amputations, 1904 of whom were transferred to a rehabilitation facility (36%). Patients most commonly underwent single below-knee (74%) and above-knee (17%) amputations. The duration of rehabilitation varied by whether the amputation was performed by a vascular (median = 36 days), orthopedic (median = 38 days), or general surgeon (median = 35 days). The overall median length of stay was 36 days. Most patients (72%) subsequently were discharged home and 9% were readmitted to hospital. Predictors of longer rehabilitation included amputation by an orthopedic surgeon (beta = 5.0, P ≤ .01), older age (beta = 0.2, P ≤ .01), and a history of ischemic heart disease (beta = 3.8, P = .03) or congestive heart failure (beta = 5, P = .04). Patients who spent Canada after lower extremity amputation varies by the type of surgeon performing the amputation. Advanced age

Aortic dissection: natural course of disease? Report of two cases representing the extremes of the condition

International Nuclear Information System (INIS)

Tollefsen, Isak; Joergensen, Ingrid K.; Woie, Leik; Fossdal, Jan E.

2001-01-01

Objective: In a time when diagnostic methods and above all, surgical as well as interventional radiological treatment for aortic aneurysms and aortic dissections have reached a point nobody could think of a few years back, the present authors feel that it is worth while to remind oneself of the natural course of disease in these conditions. Taking into consideration the high morbidity and mortality rate in surgically treated patients with aortic dissection, and the high complication rate per- and postoperatively, it also seems right to ask if a more expectative and conservative approach to the condition sometimes perhaps may be justified. Methods and material: Two case reports are given. One was a 15-year-old boy with Stanford (Daily) type B dissection who statistically ought to have a good prognosis, but who died within 2 h after onset of symptoms. The other patient, a middle-aged woman with Stanford type A dissection, survived for 25 years without operation. Conclusion: These two cases, though not unique viewed separately, we consider to represent the extremes of the condition and also a natural course of disease, while none of them was operated on

Aortic dissection: natural course of disease? Report of two cases representing the extremes of the condition.

Science.gov (United States)

Tollefsen, I; Jørgensen, I K; Woie, L; Fossdal, J E

2001-10-01

In a time when diagnostic methods and above all, surgical as well as interventional radiological treatment for aortic aneurysms and aortic dissections have reached a point nobody could think of a few years back, the present authors feel that it is worth while to remind oneself of the natural course of disease in these conditions. Taking into consideration the high morbidity and mortality rate in surgically treated patients with aortic dissection, and the high complication rate per- and postoperatively, it also seems right to ask if a more expectative and conservative approach to the condition sometimes perhaps may be justified. Two case reports are given. One was a 15-year-old boy with Stanford (Daily) type B dissection who statistically ought to have a good prognosis, but who died within 2 h after onset of symptoms. The other patient, a middle-aged woman with Stanford type A dissection, survived for 25 years without operation. These two cases, though not unique viewed separately, we consider to represent the extremes of the condition and also a natural course of disease, while none of them was operated on.

Haplotype Analysis Discriminates Genetic Risk for DR3-Associated Endocrine Autoimmunity and Helps Define Extreme Risk for Addison’s Disease

Science.gov (United States)

Baker, Peter R.; Baschal, Erin E.; Fain, Pam R.; Triolo, Taylor M.; Nanduri, Priyaanka; Siebert, Janet C.; Armstrong, Taylor K.; Babu, Sunanda R.; Rewers, Marian J.; Gottlieb, Peter A.; Barker, Jennifer M.; Eisenbarth, George S.

2010-01-01

Context: Multiple autoimmune disorders (e.g. Addison’s disease, type 1 diabetes, celiac disease) are associated with HLA-DR3, but it is likely that alleles of additional genes in linkage disequilibrium with HLA-DRB1 contribute to disease. Objective: The objective of the study was to characterize major histocompatability complex (MHC) haplotypes conferring extreme risk for autoimmune Addison’s disease (AD). Design, Setting, and Participants: Eighty-six 21-hydroxylase autoantibody-positive, nonautoimmune polyendocrine syndrome type 1, Caucasian individuals collected from 1992 to 2009 with clinical AD from 68 families (12 multiplex and 56 simplex) were genotyped for HLA-DRB1, HLA-DQB1, MICA, HLA-B, and HLA-A as well as high density MHC single-nucleotide polymorphism (SNP) analysis for 34. Main Outcome Measures: AD and genotype were measured. Result: Ninety-seven percent of the multiplex individuals had both HLA-DR3 and HLA-B8 vs. 60% of simplex AD patients (P = 9.72 × 10−4) and 13% of general population controls (P = 3.00 × 10−19). The genotype DR3/DR4 with B8 was present in 85% of AD multiplex patients, 24% of simplex patients, and 1.5% of control individuals (P = 4.92 × 10−191). The DR3-B8 haplotype of AD patients had HLA-A1 less often (47%) than controls (81%, P = 7.00 × 10−5) and type 1 diabetes patients (73%, P = 1.93 × 10−3). Analysis of 1228 SNPs across the MHC for individuals with AD revealed a shorter conserved haplotype (3.8) with the loss of the extended conserved 3.8.1 haplotype approximately halfway between HLA-B and HLA-A. Conclusion: Extreme risk for AD, especially in multiplex families, is associated with haplotypic DR3 variants, in particular a portion (3.8) but not all of the conserved 3.8.1 haplotype. PMID:20631027

Changes in extreme events and the potential impacts on human health.

Science.gov (United States)

Bell, Jesse E; Brown, Claudia Langford; Conlon, Kathryn; Herring, Stephanie; Kunkel, Kenneth E; Lawrimore, Jay; Luber, George; Schreck, Carl; Smith, Adam; Uejio, Christopher

2018-04-01

Extreme weather and climate-related events affect human health by causing death, injury, and illness, as well as having large socioeconomic impacts. Climate change has caused changes in extreme event frequency, intensity, and geographic distribution, and will continue to be a driver for change in the future. Some of these events include heat waves, droughts, wildfires, dust storms, flooding rains, coastal flooding, storm surges, and hurricanes. The pathways connecting extreme events to health outcomes and economic losses can be diverse and complex. The difficulty in predicting these relationships comes from the local societal and environmental factors that affect disease burden. More information is needed about the impacts of climate change on public health and economies to effectively plan for and adapt to climate change. This paper describes some of the ways extreme events are changing and provides examples of the potential impacts on human health and infrastructure. It also identifies key research gaps to be addressed to improve the resilience of public health to extreme events in the future. Extreme weather and climate events affect human health by causing death, injury, and illness, as well as having large socioeconomic impacts. Climate change has caused changes in extreme event frequency, intensity, and geographic distribution, and will continue to be a driver for change in the future. Some of these events include heat waves, droughts, wildfires, flooding rains, coastal flooding, surges, and hurricanes. The pathways connecting extreme events to health outcomes and economic losses can be diverse and complex. The difficulty in predicting these relationships comes from the local societal and environmental factors that affect disease burden.

The Relation Between Visual Impairment and Extremity Fractures

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Berrak Şekeryapan

2013-08-01

Full Text Available Purpose: To evaluate the association between the development of extremity fracture and visual impairment in adults. Material and Method: This study included 56 patients (patient group aged 18 years or older who had extremity fractures due to a fall. The control group (n=42 was selected from visitors who had regular medical check-ups at our hospital. Each participant underwent a full ophthalmologic examination. Mean age was compared by Student’s t test. The other variables were compared by chi-square test. Results: The prevalence of subjects with visual impairment was significantly higher in the patients group (78.6% than in the control group (38.1% (p<0.05. The prevalence of treatable eye diseases such as cataract and refractive errors were significantly higher in the patient group than in the control group (p<0.05 for both. Twenty-eight patients (50% in the patient group and 8 subjects in the control group had visual acuities lower than 0.5 (p<0.05. Discussion: We have found that the prevalence of visual impairment was significantly higher in adults with extremity fractures due to falls than in the control group. Hence, we believe that regular ophthalmological examination in adults, providing regular use of eyeglasses in patients with refractive errors, and timely treatment of treatable eye diseases such as cataract could decrease the extremity fractures from falls in adults. (Turk J Ophthalmol 2013; 43: 250-2

Changes in Extreme Events and the Potential Impacts on National Security

Science.gov (United States)

Bell, J.

2017-12-01

Extreme weather and climate events affect human health by causing death, injury, and illness, as well as having large socio-economic impacts. Climate change has caused changes in extreme event frequency, intensity and geographic distribution, and will continue to be a driver for changes in the future. Some of the extreme events that have already changed are heat waves, droughts, wildfires, flooding rains, coastal flooding, storm surge, and hurricanes. The pathways connecting extreme events to health outcomes and economic losses can be diverse and complex. The difficulty in predicting these relationships comes from the local intricacies of societal and environmental factors that influences the level of exposure. The goal of this presentation is to discuss the national security implications of changes in extreme weather events and demonstrate how changes in extremes can lead to a host cascading issues. To illustrate this point, this presentation will provide examples of the various pathways that extreme events can increase disease burden and cause economic stress.

Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines

Energy Technology Data Exchange (ETDEWEB)

Hwang, Ji Young [Dept. of Radiology, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

2017-04-15

Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines

Directory of Open Access Journals (Sweden)

Ji Young Hwang

2017-04-01

Full Text Available Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

[COMPARISON OF INTRAOPERATIVE SCLEROOBLITERATION AND ECHOSCLEROOBLITERATION EFFICIENCY OF VARICOSE DISEASES OF THE LOWER EXTREMITIES C6 CLASS IN PATIENTS BY TYPE II DIABETES MELLITUS].

Science.gov (United States)

Palamarchuk, V I; Odnorog, S I; Gvozdyak, M M; Vilgash, A M

2015-06-01

The experience of surgical treatment of 50 patients for varicose disease of lower extremities, complicated by trophic ulcers, in the presence of diabetes mellitus type II were analysed. During surgery in patients of the 1st group performed a combined phlebectomy, group 2--scleroobliteration and echoscleroobliteration. Using fleboscleroobliteration method helped reduce the frequency of early postoperative complications in (6.5 +/- 1.3) times.

Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

Directory of Open Access Journals (Sweden)

A. E. Karateev

2015-01-01

Full Text Available Rheumatic diseases of juxta-articular soft tissues (RDJAST (tendinitis, tenosynovitis, bursitis, etc. are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and conferences of rheumatologists in recent years. This review is to refresh physicians’interest in this problem. Part 1 of this review briefly considers the general issues relating to the epidemiology, pathogenesis, and diagnosis of RDJAST of the upper extremity, such as rotator cuff tendinitis, lateral and medial epicondylitis, stenosing flexor tenosynovitis, de Quervain’s syndrome, and carpal tunnel syndrome.

Investigating NARCCAP Precipitation Extremes via Bivariate Extreme Value Theory (Invited)

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Weller, G. B.; Cooley, D. S.; Sain, S. R.; Bukovsky, M. S.; Mearns, L. O.

2013-12-01

We introduce methodology from statistical extreme value theory to examine the ability of reanalysis-drive regional climate models to simulate past daily precipitation extremes. Going beyond a comparison of summary statistics such as 20-year return values, we study whether the most extreme precipitation events produced by climate model simulations exhibit correspondence to the most extreme events seen in observational records. The extent of this correspondence is formulated via the statistical concept of tail dependence. We examine several case studies of extreme precipitation events simulated by the six models of the North American Regional Climate Change Assessment Program (NARCCAP) driven by NCEP reanalysis. It is found that the NARCCAP models generally reproduce daily winter precipitation extremes along the Pacific coast quite well; in contrast, simulation of past daily summer precipitation extremes in a central US region is poor. Some differences in the strength of extremal correspondence are seen in the central region between models which employ spectral nudging and those which do not. We demonstrate how these techniques may be used to draw a link between extreme precipitation events and large-scale atmospheric drivers, as well as to downscale extreme precipitation simulated by a future run of a regional climate model. Specifically, we examine potential future changes in the nature of extreme precipitation along the Pacific coast produced by the pineapple express (PE) phenomenon. A link between extreme precipitation events and a "PE Index" derived from North Pacific sea-surface pressure fields is found. This link is used to study PE-influenced extreme precipitation produced by a future-scenario climate model run.

Sexual dimorphism in epigenomicresponses of stem cells to extreme fetal growth

Science.gov (United States)

Delahaye, Fabien; Wijetunga, N. Ari; Heo, Hye J.; Tozour, Jessica N.; Zhao, Yong Mei; Greally, John M.; Einstein, Francine H.

2014-01-01

Extreme fetal growth is associated with increased susceptibility to a range of adult diseases through an unknown mechanism of cellular memory. We tested whether heritable epigenetic processes in long-lived CD34+ hematopoietic stem/progenitor cells (HSPCs) showed evidence for re-programming associated with the extremes of fetal growth. Here we show that both fetal growth restriction and over-growth are associated with global shifts towards DNA hypermethylation, targeting cis-regulatory elements in proximity to genes involved in glucose homeostasis and stem cell function. We find a sexually dimorphic response; intrauterine growth restriction (IUGR) is associated with substantially greater epigenetic dysregulation in males, whereas large for gestational age (LGA) growth predominantly affects females. The findings are consistent with extreme fetal growth interacting with variable fetal susceptibility to influence cellular aging and metabolic characteristics through epigenetic mechanisms, potentially generating biomarkers that could identify infants at higher risk for chronic disease later in life. PMID:25300954

Fluoroscopically-guided foam sclerotherapy with sodium morrhuate for the treatment of lower extremity varices

International Nuclear Information System (INIS)

Wang Haiting; Jiang Zhongpu; Zhou Yi

2011-01-01

Objective: To evaluate fluoroscopically-guided foam sclerotherapy with injection of domestic sodium morrhuate in treating lower extremity varices. Methods: A total of 30 cases (39 diseased lower limbs) with lower extremity varices were enrolled in this study. Under fluoroscopic guidance foam sclerotherapy with injection of domestic sodium morrhuate was carried out in all patients. The obstructed condition of the great saphenous vein was observed during the following three months. Results: The technical success was achieved in all 39 patients. The mean dose of foam sclerosant used for each diseased limb was 5.9 ml (3.4-8.2 ml). Disappearance of blood flow reflux in lower extremity vein immediately after the treatment was seen in 35 patients (90%). Three months after the therapy, vascular sonography showed that the great saphenous vein was obstructed, and no serious complications occurred. Conclusion: For the treatment of lower extremity varices, fluoroscopically-guided foam sclerotherapy with injection of domestic sodium morrhuate is safe and effective with satisfactory results. This technique is a newly-developed micro-invasive therapy for lower extremity varices. (authors)

Reconstruction of Lower Extremity Primary Malignant and Metastatic ...

African Journals Online (AJOL)

2017-10-26

Oct 26, 2017 ... Lower extremity tumors and endoprosthesis. 1130. Nigerian Journal of Clinical Practice ¦ Volume 20 ¦ Issue 9 ¦ September 2017 renal failure, and the other patients died due to advanced metastatic disease. None of our patients who received radiotherapy and chemotherapy died due to oncologic treatment.

Impact of chronic kidney disease stage on lower-extremity arthroplasty.

Science.gov (United States)

Deegan, Brian F; Richard, Raveesh D; Bowen, Thomas R; Perkins, Robert M; Graham, Jove H; Foltzer, Michael A

2014-07-01

End-stage renal disease and dialysis is commonly associated with poor outcomes after joint replacement surgery. The goal of this study was to evaluate postoperative complications in patients with less advanced chronic kidney disease undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patients who underwent THA or TKA between 2004 and 2011 with stage 1, 2, or 3 chronic kidney disease were retrospectively reviewed via an electronic medical record. The authors compared 377 patients who had stage 1 to 2 chronic kidney disease with 402 patients who had stage 3 chronic kidney disease. No significant differences in 90-day readmission or revision rates were found between the stage 1 to 2 and stage 3 patient groups. For patients with stage 3 chronic kidney disease, the overall mortality rate was greater than that in patients with stage 1 to 2 chronic kidney disease. However, when adjusted for comorbid disease, no significant increases were seen in joint infection, readmission, or early revision between patients with stage 1 to 2 chronic kidney disease vs patients with stage 3 chronic kidney disease. The overall incidence of infection was high (3.5%) but far less than reported for patients with end-stage renal disease, dialysis, and kidney transplant. In conclusion, patients with stage 1, 2, or 3 chronic kidney disease may have a higher than expected rate of prosthetic joint infection (3.5%) after total joint arthroplasty. Patients with stage 3 chronic kidney disease are at higher risk for postoperative mortality compared with those with lesser stages of kidney disease. Copyright 2014, SLACK Incorporated.

The comparative study of conventional and innovative phlebographies in lower extremity

International Nuclear Information System (INIS)

Chen Guoping; Gu Jianping; He Xu; Lou Wensheng; Chen Liang; Su Haobo; Song Jinghua

2008-01-01

Objective: The clinical values of conventional phlebography via percutaneous dorsal pedal vein access with scalp puncture was compared with innovative phlebography via a percutaneous great saphenous approach with retained catheter in lower extremity for detection of venous diseases. Methods: Conventional and innovative phlebographies in lower extremity were performed in 34 suffering lower extremities of 30 patients, and the efficacy of the two methods was compared in demonstrating the venous diseases in lower extremities. Results: The rates of vascular display of the common iliac vein, the valve of saphenous-femoral vein and the first couple valve of femoral vein were 100%, 100% and 91.18% respectively with innovative phlebography while the rates of vascular display were 32.25%, 73.53% and 64.71% respectively with conventional phlebography. Iliac vein compression syndrome (IVCS), venous valvular disfunction of saphenous-femoral vein and the venous valvular disfunction of the first couple valve of femoral vein were shown in 14, 25 and 21 cases respectively by innovative phlebography, and in 3, 14 and 12 cases respectively by conventional phlebography in patients suffering from varicose veins and chronic swelling of the lower extremities. There was significant difference between the innovative and conventional phlebographies (P < 0.05). Conclusion: The innovative phlebography possesses a higher efficacy in diagnosing IVCS, venous valvular disfunctions of saphenous-femoral vein and the first couple valve of femoral vein compared with conventional method. It would be an alternative method to the conventional one or percutaneous femoral venous approach. (authors)

Prevalence and Significance of Unrecognized Lower Extremity Peripheral Arterial Disease in General Medicine Practice

Science.gov (United States)

McGrae McDermott, Mary; Kerwin, Diana R; Liu, Kiang; Martin, Gary J; O'Brien, Erin; Kaplan, Heather; Greenland, Philip

2001-01-01

OBJECTIVE To determine the prevalence of unrecognized lower extremity peripheral arterial disease (PAD) among men and women aged 55 years and older in a general internal medicine (GIM) practice and to identify characteristics and functional performance associated with unrecognized PAD. DESIGN Cross-sectional. SETTING Academic medical center. PARTICIPANTS We identified 143 patients with known PAD from the noninvasive vascular laboratory, and 239 men and women aged 55 and older with no prior PAD history from a GIM practice. Group 1 consisted of patients with PAD consecutively identified from the noninvasive vascular laboratory (n = 143). Group 2 included GIM practice patients found to have an ankle brachial index less than 0.90, consistent with PAD (n = 34). Group 3 consisted of GIM practice patients without PAD (n = 205). MEASUREMENTS AND MAIN RESULTS Leg functioning was assessed with the 6-minute walk, 4-meter walking velocity, and Walking Impairment Questionnaire (WIQ). Of GIM practice patients, 14% had unrecognized PAD. Only 44% of patients in Group 2 had exertional leg symptoms. Distances achieved in the 6-minute walk were 1,130, 1,362, and 1,539 feet for Groups 1, 2, and 3, respectively, adjusting for age, gender, and race (P < .001). The degree of difficulty walking due to leg symptoms as reported on the WIQ was comparable between Groups 2 and 3 and significantly greater in Group 1 than Group 2. In multiple logistic regression analysis including Groups 2 and 3, current cigarette smoking was associated independently with unrecognized PAD (odds ratio [OR], 6.82; 95% confidence interval [95% CI], 1.55 to 29.93). Aspirin therapy was nearly independently associated with absence of PAD (OR, 0.37; 95% CI, 0.12 to 1.12). CONCLUSION Unrecognized PAD is common among men and women aged 55 years and older in GIM practice and is associated with impaired lower extremity functioning. Ankle brachial index screening may be necessary to diagnose unrecognized PAD in a GIM

Mandelbrot's Extremism

NARCIS (Netherlands)

Beirlant, J.; Schoutens, W.; Segers, J.J.J.

2004-01-01

In the sixties Mandelbrot already showed that extreme price swings are more likely than some of us think or incorporate in our models.A modern toolbox for analyzing such rare events can be found in the field of extreme value theory.At the core of extreme value theory lies the modelling of maxima

Lou Gehrig's Disease (ALS)

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... disease. Who Gets ALS? Although this disease can strike anyone, ALS is extremely rare in kids. According ... home to provide care that the family cannot handle alone. Living With Lou Gehrig's Disease Living with ...

Autochthonous Chikungunya Transmission and Extreme Climate Events in Southern France.

Science.gov (United States)

Roiz, David; Boussès, Philippe; Simard, Frédéric; Paupy, Christophe; Fontenille, Didier

2015-06-01

Extreme precipitation events are increasing as a result of ongoing global warming, but controversy surrounds the relationship between flooding and mosquito-borne diseases. A common view among the scientific community and public health officers is that heavy rainfalls have a flushing effect on breeding sites, which negatively affects vector populations, thereby diminishing disease transmission. During 2014 in Montpellier, France, there were at least 11 autochthonous cases of chikungunya caused by the invasive tiger mosquito Aedes albopictus in the vicinity of an imported case. We show that an extreme rainfall event increased and extended the abundance of the disease vector Ae. albopictus, hence the period of autochthonous transmission of chikungunya. We report results from close monitoring of the adult and egg population of the chikungunya vector Ae. albopictus through weekly sampling over the entire mosquito breeding season, which revealed an unexpected pattern. Statistical analysis of the seasonal dynamics of female abundance in relation to climatic factors showed that these relationships changed after the heavy rainfall event. Before the inundations, accumulated temperatures are the most important variable predicting Ae. albopictus seasonal dynamics. However, after the inundations, accumulated rainfall over the 4 weeks prior to capture predicts the seasonal dynamics of this species and extension of the transmission period. Our empirical data suggests that heavy rainfall events did increase the risk of arbovirus transmission in Southern France in 2014 by favouring a rapid rise in abundance of vector mosquitoes. Further studies should now confirm these results in different ecological contexts, so that the impact of global change and extreme climatic events on mosquito population dynamics and the risk of disease transmission can be adequately understood.

How extreme is extreme hourly precipitation?

Science.gov (United States)

Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

2016-04-01

The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

Why do people buy dogs with potential welfare problems related to extreme conformation and inherited disease? A representative study of Danish owners of four small dog breeds.

Science.gov (United States)

Sandøe, P; Kondrup, S V; Bennett, P C; Forkman, B; Meyer, I; Proschowsky, H F; Serpell, J A; Lund, T B

2017-01-01

A number of dog breeds suffer from welfare problems due to extreme phenotypes and high levels of inherited diseases but the popularity of such breeds is not declining. Using a survey of owners of two popular breeds with extreme physical features (French Bulldog and Chihuahua), one with a high load of inherited diseases not directly related to conformation (Cavalier King Charles Spaniel), and one representing the same size range but without extreme conformation and with the same level of disease as the overall dog population (Cairn Terrier), we investigated this seeming paradox. We examined planning and motivational factors behind acquisition of the dogs, and whether levels of experienced health and behavior problems were associated with the quality of the owner-dog relationship and the intention to re-procure a dog of the same breed. Owners of each of the four breeds (750/breed) were randomly drawn from a nationwide Danish dog registry and invited to participate. Of these, 911 responded, giving a final sample of 846. There were clear differences between owners of the four breeds with respect to degree of planning prior to purchase, with owners of Chihuahuas exhibiting less. Motivations behind choice of dog were also different. Health and other breed attributes were more important to owners of Cairn Terriers, whereas the dog's personality was reported to be more important for owners of French Bulldogs and Cavalier King Charles Spaniels but less important for Chihuahua owners. Higher levels of health and behavior problems were positively associated with a closer owner-dog relationship for owners of Cavalier King Charles Spaniels and Chihuahuas but, for owners of French Bulldogs, high levels of problems were negatively associated with an intention to procure the same breed again. In light of these findings, it appears less paradoxical that people continue to buy dogs with welfare problems.

[Extreme reactive thrombocytosis in a healthy 6 year-old child].

Science.gov (United States)

de Lama Caro-Patón, G; García-Salido, A; Iglesias-Bouzas, M I; Guillén, M; Cañedo-Villaroya, E; Martínez-Romera, I; Serrano-González, A; Casado-Flores, J

2014-11-01

Thrombocytosis is usually a casual finding in children. Reactive or secondary thrombocytosis is the more common form, being the infections diseases the most prevalent cause of it. Regarding the number of platelets there are four degrees of thrombocytosis; in its extreme degree the number of platelets exceeds 1,000,000/mm(3). We describe a case of extreme reactive thrombocytosis in a healthy 6-year-old child. He required critical care admission for diagnosis and treatment (maximum number of platelets 7,283,000/mm(3)). We review the different causes of thrombocytosis in childhood, the differential diagnosis, and the available treatments in case of extreme thrombocytosis. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Black breast cancer survivors experience greater upper extremity disability.

Science.gov (United States)

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

Clinical application of lower extremity CTA and lower extremity perfusion CT as a method of diagnostic for lower extremity atherosclerotic obliterans

Energy Technology Data Exchange (ETDEWEB)

Moon, Il Bong; Dong, Kyung Rae [Dept. Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Goo, Eun Hoe [Dept. Radiological Science, Cheongju University, Cheongju (Korea, Republic of)

2016-11-15

The purpose of this study was to assess clinical application of lower extremity CTA and lower extremity perfusion CT as a method of diagnostic for lower extremity atherosclerotic obliterans. From January to July 2016, 30 patients (mean age, 68) were studied with lower extremity CTA and lower extremity perfusion CT. 128 channel multi-detector row CT scans were acquired with a CT scanner (SOMATOM Definition Flash, Siemens medical solution, Germany) of lower extremity perfusion CT and lower extremity CTA. Acquired images were reconstructed with 3D workstation (Leonardo, Siemens, Germany). Site of lower extremity arterial occlusive and stenosis lesions were detected superficial femoral artery 36.6%, popliteal artery 23.4%, external iliac artery 16.7%, common femoral artery 13.3%, peroneal artery 10%. The mean total DLP comparison of lower extremity perfusion CT and lower extremity CTA, 650 mGy-cm and 675 mGy-cm, respectively. Lower extremity perfusion CT and lower extremity CTA were realized that were never be two examination that were exactly the same legions. Future through the development of lower extremity perfusion CT soft ware programs suggest possible clinical applications.

Thermodynamics of extremal rotating thin shells in an extremal BTZ spacetime and the extremal black hole entropy

Science.gov (United States)

Lemos, José P. S.; Minamitsuji, Masato; Zaslavskii, Oleg B.

2017-02-01

In a (2 +1 )-dimensional spacetime with a negative cosmological constant, the thermodynamics and the entropy of an extremal rotating thin shell, i.e., an extremal rotating ring, are investigated. The outer and inner regions with respect to the shell are taken to be the Bañados-Teitelbom-Zanelli (BTZ) spacetime and the vacuum ground state anti-de Sitter spacetime, respectively. By applying the first law of thermodynamics to the extremal thin shell, one shows that the entropy of the shell is an arbitrary well-behaved function of the gravitational area A+ alone, S =S (A+). When the thin shell approaches its own gravitational radius r+ and turns into an extremal rotating BTZ black hole, it is found that the entropy of the spacetime remains such a function of A+, both when the local temperature of the shell at the gravitational radius is zero and nonzero. It is thus vindicated by this analysis that extremal black holes, here extremal BTZ black holes, have different properties from the corresponding nonextremal black holes, which have a definite entropy, the Bekenstein-Hawking entropy S (A+)=A/+4G , where G is the gravitational constant. It is argued that for extremal black holes, in particular for extremal BTZ black holes, one should set 0 ≤S (A+)≤A/+4G;i.e., the extremal black hole entropy has values in between zero and the maximum Bekenstein-Hawking entropy A/+4 G . Thus, rather than having just two entropies for extremal black holes, as previous results have debated, namely, 0 and A/+4 G , it is shown here that extremal black holes, in particular extremal BTZ black holes, may have a continuous range of entropies, limited by precisely those two entropies. Surely, the entropy that a particular extremal black hole picks must depend on past processes, notably on how it was formed. A remarkable relation between the third law of thermodynamics and the impossibility for a massive body to reach the velocity of light is also found. In addition, in the procedure, it

Extreme value distributions

CERN Document Server

Ahsanullah, Mohammad

2016-01-01

The aim of the book is to give a through account of the basic theory of extreme value distributions. The book cover a wide range of materials available to date. The central ideas and results of extreme value distributions are presented. The book rwill be useful o applied statisticians as well statisticians interrested to work in the area of extreme value distributions.vmonograph presents the central ideas and results of extreme value distributions.The monograph gives self-contained of theory and applications of extreme value distributions.

Extremely Preterm Birth

Science.gov (United States)

... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

Impacts of temperature extremes on cardiovascular morbidity and mortality in the Czech Republic

Science.gov (United States)

Davídkovová, H.; Kyselý, J.; Plavcová, E.; Urban, A.; Kriz, B.; Kyncl, J.

2012-04-01

Elevated mortality associated with high ambient temperatures in summer represents one of the main impacts of weather extremes on human society. Increases in cardiovascular mortality during heat waves have been reported in many European countries; much less is known about which particular cardiovascular disorders are most affected during heat waves, and whether similar patterns are found for morbidity (hospital admissions). Relatively less understood is also cold-related mortality and morbidity in winter, when the relationships between weather and human health are more complex, less direct, and confounded by other factors such as epidemics of influenza/acute respiratory infections. The present study analyses relationships between temperature extremes and cardiovascular morbidity and mortality. We make use of the datasets on hospital admissions and daily mortality in the population of the Czech Republic (about 10.3 million) over 1994-2009. The data have been standardized to remove the effects of the long-term trend and the seasonal and weekly cycles. Periods when the morbidity/mortality data were affected by epidemics of influenza and other acute respiratory infections have been removed from the analysis. We use analogous definitions for hot and cold spells based on quantiles of daily average temperature anomalies, which allows for a comparison of the findings for summer hot spells and winter cold spells. The main aims of the study are (i) to identify deviations of mortality and morbidity from the baseline associated with hot and cold spells, (ii) to compare the hot- and cold-spell effects for individual cardiovascular diseases (e.g. ischaemic heart disease I20-I25, cerebrovascular disease I60-I69, hypertension I10, aterosclerosis I70) and to identify those diagnoses that are most closely linked to temperature extremes, (iii) to identify population groups most vulnerable to temperature extremes, and (iv) to compare the links to temperature extremes for morbidity and

Extreme environment electronics

CERN Document Server

Cressler, John D

2012-01-01

Unfriendly to conventional electronic devices, circuits, and systems, extreme environments represent a serious challenge to designers and mission architects. The first truly comprehensive guide to this specialized field, Extreme Environment Electronics explains the essential aspects of designing and using devices, circuits, and electronic systems intended to operate in extreme environments, including across wide temperature ranges and in radiation-intense scenarios such as space. The Definitive Guide to Extreme Environment Electronics Featuring contributions by some of the world's foremost exp

An extremely rare neoplasm, histiocytic sarcoma: A report of two cases with an aggressive clinical course

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Erkan Kayikcioglu

2017-07-01

Conclusions: HS is an extremely rare malignant neoplasm of the monocytic/macrophage lineage, with no standardized chemotherapy regimen for multisystemic disease. Metastatic patients have a more aggressive clinical course than those with unifocal disease.

The Translucency Effect of Different Colored Resin Cements used ...

African Journals Online (AJOL)

2018-01-30

Jan 30, 2018 ... color of resin cements and zirconia cores on the translucency parameter (TP) of the restoration that ... physical, mechanical, and esthetic properties. One of the ..... Raptis NV, Michalakis KX, Hirayama H. Optical behavior of.

Prions and neuro degenerative diseases

African Journals Online (AJOL)

user

2011-03-28

Mar 28, 2011 ... scrapie (a fatal disease of sheep and goats), mad cow disease, Creutzfeldt-Jacob disease, fatal familial insomnia, kuru .... The scrapie agent is extremely resistant to heat ... movement, or the stress of handling, the animal may.

Extreme-Dipper Profile, Increased Aortic Stiffness, and Impaired Subendocardial Viability in Hypertension.

Science.gov (United States)

Amah, Guy; Ouardani, Rahma; Pasteur-Rousseau, Adrien; Voicu, Sebastian; Safar, Michel E; Kubis, Nathalie; Bonnin, Philippe

2017-04-01

In treated hypertensives, extreme-dippers with stable coronary artery disease (CAD) exhibit more severe nighttime cardiac ischemia than dippers. After excluding confounding factors such as diabetes, CAD or chronic kidney disease (CKD), we assessed whether subendocardial viability, determined by the Buckberg index, was more significantly impaired in extreme-dippers than in dippers. Two hundred thirteen consecutive treated hypertensives (156 dippers, 57 extreme-dippers), were included. After 24-hour ambulatory blood pressure (BP) monitoring, patients underwent radial applanation tonometry (with determination of: subendocardial viability ratio [SEVR], central augmentation index [AIx], and pulse pressure amplification [PPamp]), carotid-femoral pulse wave velocity (cfPWV) measurement, and cycle ergometer stress testing. Extreme-dippers showed higher cfPWV (8.99 ± 2.16 vs. 8.29 ± 1.69 m/s, P = 0.014), higher AIx (29.7 ± 9.4 vs. 26.4 ± 10.4%, P = 0.042), lower PPamp (1.22 ± 0.14 vs. 1.30 ± 0.15, P < 0.001), lower SEVR (146 ± 23% vs. 157 ± 26%, P = 0.007), and lower nighttime diastolic BP (DBP) (70 ± 9 vs. 75 ± 9 mm Hg, P < 0.001) than dippers. SEVR and cfPWV were inversely correlated. Among extreme-dippers, women exhibited lower SEVR (138 ± 21% vs. 161 ± 23%, P = 0.004), PPamp (1.16 ± 0.10 vs. 1.31 ± 0.15, P < 0.001), and nighttime DBP (67 ± 8 mm Hg vs. 72 ± 8 mm Hg, P = 0.017) than men. Extreme-dipper treated hypertensives with no history of CAD, diabetes or CKD, present increased aortic stiffness and low PPamp. Furthermore, this is the first demonstration of the greater likelihood of these patients to exhibit impaired subendocardial viability compared to dippers. Extreme-dipper hypertensive patients, women in particular, may have a significantly higher risk of silent myocardial ischemia, thus justifying systematic screening. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Treatment of lower extremity arterial occlusive through retrograde access

International Nuclear Information System (INIS)

Liu Xueqiang; Guo Pingfan; Zhang Jinchi; Cai Fanggang

2012-01-01

Objective: To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access. Methods: Twenty-seven cases (male 17, female 10; age range 32-89 years) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans, 7 with diabetic foot and 2 with thromboangiitis obliterans. According to the Fontaine staging, 6 cases were classified as Fontaine Ⅱ, 11 were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ. All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment, but in vain. So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery, peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting. Results: The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms. Hematoma at the puncture site occurred in 3 patients, and paresthesia of toes occurred in 1 after dorsalis pedis arteriotomy. No severe perioperative complication occurred. The average ankle brachial index increased from 0.37 ± 0.11 preoperatively to 0.85 ± 0.12 postoperatively. Conclusions: Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access. (authors)

Overview of the biology of extreme events

Science.gov (United States)

Gutschick, V. P.; Bassirirad, H.

2008-12-01

Extreme events have, variously, meteorological origins as in heat waves or precipitation extremes, or biological origins as in pest and disease eruptions (or tectonic, earth-orbital, or impact-body origins). Despite growing recognition that these events are changing in frequency and intensity, a universal model of ecological responses to these events is slow to emerge. Extreme events, negative and positive, contrast with normal events in terms of their effects on the physiology, ecology, and evolution of organisms, hence also on water, carbon, and nutrient cycles. They structure biogeographic ranges and biomes, almost surely more than mean values often used to define biogeography. They are challenging to study for obvious reasons of field-readiness but also because they are defined by sequences of driving variables such as temperature, not point events. As sequences, their statistics (return times, for example) are challenging to develop, as also from the involvement of multiple environmental variables. These statistics are not captured well by climate models. They are expected to change with climate and land-use change but our predictive capacity is currently limited. A number of tools for description and analysis of extreme events are available, if not widely applied to date. Extremes for organisms are defined by their fitness effects on those organisms, and are specific to genotypes, making them major agents of natural selection. There is evidence that effects of extreme events may be concentrated in an extended recovery phase. We review selected events covering ranges of time and magnitude, from Snowball Earth to leaf functional loss in weather events. A number of events, such as the 2003 European heat wave, evidence effects on water and carbon cycles over large regions. Rising CO2 is the recent extreme of note, for its climatic effects and consequences for growing seasons, transpiration, etc., but also directly in its action as a substrate of photosynthesis

Normal venous anatomy and physiology of the lower extremity.

Science.gov (United States)

Notowitz, L B

1993-06-01

Venous disease of the lower extremities is common but is often misunderstood. It seems that the focus is on the exciting world of arterial anatomy and pathology, while the topic of venous anatomy and pathology comes in second place. However, venous diseases such as chronic venous insufficiency, leg ulcers, and varicose veins affect much of the population and may lead to disability and death. Nurses are often required to answer complex questions from the patients and his or her family about the patient's disease. Patients depend on nurses to provide accurate information in terms they can understand. Therefore it is important to have an understanding of the normal venous system of the legs before one can understand the complexities of venous diseases and treatments. This presents an overview of normal venous anatomy and physiology.

A genome-wide study reveals rare CNVs exclusive to extreme phenotypes of Alzheimer disease.

Science.gov (United States)

Rovelet-Lecrux, Anne; Legallic, Solenn; Wallon, David; Flaman, Jean-Michel; Martinaud, Olivier; Bombois, Stéphanie; Rollin-Sillaire, Adeline; Michon, Agnès; Le Ber, Isabelle; Pariente, Jérémie; Puel, Michèle; Paquet, Claire; Croisile, Bernard; Thomas-Antérion, Catherine; Vercelletto, Martine; Lévy, Richard; Frébourg, Thierry; Hannequin, Didier; Campion, Dominique

2012-06-01

Studying rare extreme forms of Alzheimer disease (AD) may prove to be a useful strategy in identifying new genes involved in monogenic determinism of AD. Amyloid precursor protein (APP), PSEN1, and PSEN2 mutations account for only 85% of autosomal dominant early-onset AD (ADEOAD) families. We hypothesised that rare copy number variants (CNVs) could be involved in ADEOAD families without mutations in known genes, as well as in rare sporadic young-onset AD cases. Using high-resolution array comparative genomic hybridisation, we assessed the presence of rare CNVs in 21 unrelated ADEOAD cases, having no alteration on known genes, and 12 sporadic AD cases, with an age of onset younger than 55 years. The analysis revealed the presence of 7 singleton CNVs (4 in ADEOAD and 3 in sporadic cases) absent in 1078 controls and 912 late-onset AD cases. Strikingly, 4 out of 7 rearrangements target genes (KLK6, SLC30A3, MEOX2, and FPR2) encoding proteins that are tightly related to amyloid-β peptide metabolism or signalling. Although these variants are individually rare and restricted to particular subgroups of patients, these findings support the causal role, in human pathology, of a set of genes coding for molecules suspected for a long time to modify Aβ metabolism or signalling, and for which animal or cellular models have already been developed.

Extreme cosmos

CERN Document Server

Gaensler, Bryan

2011-01-01

The universe is all about extremes. Space has a temperature 270°C below freezing. Stars die in catastrophic supernova explosions a billion times brighter than the Sun. A black hole can generate 10 million trillion volts of electricity. And hypergiants are stars 2 billion kilometres across, larger than the orbit of Jupiter. Extreme Cosmos provides a stunning new view of the way the Universe works, seen through the lens of extremes: the fastest, hottest, heaviest, brightest, oldest, densest and even the loudest. This is an astronomy book that not only offers amazing facts and figures but also re

A Case Report on Upper Extremity Pain of Cardiac Origin

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Turgay Altınbilek

2016-08-01

Full Text Available Upper extremity pain can originate from the musculoskeletal system, or be a reflection of problems originating from various organs. Therefore, it is highly important to perform a detailed clinical evaluation on patients during differential diagnosis. In this case report, we present a 61 year-old male patient who was admitted with pain in both upper extremities and the upper back that presumed to be of cardiac origin following our clinical evaluations. The patient was referred to the cardiology department, where he was diagnosed with coronary heart disease. The patient’s complaints of pain were fully resolved through the application of an intracoronary stent.

Further outlooks: extremely uncomfortable; Die weiteren Aussichten: extrem ungemuetlich

Energy Technology Data Exchange (ETDEWEB)

Resenhoeft, T.

2006-07-01

Climate is changing extremely in the last decades. Scientists dealing with extreme weather, should not only stare at computer simulations. They have also to turn towards psyche, seriously personal experiences, knowing statistics, relativise supposed sensational reports and last not least collecting more data. (GL)

Alcohol Consumption Is a Risk Factor for Lower Extremity Arterial Disease in Chinese Patients with T2DM

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Shanshan Yang

2017-01-01

Full Text Available Objective. To investigate the relationship between alcohol consumption and diabetic lower extremity arterial disease (LEAD in hospitalized patients with type 2 diabetes mellitus (T2DM. Methods. We evaluated 138 hospitalized patients with T2DM who consumed alcohol and 833 who did not. We used propensity score matching to reduce the confounding bias between groups. Additionally, a logistic regression analysis was performed with the matched data to evaluate the LEAD risk. Results. In total, 119 pairs of patients who did and did not consume alcohol were matched. According to the logistic regression analysis, patients who consumed >8 U of alcohol/day had a higher risk of LEAD (odds ratio (OR: 6.35, 95% confidence interval (CI: 1.78–22.65 than patients who did not consume alcohol. Additionally, after adjusting for age, gender, region, occupation, smoking status, body mass index, weight change, and duration of diabetes, the OR of peripheral artery disease after >20 years of alcohol consumption was 3.48 (95% CI: 1.09–11.15. Furthermore, we observed a significant dose-response relationship between alcohol consumption and LEAD. Conclusions. Alcohol consumption may be a risk factor of LEAD in patients with T2DM. Patients with T2DM should be advised to stop drinking, to prevent the onset of LEAD.

Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

Directory of Open Access Journals (Sweden)

Tsarev О.А.

2015-12-01

Full Text Available Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recurrence of varicose veins of lower extremities associated with disease progression; 36 patients did not have recurrence of varicose veins of lower extremities. Results. All the patients demonstrated the signs of indeterminate connective tissue dysplasia, whereas their frequency was different. There were specified nine phenotypic characteristics of indeterminate connective tissue dysplasia, which were significantly more frequent for patients with recurrence of varicose vein disease of lower extremities: 1 postural abnormality, 2 flat foot, 3 skin pallor, 4 hyperextension of skin, 5 positive "wrist test", 6 positive "pollex test", 7 diastasis recti abdominis, 8 myopia, 9 hematomas which form quickly. Conclusion. The determined sum of phenotypic characters of indeterminate connective tissue dysplasia allows to predict progression of varicose vein disease of lower extremities, and offers new opportunities for improving the results of surgical treatment via developing special therapeutic measures aimed at improving lifestyle and dysplasia treatment.

Legacies from extreme drought increase ecosystem sensitivity to future extremes

Science.gov (United States)

Smith, M. D.; Knapp, A.; Hoover, D. L.; Avolio, M. L.; Felton, A. J.; Wilcox, K. R.

2016-12-01

Climate extremes, such as drought, are increasing in frequency and intensity, and the ecological consequences of these extreme events can be substantial and widespread. Although there is still much to be learned about how ecosystems will respond to an intensification of drought, even less is known about the factors that determine post-drought recovery of ecosystem function. Such knowledge is particularly important because post-drought recovery periods can be protracted depending on the extent to which key plant populations, community structure and biogeochemical processes are affected. These drought legacies may alter ecosystem function for many years post-drought and may impact future sensitivity to climate extremes. We experimentally imposed two extreme growing season droughts in a central US grassland to assess the impacts of repeated droughts on ecosystem resistance (response) and resilience (recovery). We found that this grassland was not resistant to the first extreme drought due to reduced productivity and differential sensitivity of the co-dominant C4 grass (Andropogon gerardii) and C3 forb (Solidago canadensis) species. This differential sensitivity led to a reordering of species abundances within the plant community. Yet, despite this large shift in plant community composition, which persisted post-drought, the grassland was highly resilient post-drought, due to increased abundance of the dominant C4 grass. Because of this shift to increased C4 grass dominance, we expected that previously-droughted grassland would be more resistant to a second extreme drought. However, contrary to these expectations, previously droughted grassland was more sensitive to drought than grassland that had not experienced drought. Thus, our result suggest that legacies of drought (shift in community composition) may increase ecosystem sensitivity to future extreme events.

Addison disease

Science.gov (United States)

Symptoms of Addison disease include: Chronic diarrhea, nausea, and vomiting Darkening of the skin in some places Dehydration Dizziness when standing up Low-grade fever Extreme weakness , fatigue , and slow, sluggish movement Darker ...

Asymmetrical Pedaling Patterns in Parkinson's Disease Patients

Science.gov (United States)

Penko, Amanda L.; Hirsch, Joshua R.; Voelcker-Rehage, Claudia; Martin, Philip E.; Blackburn, Gordon; Alberts, Jay L.

2015-01-01

Background Approximately 1.5 million Americans are affected by Parkinson's disease [1] which includes the symptoms of postural instability and gait dysfunction. Currently, clinical evaluations of postural instability and gait dysfunction consist of a subjective rater assessment of gait patterns using items from the Unified Parkinson's Disease Rating Scale, and assessments can be insensitive to the effectiveness of medical interventions. Current research suggests the importance of cycling for Parkinson's disease patients, and while Parkinson's gait has been evaluated in previous studies, little is known about lower extremity control during cycling. The purpose of this study is to examine the lower extremity coordination patterns of Parkinson's patients during cycling. Methods Twenty five participants, ages 44-72, with a clinical diagnosis of idiopathic Parkinson's disease participated in an exercise test on a cycle ergometer that was equipped with pedal force measurements. Crank torque, crank angle and power produced by right and left leg were measured throughout the test to calculate Symmetry Index at three stages of exercise (20 Watt, 60 Watt, maximum performance). Findings Decreases in Symmetry Index were observed for average power output in Parkinson's patients as workload increased. Maximum power Symmetry Index showed a significant difference in symmetry between performance at both the 20 Watt and 60 Watt stage and the maximal resistance stage. Minimum power Symmetry Index did not show significant differences across the stages of the test. While lower extremity asymmetries were present in Parkinson's patients during pedaling, these asymmetries did not correlate to postural instability and gait dysfunction Unified Parkinson's Disease Rating Scale scores. Interpretation This pedaling analysis allows for a more sensitive measure of lower extremity function than the Unified Parkinson's Disease Rating Scale and may help to provide unique insight into current and

Human disease mortality kinetics are explored through a chain model embodying principles of extreme value theory and competing risks.

Science.gov (United States)

Juckett, D A; Rosenberg, B

1992-04-21

The distributions for human disease-specific mortality exhibit two striking characteristics: survivorship curves that intersect near the longevity limit; and, the clustering of best-fitting Weibull shape parameter values into groups centered on integers. Correspondingly, we have hypothesized that the distribution intersections result from either competitive processes or population partitioning and the integral clustering in the shape parameter results from the occurrence of a small number of rare, rate-limiting events in disease progression. In this report we initiate a theoretical examination of these questions by exploring serial chain model dynamics and parameteric competing risks theory. The links in our chain models are composed of more than one bond, where the number of bonds in a link are denoted the link size and are the number of events necessary to break the link and, hence, the chain. We explored chains with all links of the same size or with segments of the chain composed of different size links (competition). Simulations showed that chain breakage dynamics depended on the weakest-link principle and followed kinetics of extreme-values which were very similar to human mortality kinetics. In particular, failure distributions for simple chains were Weibull-type extreme-value distributions with shape parameter values that were identifiable with the integral link size in the limit of infinite chain length. Furthermore, for chains composed of several segments of differing link size, the survival distributions for the various segments converged at a point in the S(t) tails indistinguishable from human data. This was also predicted by parameteric competing risks theory using Weibull underlying distributions. In both the competitive chain simulations and the parametric competing risks theory, however, the shape values for the intersecting distributions deviated from the integer values typical of human data. We conclude that rare events can be the source of

Femoral artery plaque characteristics, lower extremity collaterals, and mobility loss in peripheral artery disease.

Science.gov (United States)

McDermott, Mary M; Carroll, Timothy; Carr, James; Yuan, Chun; Ferrucci, Luigi; Guralnik, Jack M; Kibbe, Melina; Criqui, Michael H; Tian, Lu; Polonsky, Tamar; Zhao, Lihui; Gao, Ying; Hippe, Daniel S; Xu, Dongxiang; McCarthy, Walter; Kramer, Christopher M

2017-12-01

Little is known about the prognostic significance of specific characteristics of magnetic resonance imaging (MRI) measured plaque in the superficial femoral artery (SFA). Associations of MRI-measured plaque quantity, lumen area, and plaque composition in the SFA with subsequent mobility loss were studied in people with lower extremity peripheral artery disease (PAD). Participants with an ankle-brachial index (ABI) Mobility loss was defined as becoming unable to walk up and down a flight of stairs or walk one-quarter of a mile without assistance among participants without mobility impairment at baseline. Analyses adjusted for age, sex, race, comorbidities, ABI, physical activity, and other confounders. Of 308 PAD participants without baseline mobility impairment, 100 (32.5%) developed mobility loss during follow-up. Compared to the lowest mean plaque area tertile at baseline, participants in the highest (worst) plaque area tertile had a higher rate of mobility loss (hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.14-3.79, p = 0.018). Compared to the highest mean lumen area tertile, the smallest (worst) mean lumen area tertile was associated with greater mobility loss (HR = 2.18, 95% CI = 1.20-3.96, p = 0.011). Neither lipid rich necrotic core nor calcium in the SFA were associated with mobility loss. In conclusion, greater plaque quantity and smaller lumen area in the proximal SFA, but not lipid rich necrotic core or calcium, were associated with higher mobility loss in people with PAD.

Gerstmann-Straussler-Scheinker Disease

Science.gov (United States)

... SEARCH Definition Treatment Prognosis Clinical Trials Organizations Publications Definition Gerstmann-Straussler-Scheinker disease (GSS) is an extremely rare, neurodegenerative brain disorder. ...

Definitive Radiotherapy for Ewing Tumors of Extremities and Pelvis: Long-Term Disease Control, Limb Function, and Treatment Toxicity

International Nuclear Information System (INIS)

Indelicato, Daniel J.; Keole, Sameer R.; Shahlaee, Amir H.; Shi Wenyin; Morris, Christopher G.; Marcus, Robert B.

2008-01-01

Purpose: More than 70% of Ewing tumors occur in the extremities and pelvis. This study identified factors influencing local control and functional outcomes after management with definitive radiotherapy (RT). Patients and Methods: A total of 75 patients with a localized Ewing tumor of the extremity or pelvis were treated with definitive RT at the University of Florida between 1970 and 2006 (lower extremity tumors in 30, pelvic tumors in 26, and upper extremity tumors in 19). RT was performed on a once-daily (40%) or twice-daily (60%) basis. The median dose was 55.2 Gy in 1.8-Gy daily fractions or 55.0 Gy in 1.2-Gy twice-daily fractions. The median observed follow-up was 4.7 years. Functional outcome was assessed using the Toronto Extremity Salvage Score. Results: The 10-year actuarial overall survival, cause-specific survival, freedom from relapse, and local control rate was 48%, 48%, 42%, and 71%, respectively. Of the 72 patients, 3 required salvage amputation. Inferior cause-specific survival was associated with larger tumors (81% for tumors 3 . Conclusions: Limb preservation was effectively achieved through definitive RT. Treating limited field sizes with hyperfractionated high-energy RT could minimize long-term complications and provides superior functional outcomes

Hashimoto’s Thyroiditis and Graves’ Disease in One Patient: The Extremes of Thyroid Dysfunction Associated with Interferon Treatment

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R. H. Bishay

2016-01-01

Full Text Available Autoimmune thyroid disease associated with interferon therapy can manifest as destructive thyroiditis, Graves’ Hyperthyroidism, and autoimmune (often subclinical hypothyroidism, the latter persisting in many patients. There are scare reports of a single patient developing extremes of autoimmune thyroid disease activated by the immunomodulatory effects of interferon. A 60-year-old man received 48 weeks of pegylated interferon and ribavirin therapy for chronic HCV. Six months into treatment, he reported fatigue, weight gain, and slowed cognition. Serum thyroid stimulating hormone (TSH was 58.8 mIU/L [0.27–4.2], fT4 11.1 pmol/L [12–25], and fT3 4.2 pmol/L [2.5–6.0] with elevated anti-TPO (983 IU/mL [<35] and anti-TG (733 U/mL [<80] antibodies. He commenced thyroxine with initial clinical and biochemical resolution but developed symptoms of hyperthyroidism with weight loss and tremor 14 months later. Serum TSH was <0.02 mIU/L, fT4 54.3 pmol/L, and fT3 20.2 pmol/L, with an elevated TSH receptor (TRAb, 4.0 U/L [<1.0], anti-TPO (1,163 IU/mL and anti-TG (114 U/mL antibodies. Technetium scan confirmed Graves’ Disease with bilateral diffuse increased tracer uptake (5.9% [0.5–3.5%]. The patient commenced carbimazole therapy for 6 months. Treatment was ceased following spontaneous clinical and biochemical remission (TSH 3.84 mIU/L, fT4 17pmol/L, fT3 4.5 pmol/L, and TRAb <1 U/L. This raises the need to monitor thyroid function closely in patients both during and following completion of interferon treatment.

Global patterns of NDVI-indicated vegetation extremes and their sensitivity to climate extremes

International Nuclear Information System (INIS)

Liu Guo; Liu Hongyan; Yin Yi

2013-01-01

Extremes in climate have significant impacts on ecosystems and are expected to increase under future climate change. Extremes in vegetation could capture such impacts and indicate the vulnerability of ecosystems, but currently have not received a global long-term assessment. In this study, a robust method has been developed to detect significant extremes (low values) in biweekly time series of global normalized difference vegetation index (NDVI) from 1982 to 2006 and thus to acquire a global pattern of vegetation extreme frequency. This pattern coincides with vegetation vulnerability patterns suggested by earlier studies using different methods over different time spans, indicating a consistent mechanism of regulation. Vegetation extremes were found to aggregate in Amazonia and in the semi-arid and semi-humid regions in low and middle latitudes, while they seldom occurred in high latitudes. Among the environmental variables studied, extreme low precipitation has the highest slope against extreme vegetation. For the eight biomes analyzed, these slopes are highest in temperate broadleaf forest and temperate grassland, suggesting a higher sensitivity in these environments. The results presented here contradict the hypothesis that vegetation in water-limited semi-arid and semi-humid regions might be adapted to drought and suggest that vegetation in these regions (especially temperate broadleaf forest and temperate grassland) is highly prone to vegetation extreme events under more severe precipitation extremes. It is also suggested here that more attention be paid to precipitation-induced vegetation changes than to temperature-induced events. (letter)

The effect of extremity strength training on fibromyalgia symptoms and disease impact in an existing multidisciplinary treatment program.

Science.gov (United States)

Kas, Tamara; Colby, Megan; Case, Maureen; Vaughn, Dan

2016-10-01

The purpose of this study was to examine the effect of upper and lower body extremity strengthening exercise in patients with Fibromyalgia (FM) within an existing multidisciplinary treatment program. Patients between the ages of 18-65 with the medical diagnosis of FM. Comparative study design. The control and experimental group received the same multidisciplinary treatment except that the experimental group performed upper and lower extremity strengthening exercises. The Fibromyalgia Impact Questionnaire (FIQ) was administered at evaluation and discharge from the program in order to measure change in quality of life (QOL). Statistically significant changes in FIQ scores were found for both groups. The addition of extremity strengthening in the experimental group produced an average 4 points greater reduction in FIQ score, however, these results are not considered statistically significant. This study appears to validate the success of a multidisciplinary approach in treating patients with FM, with the possibility for further benefit with the addition of extremity strengthening. Copyright © 2016 Elsevier Ltd. All rights reserved.

Early warnings of extreme winds using the ECMWF Extreme Forecast Index

OpenAIRE

Petroliagis, Thomas I.; Pinson, Pierre

2014-01-01

The European FP7 SafeWind Project aims at developing research towards a European vision of wind power forecasting, which requires advanced meteorological support concerning extreme wind events. This study is focused mainly on early warnings of extreme winds in the early medium-range. Three synoptic stations (airports) of North Germany (Bremen, Hamburg and Hannover) were considered for the construction of time series of daily maximum wind speeds. All daily wind extremes were found to be linked...

Bilateral macrodystrophia lipomatosa of the upper extremities with syndactyly and multiple lipomas

NARCIS (Netherlands)

van der Meer, Saskia; Nicolai, Jean-Philippe A.; Schut, Simone M.; Meek, Marcel F.

2011-01-01

Macrodystrophia lipomatosa is a rare disease that causes congenital local gigantism of part of an extremity, which is characterised by an increase in all mesenchymal elements, particularly fibroadipose tissue. This is the first report to our knowledge of a case of histologically confirmed bilateral

Diagnosis of Alzheimer’s Disease Based on Structural MRI Images Using a Regularized Extreme Learning Machine and PCA Features

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Ramesh Kumar Lama

2017-01-01

Full Text Available Alzheimer’s disease (AD is a progressive, neurodegenerative brain disorder that attacks neurotransmitters, brain cells, and nerves, affecting brain functions, memory, and behaviors and then finally causing dementia on elderly people. Despite its significance, there is currently no cure for it. However, there are medicines available on prescription that can help delay the progress of the condition. Thus, early diagnosis of AD is essential for patient care and relevant researches. Major challenges in proper diagnosis of AD using existing classification schemes are the availability of a smaller number of training samples and the larger number of possible feature representations. In this paper, we present and compare AD diagnosis approaches using structural magnetic resonance (sMR images to discriminate AD, mild cognitive impairment (MCI, and healthy control (HC subjects using a support vector machine (SVM, an import vector machine (IVM, and a regularized extreme learning machine (RELM. The greedy score-based feature selection technique is employed to select important feature vectors. In addition, a kernel-based discriminative approach is adopted to deal with complex data distributions. We compare the performance of these classifiers for volumetric sMR image data from Alzheimer’s disease neuroimaging initiative (ADNI datasets. Experiments on the ADNI datasets showed that RELM with the feature selection approach can significantly improve classification accuracy of AD from MCI and HC subjects.

Extreme meteorological conditions

International Nuclear Information System (INIS)

Altinger de Schwarzkopf, M.L.

1983-01-01

Different meteorological variables which may reach significant extreme values, such as the windspeed and, in particular, its occurrence through tornadoes and hurricanes that necesarily incide and wich must be taken into account at the time of nuclear power plants' installation, are analyzed. For this kind of study, it is necessary to determine the basic phenomenum of design. Two criteria are applied to define the basic values of design for extreme meteorological variables. The first one determines the expected extreme value: it is obtained from analyzing the recurence of the phenomenum in a convened period of time, wich may be generally of 50 years. The second one determines the extreme value of low probability, taking into account the nuclear power plant's operating life -f.ex. 25 years- and considering, during said lapse, the occurrence probabilities of extreme meteorological phenomena. The values may be determined either by the deterministic method, which is based on the acknowledgement of the fundamental physical characteristics of the phenomena or by the probabilistic method, that aims to the analysis of historical statistical data. Brief comments are made on the subject in relation to the Argentine Republic area. (R.J.S.) [es

Early warnings of extreme winds using the ECMWF Extreme Forecast Index

DEFF Research Database (Denmark)

Petroliagis, Thomas I.; Pinson, Pierre

2014-01-01

The European FP7 SafeWind Project aims at developing research towards a European vision of wind power forecasting, which requires advanced meteorological support concerning extreme wind events. This study is focused mainly on early warnings of extreme winds in the early medium-range. Three synoptic...... regimes. Overall, it becomes clear that the first indications of an extreme wind event might come from the ECMWF deterministic and/or probabilistic components capturing very intense weather systems (possible windstorms) in the medium term. For early warnings, all available EPS Extreme Forecast Index (EFI......) formulations were used, by linking daily maximum wind speeds to EFI values for different forecast horizons. From all possible EFI schemes deployed for issuing early warnings, the highest skill was found for the Gust Factor formulation (EFI-10FGI). Using EFI-10FGI, the corresponding 99% threshold could provide...

Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system

Energy Technology Data Exchange (ETDEWEB)

Hiremath, Rudresh; Gowda, Goutham; Ibrahim, Jebin; Reddy, Harish T.; Chodiboina, Haritha; Shah, Rushit [Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia (India)

2017-07-15

The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (P<0.001). Duplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.

Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system.

Science.gov (United States)

Hiremath, Rudresh; Gowda, Goutham; Ibrahim, Jebin; Reddy, Harish T; Chodiboina, Haritha; Shah, Rushit

2017-07-01

The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (PDuplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.

Optimization with Extremal Dynamics

International Nuclear Information System (INIS)

Boettcher, Stefan; Percus, Allon G.

2001-01-01

We explore a new general-purpose heuristic for finding high-quality solutions to hard discrete optimization problems. The method, called extremal optimization, is inspired by self-organized criticality, a concept introduced to describe emergent complexity in physical systems. Extremal optimization successively updates extremely undesirable variables of a single suboptimal solution, assigning them new, random values. Large fluctuations ensue, efficiently exploring many local optima. We use extremal optimization to elucidate the phase transition in the 3-coloring problem, and we provide independent confirmation of previously reported extrapolations for the ground-state energy of ±J spin glasses in d=3 and 4

Ideologies and Discourses: Extreme Narratives in Extreme Metal Music

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Bojana Radovanović

2016-10-01

Full Text Available Historically speaking, metal music has always been about provoking a strong reaction. Depending on the characteristics of different sub-genres, one can focus on the sound, technique, visual appearance, and furthermore, the ideologies and ideas that are the foundation for each of the sub-genres. Although the majority of the metal community rejects accusations of being racially intolerant, some ideologies of extreme sub-genres (such as black metal are in fact formed around the ideas of self-conscious elitism expressed through interest in pagan mythology, racism, Nazism and fascism. There has been much interest in the Nazi era within the extreme metal scene thus influencing other sub-genres and artists. The aim of this paper is to examine various appearances of extreme narratives such as Nazism and racism in  different sub-genres of metal, bearing in mind variations dependent on geographical, political, and other factors.

Extremal surface barriers

International Nuclear Information System (INIS)

Engelhardt, Netta; Wall, Aron C.

2014-01-01

We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy

Prodrugs for the Treatment of Neglected Diseases

Directory of Open Access Journals (Sweden)

Lorena Blau

2007-03-01

Full Text Available Recently, World Health Organization (WHO and Medicins San Frontieres (MSF proposed a classification of diseases as global, neglected and extremely neglected. Global diseases, such as cancer, cardiovascular and mental (CNS diseases represent the targets of the majority of the R&D efforts of pharmaceutical companies. Neglected diseases affect millions of people in the world yet existing drug therapy is limited and often inappropriate. Furthermore, extremely neglected diseases affect people living under miserable conditions who barely have access to the bare necessities for survival. Most of these diseases are excluded from the goals of the R&D programs in the pharmaceutical industry and therefore fall outside the pharmaceutical market. About 14 million people, mainly in developing countries, die each year from infectious diseases. From 1975 to 1999, 1393 new drugs were approved yet only 1% were for the treatment of neglected diseases [3]. These numbers have not changed until now, so in those countries there is an urgent need for the design and synthesis of new drugs and in this area the prodrug approach is a very interesting field. It provides, among other effects, activity improvements and toxicity decreases for current and new drugs, improving market availability. It is worth noting that it is essential in drug design to save time and money, and prodrug approaches can be considered of high interest in this respect. The present review covers 20 years of research on the design of prodrugs for the treatment of neglected and extremely neglected diseases such as Chagas’ disease (American trypanosomiasis, sleeping sickness (African trypanosomiasis, malaria, sickle cell disease, tuberculosis, leishmaniasis and schistosomiasis.

Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

Science.gov (United States)

Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

2015-01-01

Abstract Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes. All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed. Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS. Lower-extremity vein

Climate Change, Extreme Weather Events, and Human Health Implications in the Asia Pacific Region.

Science.gov (United States)

Hashim, Jamal Hisham; Hashim, Zailina

2016-03-01

The Asia Pacific region is regarded as the most disaster-prone area of the world. Since 2000, 1.2 billion people have been exposed to hydrometeorological hazards alone through 1215 disaster events. The impacts of climate change on meteorological phenomena and environmental consequences are well documented. However, the impacts on health are more elusive. Nevertheless, climate change is believed to alter weather patterns on the regional scale, giving rise to extreme weather events. The impacts from extreme weather events are definitely more acute and traumatic in nature, leading to deaths and injuries, as well as debilitating and fatal communicable diseases. Extreme weather events include heat waves, cold waves, floods, droughts, hurricanes, tropical cyclones, heavy rain, and snowfalls. Globally, within the 20-year period from 1993 to 2012, more than 530 000 people died as a direct result of almost 15 000 extreme weather events, with losses of more than US$2.5 trillion in purchasing power parity. © 2015 APJPH.

Extreme Precipitation and Emergency Room Visits for Influenza in Massachusetts: A Case-Crossover Analysis

Science.gov (United States)

BACKGROUND: Influenza peaks during the wintertime in temperate regions and during the annual rainy season in tropical regions – however reasons for the observed differences in disease ecology are poorly understood. We hypothesize that episodes of extreme precipitation also result...

A trauma-like model of political extremism: psycho-political fault lines in Israel.

Science.gov (United States)

Laor, Nathaniel; Yanay-Shani, Alma; Wolmer, Leo; Khoury, Oula

2010-10-01

This study examines a trauma-like model of potentially violent political extremism among Jewish Israelis. We study the psychosocial characteristics of political extremists that may lie at the root of sociopolitical instability and assess personal (gender, stressful life events, Holocaust family background, and political activism) and psychological parameters (self- and political transcendence, perceived political threats, in/out-group identification ratio) that may predict readiness to engage in destructive political behavior. We examine the ideological zeal of various political groups, the relationship between the latter and perceived political threats, and the predictors of extreme political activism. Results showed that the extreme political poles displayed high level of ideological and morbid transcendence. Right extremists displayed higher perceived threats to physical existence and national identity. Left extremists scored highest on perceived moral integrity threat. Higher perceived threats to national identity and moral integrity, risk, and self-transcendence statistically explain morbid transcendence. When fear conjures up extremely skewed sociopolitical identifications across political boundaries, morbid transcendence may manifest itself in destructive political activity. © 2010 Association for Research in Nervous and Mental Disease.

Extreme temperatures and out-of-hospital coronary deaths in six large Chinese cities.

Science.gov (United States)

Chen, Renjie; Li, Tiantian; Cai, Jing; Yan, Meilin; Zhao, Zhuohui; Kan, Haidong

2014-12-01

The seasonal trend of out-of-hospital coronary death (OHCD) and sudden cardiac death has been observed, but whether extreme temperature serves as a risk factor is rarely investigated. We therefore aimed to evaluate the impact of extreme temperatures on OHCDs in China. We obtained death records of 126,925 OHCDs from six large Chinese cities (Harbin, Beijing, Tianjin, Nanjing, Shanghai and Guangzhou) during the period 2009-2011. The short-term associations between extreme temperature and OHCDs were analysed with time-series methods in each city, using generalised additive Poisson regression models. We specified distributed lag non-linear models in studying the delayed effects of extreme temperature. We then applied Bayesian hierarchical models to combine the city-specific effect estimates. The associations between extreme temperature and OHCDs were almost U-shaped or J-shaped. The pooled relative risks (RRs) of extreme cold temperatures over the lags 0-14 days comparing the 1st and 25th centile temperatures were 1.49 (95% posterior interval (PI) 1.26-1.76); the pooled RRs of extreme hot temperatures comparing the 99th and 75th centile temperatures were 1.53 (95% PI 1.27-1.84) for OHCDs. The RRs of extreme temperature on OHCD were higher if the patients with coronary heart disease were old, male and less educated. This multicity epidemiological study suggested that both extreme cold and hot temperatures posed significant risks on OHCDs, and might have important public health implications for the prevention of OHCD or sudden cardiac death. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pattern Differences of Small Hand Muscle Atrophy in Amyotrophic Lateral Sclerosis and Mimic Disorders.

Science.gov (United States)

Fang, Jia; Liu, Ming-Sheng; Guan, Yu-Zhou; Du, Hua; Li, Ben-Hong; Cui, Bo; Ding, Qing-Yun; Cui, Li-Ying

2016-04-05

Amyotrophic lateral sclerosis (ALS) and some mimic disorders, such as distal-type cervical spondylotic amyotrophy (CSA), Hirayama disease (HD), and spinobulbar muscular atrophy (SBMA) may present with intrinsic hand muscle atrophy. This study aimed to investigate different patterns of small hand muscle involvement in ALS and some mimic disorders. We compared the abductor digiti minimi/abductor pollicis brevis (ADM/APB) compound muscle action potential (CMAP) ratios between 200 ALS patients, 95 patients with distal-type CSA, 88 HD patients, 43 SBMA patients, and 150 normal controls. The ADM/APB CMAP amplitude ratio was significantly higher in the ALS patients (P mimic disorders presumably reflect distinct pathophysiological mechanisms underlying different disorders, and may aid in distinguishing between ALS and mimic disorders.

Disease: H01111 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available . 11beta-HSD1 is a dimeric enzyme that catalyzes the reduction of cortisone to cortisol within the endoplasm...ed metabolic disease; Endocrine disease H6PD [HSA:9563] [KO:K13937] HSD11B1 [HSA:3290] [KO:K15680] ... Extremely low ratio of cortisol

Prognostic value of biochemical variables for survival after surgery for metastatic bone disease of the extremities.

Science.gov (United States)

Sørensen, Michala Skovlund; Hovgaard, Thea Bechman; Hindsø, Klaus; Petersen, Michael Mørk

2017-03-01

Prediction of survival in patients having surgery for metastatic bone disease in the extremities (MBDex) has been of interest in more than two decades. Hitherto no consensus on the value of biochemical variables has been achieved. Our purpose was (1) to investigate if standard biochemical variables have independent prognostic value for survival after surgery for MBDex and (2) to identify optimal prognostic cut off values for survival of biochemical variables. In a consecutive cohort of 270 patients having surgery for MBDex, we measured preoperative biochemical variables: hemoglobin, alkaline phosphatase, C-reactive protein and absolute, neutrophil and lymphocyte count. ROC curve analyses were performed to identify optimal cut off levels. Independent prognostic factors for variables were addressed with multiple Cox regression analyses. Optimal cut off levels were identified as: hemoglobin 7.45 mmol/L, absolute lymphocyte count 8.5 × 10 9 /L, neutrophil 5.68 × 10 9 /L, lymphocyte 1.37 × 10 9 /L, C-reactive protein 22.5 mg/L, and alkaline phosphatase 129 U/L. Regression analyses found alkaline phosphatase (HR 2.49) and neutrophil count (HR 2.49) to be independent prognostic factors. We found neutrophil count and alkaline phosphatase to be independent prognostic variables in predicting survival in patients after surgery for MBDex. © 2016 Wiley Periodicals, Inc.

[Magnetotherapy in obliterating vascular diseases of the lower extremities].

Science.gov (United States)

Kirillov, Iu B; Shval'b, P G; Lastushkin, A V; Baranov, V M; Sigaev, A A; Zueva, G V; Karpov, E I

1992-01-01

The investigators have developed a polymagnetic system "Avrora-MK-01" employing running impulse magnetic field to treat diseases of the leg vessels by the action on peripheral capillary bed. At a pregangrene stage a positive effect on peripheral capillaries was achieved in 75-82% of the patients treated.

Extreme weather events in developing countries and related injuries and mental health disorders - a systematic review

Directory of Open Access Journals (Sweden)

Elisabeth Rataj

2016-09-01

Full Text Available Abstract Background Due to climate change, extreme weather events have an incremental impact on human health. Injuries and mental health disorders are a particular burden of disease, which is broadly investigated in high income countries. Most distressed populations are, however, those in developing countries. Therefore, this study investigates mental and physical health impacts arising from extreme weather events in these populations. Method Post-traumatic Stress Disorder (PTSD, injury [primary outcomes], anxiety and depressive disorders [secondary outcomes], caused by weather extremes were systematically analyzed in people of developing countries. A systematic review of observational studies was conducted searching six databases, complemented by hand search, and utilizing two search engines. Review processing was done independently by two reviewers. Prevalence rates were analyzed in a pre/post design; an additional semi-structured search was conducted, to provide reference data for studies not incorporating reference values. Results All 17 identified studies (70,842 individuals indicate a disease increase, compared to the reference data. Increase ranges from 0.7–52.6 % for PTSD, and from 0.3–37.3 % for injury. No studies on droughts and heatwaves were identified. All studies were conducted in South America and Asia. Conclusion There is an increased burden of psychological diseases and injury. This finding needs to be incorporated into activities of prevention, preparedness and general health care of those developing countries increasingly experiencing extreme weather events. There is also a gap in research in Africa (in quantity and quality of studies in this field and a predominant heterogeneity of health assessment tools. PROSPERO registration no.: CRD42014009109

Scintigraphy in diagnostics of algodystrophy in the upper extremity: a review

International Nuclear Information System (INIS)

Zyluk, A.

1995-01-01

Basing on the literature, the information concerning usefulness of the three phase scintigraphy in algodystrophy of the upper extremity, both in diagnostic and etiopathogenetic aspects were presented. Delayed image phase is the examination of the best value in the diagnostics of the condition (the highest sensitivity and specificity). Typical feature of algodystrophy on the bone scan is diffuse periarticular hyperfixation of the tracer, in many joints of the distal part of the extremity. Early phases of scintigraphy are valuable in staging of the disease (distinguishing between 1. and 2. stage), in choice of the method of the treatment (vasoconstrictive or vasodilatative) and in monitoring of the course of the treatment. Haemodynamic changes in dystrophic extremity, appearing in early phases, provide interesting information about the etiopathogenesis of algodystrophy. Prognostic implications of scintigraphy (the prediction of the possibility of algodystrophy developing and prediction of good result of the treatment) were mentioned. The method of quantitative analysis of the scans and the problems concerning the choice of proper region of interesting were discussed. (author). 20 refs, 1 tab

Current knowledge in the treatment of peripheral arterial disease of the lower extremities: surgical and endovascular therapy

International Nuclear Information System (INIS)

Pobehova, J.; Kubikova, M.; Frankovicova, M.; Zavacka, M.; Stasko, P.; Tomecko, M.

2014-01-01

The etiology of PAOD is the most common cause of disability atherosclerotic arteries. Significantly reduces the quality of life (leading to limb amputation). Chronic renal insufficiency, diabetes and smoking are risk factors for progression of PAOD. In patients with claudication significantly reduced in active life reconstruction is indicated in the form of classical femoropopliteal bypass. Surgery may be supplemented or replaced transluminal percutaneous angioplasty (PTA). The aim of this retrospective study at the Department of Vascular Surgery and LF UPJS VUSCH, a. s. in Kosice in 2008 – 2010 was due to the ambiguous result of several previous studies, analyze and compare the results of the surgical and endovascular revascularisation in patients with peripheral artery disease of the lower extremities in the femoropopliteal region. We found that the use of bypass respectively endovascular angioplasty in patients with infra inguinal disability for 1 year follow-up did not lead to differences in clinical and technical success in primary and secondary patency of blood vessels, or in improving claudication interval between groups. There also were no differences in the need for revascularization or limb amputation within 1 year of performance. Use bypass was associated with a higher incidence of improving symptoms of critical limb ischemia and a higher incidence of hematoma following exercise. (author)

Hiccup: An Extremely Rare Presentation of Thyrotoxicosis of Graves’ Disease

Directory of Open Access Journals (Sweden)

Irshad Parray

2011-03-01

Full Text Available Persistent hiccup is a rare but potentially severe condition that can be symptomatic of a variety of diseases or idiopathic. Most episodes last only a few minutes and are self-limited, but hiccup can get persistent and become a real problem for physician and patient alike. The center of hiccup may be activated by a great variety of stimuli travelling along different nerve pathways and bring different effecter responses. We report a case of persistent hiccup as a presentation of impending thyroid storm of Graves’ disease. Though the condition is rare, clinicians should remain alert to the possibility of this diagnosis.

[Indicators and factors of influence on the long-term follow-up of psychogenic diseases--a comparison of extreme groups].

Science.gov (United States)

Franz, M; Schellberg, D; Schepank, H

1995-02-01

The present investigation aimed at the identification of possible indicators of course, predictors, and etiologically relevant factors of psychogenic diseases. According to their complaints a sample of probands suffering from psychogenic impairment of medium degree (n = 240) was chosen out of a representative sample of an urban adult population (n = 528). This procedure should ensure a relatively high intraindividual variance of course of the criterion, since a sufficient variability of course seems improbable with chronic and severe psychogenic impaired or stabile healthy probands. Within 10 years the sample was investigated three times by psychodynamically trained physicians and psychologists. By means of cluster analysis the sample was subdivided in different types of course of psychogenic impairment. Both extreme types of course-the probands who showed the most positive and the most negative spontaneous longterm course-were investigated univariately and by means of a multivariate discriminant analysis with regard to potentially course determining variables. It became obvious that personality variables and conditions of early childhood considerably influenced the spontaneous longterm course of psychogenic impairment.

Statistics of Extremes

KAUST Repository

Davison, Anthony C.

2015-04-10

Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event of interest may be very limited, efficient methods of inference play an important role. This article reviews this domain, emphasizing current research topics. We first sketch the classical theory of extremes for maxima and threshold exceedances of stationary series. We then review multivariate theory, distinguishing asymptotic independence and dependence models, followed by a description of models for spatial and spatiotemporal extreme events. Finally, we discuss inference and describe two applications. Animations illustrate some of the main ideas. © 2015 by Annual Reviews. All rights reserved.

Moving in extreme environments: what's extreme and who decides?

Science.gov (United States)

Cotter, James David; Tipton, Michael J

2014-01-01

Humans work, rest and play in immensely varied extreme environments. The term 'extreme' typically refers to insufficiency or excess of one or more stressors, such as thermal energy or gravity. Individuals' behavioural and physiological capacity to endure and enjoy such environments varies immensely. Adverse effects of acute exposure to these environments are readily identifiable (e.g. heat stroke or bone fracture), whereas adverse effects of chronic exposure (e.g. stress fractures or osteoporosis) may be as important but much less discernable. Modern societies have increasingly sought to protect people from such stressors and, in that way, minimise their adverse effects. Regulations are thus established, and advice is provided on what is 'acceptable' exposure. Examples include work/rest cycles in the heat, hydration regimes, rates of ascent to and duration of stay at altitude and diving depth. While usually valuable and well intentioned, it is important to realise the breadth and importance of limitations associated with such guidelines. Regulations and advisories leave less room for self-determination, learning and perhaps adaptation. Regulations based on stress (e.g. work/rest cycles relative to WBGT) are more practical but less direct than those based on strain (e.g. core temperature), but even the latter can be substantively limited (e.g. by lack of criterion validation and allowance for behavioural regulation in the research on which they are based). Extreme Physiology & Medicine is publishing a series of reviews aimed at critically examining the issues involved with self- versus regulation-controlled human movement acutely and chronically in extreme environments. These papers, arising from a research symposium in 2013, are about the impact of people engaging in such environments and the effect of rules and guidelines on their safety, enjoyment, autonomy and productivity. The reviews will cover occupational heat stress, sporting heat stress, hydration, diving

Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatments

Directory of Open Access Journals (Sweden)

Andrei Evgenyevich Karateev

2015-01-01

Full Text Available The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs and glucocorticosteroids (GCs. The paper considers the largest and known studies that are an evidence base for the expediency of using agents, such NSAIDs, local administration of GCs, hyaluronic acid, and plateletrich plasma, as well as different non-drug treatments, in RDJAST. The latter (physiotherapy, exercises, and rehabilitation programs should be regarded as a necessary component of the therapeutic process in patients with RDJAST-associated chronic pain. Preservation of obvious pain and impaired function despite medical therapy should be regarded as an indication for surgical treatment.

Celiac disease with pulmonary haemosiderosis and cardiomyopathy

OpenAIRE

Işikay, Sedat; Yilmaz, Kutluhan; Kilinç, Metin

2012-01-01

Celiac disease or pulmonary haemosiderosis can be associated with several distinguished conditions. Pulmonary haemosiderosis is a rare, severe and fatal disease characterised by recurrent episodes of alveolar haemorrhage, haemoptysis and anaemia. Association of pulmonary haemosiderosis and celiac disease is extremely rare. We describe a case of celiac disease presented with dilated cardiomyopathy and pulmonary haemosiderosis without gastrointestinal symptoms of celiac disease. In addition, vi...

Health status evaluation in extremely premature infants

Directory of Open Access Journals (Sweden)

M. Yu. Arkhipova

2016-01-01

Full Text Available The health status was analyzed in extremely preterm infants at a postconceptual age of 38–40 weeks and in the first year of life. All the infants in the analyzed group were shown to have respiratory disorders, severe perinatal CNS lesions, and the high incidence of bronchopulmonary dysplasia and infectious and inflammatory diseases. In the first year of life, these children belonged to a group of the frequently ill. Dysfunction of the digestive system and intestinal microflora and residual signs of rickets were detected in the majority of the patients; the manifestations of bronchopulmonary dysplasia persisted in 50%. 40% of the infants had disabling complications.

Evolution caused by extreme events.

Science.gov (United States)

Grant, Peter R; Grant, B Rosemary; Huey, Raymond B; Johnson, Marc T J; Knoll, Andrew H; Schmitt, Johanna

2017-06-19

Extreme events can be a major driver of evolutionary change over geological and contemporary timescales. Outstanding examples are evolutionary diversification following mass extinctions caused by extreme volcanism or asteroid impact. The evolution of organisms in contemporary time is typically viewed as a gradual and incremental process that results from genetic change, environmental perturbation or both. However, contemporary environments occasionally experience strong perturbations such as heat waves, floods, hurricanes, droughts and pest outbreaks. These extreme events set up strong selection pressures on organisms, and are small-scale analogues of the dramatic changes documented in the fossil record. Because extreme events are rare, almost by definition, they are difficult to study. So far most attention has been given to their ecological rather than to their evolutionary consequences. We review several case studies of contemporary evolution in response to two types of extreme environmental perturbations, episodic (pulse) or prolonged (press). Evolution is most likely to occur when extreme events alter community composition. We encourage investigators to be prepared for evolutionary change in response to rare events during long-term field studies.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'. © 2017 The Author(s).

Observation and nursing of complications due to high re-perfusion injury occurring after balloon angioplasty for diabetic vascular diseases of lower extremity

International Nuclear Information System (INIS)

Zhang Lingling; Zhu Yueqi; Mou Ling

2011-01-01

Objective: To evaluate the symptomatic nursing in treating the complications caused by high re-perfusion which develops after balloon angioplasty for the treatment of diabetic vascular diseases of lower extremity. Methods: Eighteen patients with lower limb ischemia caused by diabetes mellitus developed high re-perfusion injury complications after receiving balloon angioplasty. The patients were randomly and equally divided into study group and control group. The special nursing measures designed by the author's department, including raising the diseased lower limb, enforcing the flexion and extension movement of the leg, cold compress, wound exposure, etc. were carried out for patients of study group, while no special nursing measures were adopted for patients of control group. The clinical results, such as limb pain, swelling and subcutaneous petechia after re-perfusion injury, were evaluated and compared between two groups. Results: After the treatment, the limb pain, swelling and subcutaneous petechia due to high re-perfusion injury in study group were relieved more markedly than that in control group, the difference in evaluation score between two groups was statistically significant (P<0.01). Conclusion: The special symptomatic nursing measures are very effective in relieving the high re-perfusion injury after balloon angioplasty for the treatment of diabetic lower limb ischemia. (authors)

Likelihood estimators for multivariate extremes

KAUST Repository

Huser, Raphaë l; Davison, Anthony C.; Genton, Marc G.

2015-01-01

The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

Likelihood estimators for multivariate extremes

KAUST Repository

Huser, Raphaël

2015-11-17

The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

Classifying Returns as Extreme

DEFF Research Database (Denmark)

Christiansen, Charlotte

2014-01-01

I consider extreme returns for the stock and bond markets of 14 EU countries using two classification schemes: One, the univariate classification scheme from the previous literature that classifies extreme returns for each market separately, and two, a novel multivariate classification scheme tha...

Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population.

Science.gov (United States)

Varbo, Anette; Freiberg, Jacob J; Nordestgaard, Børge G

2015-03-01

Increased nonfasting remnant cholesterol, like increased LDL cholesterol, is causally associated with increased risk for ischemic heart disease (IHD). We tested the hypothesis that extreme concentrations of nonfasting remnant and LDL cholesterol are equal contributors to the risk of IHD, myocardial infarction (MI), and all-cause mortality. We compared stepwise increasing concentrations of nonfasting remnant and LDL cholesterol for association with risk of IHD, MI, and all-cause mortality in approximately 90 000 individuals from the Danish general population. During up to 22 years of complete follow-up, 4435 participants developed IHD, 1722 developed MI, and 8121 died. Compared with participants with nonfasting remnant cholesterol cholesterol of 0.5-0.99 mmol/L (19.3-38.2 mg/dL) to 2.4 (1.9-2.9) for remnant cholesterol of ≥1.5 mmol/L (58 mg/dL) (P for trend LDL cholesterol LDL cholesterol of 3-3.99 mmol/L (115.8-154 mg/dL) to 2.3 (1.9-2.8) for LDL cholesterol of ≥5 mmol/L (193 mg/dL) (P cholesterol (P LDL cholesterol (P cholesterol concentrations were associated stepwise with all-cause mortality ranging from hazard ratio 1.0 (0.9-1.1) to 1.6 (1.4-1.9) (P LDL cholesterol concentrations were associated with decreased all-cause mortality risk in a U-shaped pattern, with hazard ratios from 0.8 (0.7-0.8) to 0.9 (0.8-1.0) (P = 0.002). After mutual adjustment, LDL cholesterol best predicted MI, and remnant cholesterol best predicted all-cause mortality. Both lipoproteins were associated equally with risk of IHD and MI; however, only nonfasting remnant cholesterol concentrations were associated stepwise with increased all-cause mortality risk. © 2015 American Association for Clinical Chemistry.

Probabilistic analysis of extreme wind events

Energy Technology Data Exchange (ETDEWEB)

Chaviaropoulos, P.K. [Center for Renewable Energy Sources (CRES), Pikermi Attikis (Greece)

1997-12-31

A vital task in wind engineering and meterology is to understand, measure, analyse and forecast extreme wind conditions, due to their significant effects on human activities and installations like buildings, bridges or wind turbines. The latest version of the IEC standard (1996) pays particular attention to the extreme wind events that have to be taken into account when designing or certifying a wind generator. Actually, the extreme wind events within a 50 year period are those which determine the ``static`` design of most of the wind turbine components. The extremes which are important for the safety of wind generators are those associated with the so-called ``survival wind speed``, the extreme operating gusts and the extreme wind direction changes. A probabilistic approach for the analysis of these events is proposed in this paper. Emphasis is put on establishing the relation between extreme values and physically meaningful ``site calibration`` parameters, like probability distribution of the annual wind speed, turbulence intensity and power spectra properties. (Author)

Lower-Extremity Weakness in a Teenager Due to Thyrotoxic Periodic Paralysis.

Science.gov (United States)

Thornton, Matthew D

2017-04-01

Thyrotoxic hypokalemic paralysis is the hallmark of thyrotoxic periodic paralysis (TPP). TPP is a potentially deadly complication of hyperthyroidism that occurs because of rapid and dramatic intracellular shift of potassium. This transference results in severe hypokalemia and clinically manifests itself as muscle weakness or paralysis. This condition predominantly affects males of Asian descent, and its presentation can range from mild to severe, as seen in our case. We present the case of a 15-year-old Asian-American male who presented to a tertiary-care pediatric emergency department complaining of generalized weakness and flaccid paralysis of his lower extremities. The differential for such a complaint is extremely broad, and the symptoms can result from etiologies arising from the cerebral cortex, the spinal cord, peripheral nerves, the neuromuscular junction, or even the muscles themselves. Our patient was found to have an extremely low serum potassium concentration, as well as an electrocardiogram that revealed a prolonged QT interval and right bundle branch block. The etiology of these abnormalities and the patient's symptoms was found to be undiagnosed and uncontrolled hyperthyroidism from Grave's disease, which resulted in this dramatic presentation of thyrotoxic hypokalemic paralysis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This entity is common in Asia but still somewhat rare in the United States and other Western countries. Our case illustrates that careful history taking and a focused diagnostic evaluation, in conjunction with having an awareness of this disease, can help expedite diagnosis and management, as well as avoid unnecessary and potential harmful testing in the emergency department setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Severe/Extreme Hypertriglyceridemia and LDL Apheretic Treatment: Review of the Literature, Original Findings

Directory of Open Access Journals (Sweden)

Olga Diakoumakou

2014-01-01

Full Text Available Hypertriglyceridemia (HTG is a feature of numerous metabolic disorders including dyslipidemias, metabolic syndrome, and diabetes mellitus type 2 and can increase the risk of premature coronary artery disease. HTG may also be due to genetic factors (called primary HTG and particularly the severe/extreme HTG (SEHTG, which is a usually rare genetic disorder. Even rarer are secondary cases of SEHTG caused by autoimmune disease. This review considers the causes of SEHTG, and their management including treatment with low density lipoprotein apheresis and analyzes the original findings.

Stationary and non-stationary extreme value modeling of extreme temperature in Malaysia

Science.gov (United States)

Hasan, Husna; Salleh, Nur Hanim Mohd; Kassim, Suraiya

2014-09-01

Extreme annual temperature of eighteen stations in Malaysia is fitted to the Generalized Extreme Value distribution. Stationary and non-stationary models with trend are considered for each station and the Likelihood Ratio test is used to determine the best-fitting model. Results show that three out of eighteen stations i.e. Bayan Lepas, Labuan and Subang favor a model which is linear in the location parameter. A hierarchical cluster analysis is employed to investigate the existence of similar behavior among the stations. Three distinct clusters are found in which one of them consists of the stations that favor the non-stationary model. T-year estimated return levels of the extreme temperature are provided based on the chosen models.

A note on extreme sets

Directory of Open Access Journals (Sweden)

Radosław Cymer

2017-10-01

Full Text Available In decomposition theory, extreme sets have been studied extensively due to its connection to perfect matchings in a graph. In this paper, we first define extreme sets with respect to degree-matchings and next investigate some of their properties. In particular, we prove the generalized Decomposition Theorem and give a characterization for the set of all extreme vertices in a graph.

Extreme Programming: Maestro Style

Science.gov (United States)

Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

2009-01-01

"Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme

Spatial dependence of extreme rainfall

Science.gov (United States)

Radi, Noor Fadhilah Ahmad; Zakaria, Roslinazairimah; Satari, Siti Zanariah; Azman, Muhammad Az-zuhri

2017-05-01

This study aims to model the spatial extreme daily rainfall process using the max-stable model. The max-stable model is used to capture the dependence structure of spatial properties of extreme rainfall. Three models from max-stable are considered namely Smith, Schlather and Brown-Resnick models. The methods are applied on 12 selected rainfall stations in Kelantan, Malaysia. Most of the extreme rainfall data occur during wet season from October to December of 1971 to 2012. This period is chosen to assure the available data is enough to satisfy the assumption of stationarity. The dependence parameters including the range and smoothness, are estimated using composite likelihood approach. Then, the bootstrap approach is applied to generate synthetic extreme rainfall data for all models using the estimated dependence parameters. The goodness of fit between the observed extreme rainfall and the synthetic data is assessed using the composite likelihood information criterion (CLIC). Results show that Schlather model is the best followed by Brown-Resnick and Smith models based on the smallest CLIC's value. Thus, the max-stable model is suitable to be used to model extreme rainfall in Kelantan. The study on spatial dependence in extreme rainfall modelling is important to reduce the uncertainties of the point estimates for the tail index. If the spatial dependency is estimated individually, the uncertainties will be large. Furthermore, in the case of joint return level is of interest, taking into accounts the spatial dependence properties will improve the estimation process.

Extremely deformable structures

CERN Document Server

2015-01-01

Recently, a new research stimulus has derived from the observation that soft structures, such as biological systems, but also rubber and gel, may work in a post critical regime, where elastic elements are subject to extreme deformations, though still exhibiting excellent mechanical performances. This is the realm of ‘extreme mechanics’, to which this book is addressed. The possibility of exploiting highly deformable structures opens new and unexpected technological possibilities. In particular, the challenge is the design of deformable and bi-stable mechanisms which can reach superior mechanical performances and can have a strong impact on several high-tech applications, including stretchable electronics, nanotube serpentines, deployable structures for aerospace engineering, cable deployment in the ocean, but also sensors and flexible actuators and vibration absorbers. Readers are introduced to a variety of interrelated topics involving the mechanics of extremely deformable structures, with emphasis on ...

Mental disease-related emergency admissions attributable to hot temperatures.

Science.gov (United States)

Lee, Suji; Lee, Hwanhee; Myung, Woojae; Kim, E Jin; Kim, Ho

2018-03-01

The association between high temperature and mental disease has been the focus of several studies worldwide. However, no studies have focused on the mental disease burden attributable to hot temperature. Here, we aim to quantify the risk attributed to hot temperatures based on the exposure-lag-response relationship between temperature and mental diseases. From data on daily temperature and emergency admissions (EA) for mental diseases collected from 6 major cities (Seoul, Incheon, Daejeon, Daegu, Busan, and Gwangju in South Korea) over a period of 11years (2003-2013), we estimated temperature-disease associations using a distributed lag non-linear model, and we pooled the data by city through multivariate meta-analysis. Cumulative relative risk and attributable risks were calculated for extreme hot temperatures, defined as the 99th percentile relative to the 50th percentile of temperatures. The strongest association between mental disease and high temperature was seen within a period of 0-4days of high temperature exposure. Our results reveal that 14.6% of EA for mental disease were due to extreme hot temperatures, and the elderly were more susceptible (19.1%). Specific mental diseases, including anxiety, dementia, schizophrenia, and depression, also showed significant risk attributed to hot temperatures. Of all EA for anxiety, 31.6% were attributed to extremely hot temperatures. High temperature was responsible for an attributable risk for mental disease, and the burden was higher in the elderly. This finding has important implications for designing appropriate public health policies to minimize the impact of high temperature on mental health. Copyright © 2017 Elsevier B.V. All rights reserved.

Gender specific analysis of occupational diseases of the low back caused by carrying, lifting or extreme trunk flexion—use of a prevention index to identify occupations with high prevention needs

Science.gov (United States)

Thiede, Markus; Liebers, Falk; Seidler, Andreas; Gravemeyer, Stefan; Latza, Ute

2014-01-01

Background Gender specific analysis of the occupational disease of the lumbar spine caused by carrying, lifting, or extreme trunk flexion in Germany (OD No.2108) with the aim to identify areas of focus for prevention and research with a prevention index (PI). Methods Data from the German Statutory Accident Insurance stratified by gender are shown. Results From 2002 until 2009 there were 2,877 confirmed cases of an OD No. 2108 (40.1% male and 59.1% female). The PI indicated the highest prevention need for female nursing/midwifery associate professionals and male building frame and related trades workers. Patient transfer and working in extremely bent posture were the most frequent exposures. Conclusions The identified occupations with high need for prevention among men come from nearly all major occupational groups whereas women cluster in occupational groups from the health and care sectors. Am. J. Ind. Med. 57:233–244, 2014. © 2013 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:24243091

Assessing Climate Variability using Extreme Rainfall and ...

African Journals Online (AJOL)

user1

extreme frequency); the average intensity of rainfall from extreme events ... frequency and extreme intensity indices, suggesting that extreme events are more frequent and intense during years with high rainfall. The proportion of total rainfall from ...

Climate change impacts on coffee rust disease

Science.gov (United States)

Alfonsi, W. M. V.; Koga-Vicente, A.; Pinto, H. S.; Alfonsi, E. L., Sr.; Coltri, P. P.; Zullo, J., Jr.; Patricio, F. R.; Avila, A. M. H. D.; Gonçalves, R. R. D. V.

2016-12-01

Changes in climate conditions and in extreme weather events may affect the food security due to impacts in agricultural production. Despite several researches have been assessed the impacts of extremes in yield crops in climate change scenarios, there is the need to consider the effects in pests and diseases which increase losses in the sector. Coffee Arabica is an important commodity in world and plays a key role in Brazilian agricultural exports. Although the coffee crop has a world highlight, its yield is affected by several factors abiotic or biotic. The weather as well pests and diseases directly influence the development and coffee crop yield. These problems may cause serious damage with significant economic impacts. The coffee rust, caused by the fungus Hemileia vastarix,is among the diseases of greatest impact for the crop. The disease emerged in Brazil in the 70s and is widely spread in all producing regions of coffee in Brazil, and in the world. Regions with favorable weather conditions for the pathogen may exhibit losses ranging from 30% to 50% of the total grain production. The evaluation of extreme weather events of coffee rust disease in futures scenarios was carried out using the climatic data from CMIP5 models, data field of coffee rust disease incidence and, incubation period simulation data for Brazilian municipalities. Two Regional Climate Models were selected, Eta-HadGEM2-ES and Eta-MIROC5, and the Representative Concentration Pathways 8.5 w/m2 was adopted. The outcomes pointed out that in these scenarios the period of incubation tends to decrease affecting the coffee rust disease incidence, which tends to increase. Nevertheless, the changing in average trends tends to benefit the reproduction of the pathogen. Once the temperature threshold for the disease reaches the adverse conditions it may be unfavorable for the incidence.

Acupuncture Combined with Hydrotherapy in Diabetes Patients with Mild Lower-Extremity Arterial Disease: A Prospective, Randomized, Nonblinded Clinical Study.

Science.gov (United States)

Qi, Zhengqin; Pang, Yan; Lin, Lin; Zhang, Bing; Shao, Juntao; Liu, Xiaodong; Zhang, Xin

2018-05-08

BACKGROUND The aim of this pragmatic study was to explore the intervention of acupuncture combined with hydrotherapy and perceived effects in type 2 diabetic patients with recently diagnosed, mild, lower-extremity arterial disease (LEAD) in comparison with a control group. MATERIAL AND METHODS One hundred twenty-six diabetes patients who were diagnosed mild LEAD according to ankle-brachial blood pressure index (ABPI) and peripheral neuropathy symptom were randomly assigned to either an experimental (n=64) or control group (n=62). The experimental group attended and completed (1) a 30-min session of acupuncture in certain selected points, and (2) a 30-min hydrotherapy exercise every 2 days for 15 weeks. The outcome parameters were assessed at baseline, after intervention, and at 6-week follow-up. RESULTS The intervention was associated with an improvement in leg flow conductance and partial physical capacities, including chair-sit-and-reach, the walking impairment questionnaire (WIQ), and physical component summary score (PCS), compared to the control group. The treatment benefits were sustained throughout the 6-week follow-up endpoint. There was no difference in fasting glucose levels, Hb1Ac, blood pressure, or BMI after the intervention. At the endpoint of 6-week follow-up, acupuncture plus hydrotherapy appeared to reduce inflammatory response by decreasing IL-6, TNF-α, malondialdehyde, and SOD, and increasing glutathione. CONCLUSIONS Acupuncture plus hydrotherapy, without significant glycemic-controlling effects in the type 2 diabetic patients with mild LEAD, exerts a measurable benefit in disease-specific physical functions and health-related quality of life. Our results suggest that the combined therapy regulates the inflammatory process and oxidative stress and contributes to immune protection.

Extreme events in total ozone over Arosa – Part 1: Application of extreme value theory

Directory of Open Access Journals (Sweden)

H. E. Rieder

2010-10-01

Full Text Available In this study ideas from extreme value theory are for the first time applied in the field of stratospheric ozone research, because statistical analysis showed that previously used concepts assuming a Gaussian distribution (e.g. fixed deviations from mean values of total ozone data do not adequately address the structure of the extremes. We show that statistical extreme value methods are appropriate to identify ozone extremes and to describe the tails of the Arosa (Switzerland total ozone time series. In order to accommodate the seasonal cycle in total ozone, a daily moving threshold was determined and used, with tools from extreme value theory, to analyse the frequency of days with extreme low (termed ELOs and high (termed EHOs total ozone at Arosa. The analysis shows that the Generalized Pareto Distribution (GPD provides an appropriate model for the frequency distribution of total ozone above or below a mathematically well-defined threshold, thus providing a statistical description of ELOs and EHOs. The results show an increase in ELOs and a decrease in EHOs during the last decades. The fitted model represents the tails of the total ozone data set with high accuracy over the entire range (including absolute monthly minima and maxima, and enables a precise computation of the frequency distribution of ozone mini-holes (using constant thresholds. Analyzing the tails instead of a small fraction of days below constant thresholds provides deeper insight into the time series properties. Fingerprints of dynamical (e.g. ENSO, NAO and chemical features (e.g. strong polar vortex ozone loss, and major volcanic eruptions, can be identified in the observed frequency of extreme events throughout the time series. Overall the new approach to analysis of extremes provides more information on time series properties and variability than previous approaches that use only monthly averages and/or mini-holes and mini-highs.

Extreme Weather and Climate: Workshop Report

Science.gov (United States)

Sobel, Adam; Camargo, Suzana; Debucquoy, Wim; Deodatis, George; Gerrard, Michael; Hall, Timothy; Hallman, Robert; Keenan, Jesse; Lall, Upmanu; Levy, Marc;

The Probable Ages of Asteroid Families

Science.gov (United States)

Harris, A. W.

1993-01-01

There has been considerable debate recently over the ages of the Hirayama families, and in particular if some of the families are very oung(u) It is a straightforward task to estimate the characteristic time of a collision between a body of a given diameter, d_o, by another body of diameter greater of equal to d_1. What is less straightforward is to estimate the critical diameter ratio, d_1/d_o, above which catastrophic disruption occurs, from which one could infer probable ages of the Hirayama families, by knowing the diameter of the parent body, d_o. One can gain some insight into the probable value of d_1/d_o, and of the likely ages of existing families, from the plot below. I have computed the characteristic time between collisions in the asteroid belt of a size ratio greater of equal to d_1/d_o, for 4 sizes of target asteroids, d_o. The solid curves to the lower right are the characteristic times for a single object...

Five-year forward view: lessons from emergency care at the extremes of age.

Science.gov (United States)

Minhas, J S; Minhas, D; Coats, T; Banerjee, J; Roland, D

2018-03-01

Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.

Intra-arterial Ultra-low-Dose CT Angiography of Lower Extremity in Diabetic Patients

Energy Technology Data Exchange (ETDEWEB)

Özgen, Ali, E-mail: draliozgen@hotmail.com [Yeditepe University Hospital, Department of Radiology (Turkey); Sanioğlu, Soner [Yeditepe University Hospital, Department of Cardiovascular Surgery (Turkey); Bingöl, Uğur Anıl [Yeditepe University Hospital, Department of Plastic Surgery (Turkey)

2016-08-15

PurposeTo image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).Materials and MethodsThree cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatinine levels were followed for possible CIN.ResultsIntra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.ConclusionIntra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.

Extreme Bilirubin Levels as a Causal Risk Factor for Symptomatic Gallstone Disease

DEFF Research Database (Denmark)

Stender, Stefan; Frikke-Schmidt, Ruth; Nordestgaard, Børge G

2013-01-01

In individuals without blockage of their bile ducts, levels of plasma bilirubin likely reflect levels of biliary bilirubin; higher biliary bilirubin levels may increase the risk of gallstone disease.......In individuals without blockage of their bile ducts, levels of plasma bilirubin likely reflect levels of biliary bilirubin; higher biliary bilirubin levels may increase the risk of gallstone disease....

[The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].

Science.gov (United States)

Hu, Xu-Dong; Ma, Wei-Hu; Jiang, Wei-Yu; Ruan, Chao-Yue; Chen, Yun-Lin

2017-02-25

To evaluate the early efficacy and safety of extreme lateral interbody fusion (XLIF) combined with percutaneous pedicle screw fixation for lumbar degenerative disease. From January 2013 to June 2014, 13 patients with degenerative lumbar disease were treated with XLIF combined with percutaneous pedicle screw fixation, including 8 cases of lumbar instability, 5 cases of mild to moderate lumbar spondylolisthesis;there were 5 males and 8 females, aged from 56 to 73 years with an average of 62.1 years. All patients were single segment fusion. Operation time, perioperative bleeding and perioperative complications were recorded. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. Interbody fusion rate was observed and the intervertebral foramen area changes were compared preoperation and postoperation by X-rays and CT scanning. The mean operation time and perioperative bleeding in the patients respectively was(62.8±5.2) min and(82.5±22.6) ml. One case occurred in the numbness of femoribus internus and 1 case occurred in the muscle weakness of hip flexion after operation, both of them recovered within 2 weeks. All the patients were followed up from 12 to 19 months with an average of 15.6 months. VAS was decreased from preoperative 7.31±0.75 to 2.31±0.75 at final follow-up( P degenerative disease.

HOW to Identify and Control Noninfectious Diseases of Trees

Science.gov (United States)

USDA Forest Service Northern Area State & Private Forestry

Noninfectious tree diseases are those caused by nonliving agents. This type of disease is not transmitted from one plant to another. Extremes in temperature and water supply are the most common causes of this type of disease. Other causes are chemical substances in the soil, water, and air; transplant shock; and mechanical injuries. These nonliving disease agents are a...

Extremal graph theory

CERN Document Server

Bollobas, Bela

2004-01-01

The ever-expanding field of extremal graph theory encompasses a diverse array of problem-solving methods, including applications to economics, computer science, and optimization theory. This volume, based on a series of lectures delivered to graduate students at the University of Cambridge, presents a concise yet comprehensive treatment of extremal graph theory.Unlike most graph theory treatises, this text features complete proofs for almost all of its results. Further insights into theory are provided by the numerous exercises of varying degrees of difficulty that accompany each chapter. A

Statistical Model of Extreme Shear

DEFF Research Database (Denmark)

Larsen, Gunner Chr.; Hansen, Kurt Schaldemose

2004-01-01

In order to continue cost-optimisation of modern large wind turbines, it is important to continously increase the knowledge on wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... by a model that, on a statistically consistent basis, describe the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of high-sampled full-scale time series measurements...... are consistent, given the inevitabel uncertainties associated with model as well as with the extreme value data analysis. Keywords: Statistical model, extreme wind conditions, statistical analysis, turbulence, wind loading, statistical analysis, turbulence, wind loading, wind shear, wind turbines....

Lipolytic activity in high temperature germinating Almond seedlings

African Journals Online (AJOL)

bahri

2012-09-20

Sep 20, 2012 ... Felipe A (1981). Germination accelérée d'amandes au moyen de l'acide gibbérellique. Cahier Options Méditerranéennes I:139-140. Hirayama O, Matsuda H (1972). An improved method for determining lipolytic acylhydrolases activity. Agric. Biol. Chem. 36(10):1831-. 1833. Garcia-Olmedo R, Marca-Garcia ...

Neurodevelopmental problems and extremes in BMI

Directory of Open Access Journals (Sweden)

Nóra Kerekes

2015-07-01

Full Text Available Background. Over the last few decades, an increasing number of studies have suggested a connection between neurodevelopmental problems (NDPs and body mass index (BMI. Attention deficit/hyperactivity disorder (ADHD and autism spectrum disorders (ASD both seem to carry an increased risk for developing extreme BMI. However, the results are inconsistent, and there have been only a few studies of the general population of children.Aims. We had three aims with the present study: (1 to define the prevalence of extreme (low or high BMI in the group of children with ADHD and/or ASDs compared to the group of children without these NDPs; (2 to analyze whether extreme BMI is associated with the subdomains within the diagnostic categories of ADHD or ASD; and (3 to investigate the contribution of genetic and environmental factors to BMI in boys and girls at ages 9 and 12.Method. Parents of 9- or 12-year-old twins (n = 12,496 were interviewed using the Autism—Tics, ADHD and other Comorbidities (A-TAC inventory as part of the Child and Adolescent Twin Study in Sweden (CATSS. Univariate and multivariate generalized estimated equation models were used to analyze associations between extremes in BMI and NDPs.Results. ADHD screen-positive cases followed BMI distributions similar to those of children without ADHD or ASD. Significant association was found between ADHD and BMI only among 12-year-old girls, where the inattention subdomain of ADHD was significantly associated with the high extreme BMI. ASD scores were associated with both the low and the high extremes of BMI. Compared to children without ADHD or ASD, the prevalence of ASD screen-positive cases was three times greater in the high extreme BMI group and double as much in the low extreme BMI group. Stereotyped and repetitive behaviors were significantly associated with high extreme BMIs.Conclusion. Children with ASD, with or without coexisting ADHD, are more prone to have low or high extreme BMIs than

Revisiting the spectrum of lower motor neuron diseases with snake eyes appearance on magnetic resonance imaging.

Science.gov (United States)

Lebouteux, M-V; Franques, J; Guillevin, R; Delmont, E; Lenglet, T; Bede, P; Desnuelle, C; Pouget, J; Pascal-Mousselard, H; Pradat, P-F

2014-09-01

The 'snake eyes' sign refers to bilateral hyperintensities of the anterior horns on axial spinal cord imaging. Based on sporadic reports, it has been associated with a range of lower motor neuron (LMN) syndromes, such as spondylotic amyotrophy and Hirayama disease, as well as spinal cord infarction. The objective of our study was to comprehensively characterize the full diagnostic spectrum of LMN syndromes with this radiological clue and discuss potential aetiological factors. A large patient cohort with snake eyes sign and upper limb LMN degeneration was recruited from three French neuromuscular units. Patients underwent detailed electrophysiological, radiological, clinical and anamnestic profiling. Twenty-nine patients were ascertained and followed up for 9.5 ± 8.6 years. The majority of the patients were male (86.2%) with a mean age of 37.3 ± 14.4 years. Symptoms were bilateral in most cases (86.2%). Patients with predominantly proximal and distal deficits were equally represented (44.8% and 55.2%, respectively). A history of preceding trauma or intense physical activity was confirmed in 58.6% of the cases; 27.6% of the patients were given an initial clinical diagnosis of amyotrophic lateral sclerosis (ALS), and 51.7% were originally suspected to have multifocal motor neuropathy. None of the patients developed ALS on longitudinal follow-up. The snake eyes sign on magnetic resonance imaging is associated with a wide spectrum of neurological conditions and is more common in young men with a history of strenuous activity or antecedent trauma. The recognition of this syndrome is crucial as many of these patients are initially misdiagnosed with ALS. © 2014 The Author(s) European Journal of Neurology © 2014 EAN.

Lung function after extremely preterm birth-A population-based cohort study (EXPRESS).

Science.gov (United States)

Thunqvist, Per; Tufvesson, Ellen; Bjermer, Leif; Winberg, Anna; Fellman, Vineta; Domellöf, Magnus; Melén, Erik; Norman, Mikael; Hallberg, Jenny

2018-01-01

Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation). In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed. Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV 1 , z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R 5-20 , 0.09, 95%CI: 0.05; 0.12 kPa · L -1  · s -1 ) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07 kPa · L -1 ) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV 1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls. Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up. © 2017 Wiley Periodicals, Inc.

Mobility-Related Consequences of Reduced Lower-Extremity Peripheral Nerve Function with Age

DEFF Research Database (Denmark)

Ward, Rachel E; Caserotti, P.; Cauley, Jane A

2016-01-01

-dwelling and institutionalized residents, 1 from a range of residential locations, and 1 of patients with peripheral arterial disease. Mean ages ranged from 71-82 years. Nerve function was assessed by vibration threshold (n=2); sensory measures and clinical signs and symptoms of neuropathy (n=2); motor nerve conduction (n=1......The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults. The National Library of Medicine (PubMed) was searched on March 23, 2015 with no limits on publication dates. One reviewer selected original...... research studies of older adults (>= 65 years) that assessed the relationship between lower-extremity peripheral nerve function and mobility-related outcomes. Participants, study design and methods of assessing peripheral nerve impairment were evaluated and results were reported and synthesized. Eight...

Extreme climate, not extreme weather: the summer of 1816 in Geneva, Switzerland

Directory of Open Access Journals (Sweden)

R. Auchmann

2012-02-01

Full Text Available We analyze weather and climate during the "Year without Summer" 1816 using sub-daily data from Geneva, Switzerland, representing one of the climatically most severely affected regions. The record includes twice daily measurements and observations of air temperature, pressure, cloud cover, wind speed, and wind direction as well as daily measurements of precipitation. Comparing 1816 to a contemporary reference period (1799–1821 reveals that the coldness of the summer of 1816 was most prominent in the afternoon, with a shift of the entire distribution function of temperature anomalies by 3–4 °C. Early morning temperature anomalies show a smaller change for the mean, a significant decrease in the variability, and no changes in negative extremes. Analyzing cloudy and cloud-free conditions separately suggests that an increase in the number of cloudy days was to a significant extent responsible for these features. A daily weather type classification based on pressure, pressure tendency, and wind direction shows extremely anomalous frequencies in summer 1816, with only one day (compared to 20 in an average summer classified as high-pressure situation but a tripling of low-pressure situations. The afternoon temperature anomalies expected from only a change in weather types was much stronger negative in summer 1816 than in any other year. For precipitation, our analysis shows that the 80% increase in summer precipitation compared to the reference period can be explained by 80% increase in the frequency of precipitation, while no change could be found neither in the average intensity of precipitation nor in the frequency distribution of extreme precipitation. In all, the analysis shows that the regional circulation and local cloud cover played a dominant role. It also shows that the summer of 1816 was an example of extreme climate, not extreme weather.

Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults.

Science.gov (United States)

Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M; Petersen, John W; Christou, Demetra D

2016-09-01

Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (PHIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; PHIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. Copyright © 2016 Elsevier Inc. All rights reserved.

Novel All-Extremity High-Intensity Interval Training Improves Aerobic Fitness, Cardiac Function and Insulin Resistance in Healthy Older Adults

Science.gov (United States)

Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M.; Petersen, John W.; Christou, Demetra D.

2016-01-01

Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1 years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4 minutes 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4x/week for 8 weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (PHIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; PHIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. PMID:27346646

The greenhouse effect and extreme weather

International Nuclear Information System (INIS)

Groenaas, Sigbjoern; Kvamstoe, Nils Gunnar

2002-01-01

The article asserts that an anthropogenic global warming is occurring. This greenhouse effect is expected to cause more occurrences of extreme weather. It is extremely difficult, however, to relate specific weather catastrophes to global warming with certainty, since such extreme weather conditions are rare historically. The subject is controversial. The article also discusses the public debate and the risk of floods

Carbon ion radiotherapy for localized primary sarcoma of the extremities: Results of a phase I/II trial

International Nuclear Information System (INIS)

Sugahara, Shinji; Kamada, Tadashi; Imai, Reiko; Tsuji, Hiroshi; Kameda, Noriaki; Okada, Tohru; Tsujii, Hirohiko; Tatezaki, Shinichirou

2012-01-01

Purpose: To determine the effectiveness of carbon ion radiotherapy (CIRT) for localized primary sarcomas of the extremities in a prospective study. Patients and materials: From April 2000 to May 2010, 17 (male/female: 12/5) patients with localized primary sarcoma of the extremities received CIRT. The median age was 53 years (range: 14–87 years). Nine patients had primary diseases and eight had recurrent diseases. Of the 17 patients, eight refused amputation, and the remaining nine refused surgical resection. Tumors were located in the upper limbs in four patients and lower limbs in 13. Histological diagnosis was osteosarcoma in three patients, liposarcoma in two, synovial sarcoma in two, rhabdomyosarcoma in two, pleomorphic sarcoma in two, and miscellaneous in six. The CIRT dose to the limb was 52.8 GyE for one patient, 64 GyE for three, 70.4 GyE for 13 in 16 fixed fractions over 4 weeks. Records were reviewed and outcomes including radiologic response, local control (progression-free), and survival were analyzed. Results: The median follow-up was 37 months (range: 11–97 months). Radiological response rate was 65% (PR in 11, SD in 5, and PD in 1). The local control rate at 5 years was 76%. The overall survival rate at 5 years was 56%. Of the 17 patients, 10 survived without disease progression. Four patients had local recurrences, one was salvaged by repeated CIRT and the other three died due to systemic diseases. Distant failure was observed in six patients. One patient suffered from femoral fracture (grade 3) and received surgical fixation 27 months after CIRT. No other severe reactions (grade 3) were observed. Conclusions: CIRT is suggested to be an effective and safe treatment for patients who refuse surgery for localized primary sarcomas of the extremities.

Defining Extreme Events: A Cross-Disciplinary Review

Science.gov (United States)

McPhillips, Lauren E.; Chang, Heejun; Chester, Mikhail V.; Depietri, Yaella; Friedman, Erin; Grimm, Nancy B.; Kominoski, John S.; McPhearson, Timon; Méndez-Lázaro, Pablo; Rosi, Emma J.; Shafiei Shiva, Javad

2018-03-01

Extreme events are of interest worldwide given their potential for substantial impacts on social, ecological, and technical systems. Many climate-related extreme events are increasing in frequency and/or magnitude due to anthropogenic climate change, and there is increased potential for impacts due to the location of urbanization and the expansion of urban centers and infrastructures. Many disciplines are engaged in research and management of these events. However, a lack of coherence exists in what constitutes and defines an extreme event across these fields, which impedes our ability to holistically understand and manage these events. Here, we review 10 years of academic literature and use text analysis to elucidate how six major disciplines—climatology, earth sciences, ecology, engineering, hydrology, and social sciences—define and communicate extreme events. Our results highlight critical disciplinary differences in the language used to communicate extreme events. Additionally, we found a wide range in definitions and thresholds, with more than half of examined papers not providing an explicit definition, and disagreement over whether impacts are included in the definition. We urge distinction between extreme events and their impacts, so that we can better assess when responses to extreme events have actually enhanced resilience. Additionally, we suggest that all researchers and managers of extreme events be more explicit in their definition of such events as well as be more cognizant of how they are communicating extreme events. We believe clearer and more consistent definitions and communication can support transdisciplinary understanding and management of extreme events.

Management of the mangled extremity

NARCIS (Netherlands)

Prasarn, Mark L.; Helfet, David L.; Kloen, Peter

2012-01-01

The management of a mangled extremity continues to be a matter of debate. With modern advances in trauma resuscitation, microvascular tissue transfer, and fracture fixation, severe traumatic extremity injuries that would historically have been amputated are often salvaged. Even if preserving a

Improving the image quality of contrast-enhanced MR angiography by automated image registration: A prospective study in peripheral arterial disease of the lower extremities

International Nuclear Information System (INIS)

Menke, Jan

2010-01-01

Objective: If a patient has moved during digital subtraction angiography (DSA), manual pixel shift can improve the image quality. This study investigated whether such image registration can also improve the quality of contrast-enhanced magnetic resonance angiography (MRA) in patients with peripheral arterial disease of the lower extremities. Materials and methods: 404 leg MRAs of patients likely to have peripheral artery disease were included in this prospective study. The standard non-registered MRAs were compared to automatically linear, affine and warp registered MRAs by four image quality parameters, including the vessel detection probability (VDP) in maximum intensity projection (MIP) images and contrast-to-noise ratios (CNR). The different registration types were compared by analysis of variance. Results: All studied image quality parameters showed similar trends. Generally, registration improved the leg MRA quality significantly (P < 0.05). The 12% of lower legs with a body shift of 1 mm or more showed the highest gain in image quality when using linear registration instead of no registration, with an average VDP gain of 20-49%. Warp registration improved the image quality slightly further. Conclusion: Automated image registration can improve the MRA image quality especially in the lower legs, which is comparable to the effect of pixel shift in DSA.

A decade of weather extremes

NARCIS (Netherlands)

Coumou, Dim; Rahmstorf, Stefan

The ostensibly large number of recent extreme weather events has triggered intensive discussions, both in- and outside the scientific community, on whether they are related to global warming. Here, we review the evidence and argue that for some types of extreme - notably heatwaves, but also

Attitude extremity, consensus and diagnosticity

NARCIS (Netherlands)

van der Pligt, J.; Ester, P.; van der Linden, J.

1983-01-01

Studied the effects of attitude extremity on perceived consensus and willingness to ascribe trait terms to others with either pro- or antinuclear attitudes. 611 Ss rated their attitudes toward nuclear energy on a 5-point scale. Results show that attitude extremity affected consensus estimates. Trait

Extreme Events in Nature and Society

CERN Document Server

Albeverio, Sergio; Kantz, Holger

2006-01-01

Significant, and usually unwelcome, surprises, such as floods, financial crisis, epileptic seizures, or material rupture, are the topics of Extreme Events in Nature and Society. The book, authored by foremost experts in these fields, reveals unifying and distinguishing features of extreme events, including problems of understanding and modelling their origin, spatial and temporal extension, and potential impact. The chapters converge towards the difficult problem of anticipation: forecasting the event and proposing measures to moderate or prevent it. Extreme Events in Nature and Society will interest not only specialists, but also the general reader eager to learn how the multifaceted field of extreme events can be viewed as a coherent whole.

Controlling extreme events on complex networks

Science.gov (United States)

Chen, Yu-Zhong; Huang, Zi-Gang; Lai, Ying-Cheng

2014-08-01

Extreme events, a type of collective behavior in complex networked dynamical systems, often can have catastrophic consequences. To develop effective strategies to control extreme events is of fundamental importance and practical interest. Utilizing transportation dynamics on complex networks as a prototypical setting, we find that making the network ``mobile'' can effectively suppress extreme events. A striking, resonance-like phenomenon is uncovered, where an optimal degree of mobility exists for which the probability of extreme events is minimized. We derive an analytic theory to understand the mechanism of control at a detailed and quantitative level, and validate the theory numerically. Implications of our finding to current areas such as cybersecurity are discussed.

[Clinical characteristics and prognosis of colon cancer patient with extremely elevated carcinoembryonic antigen level].

Science.gov (United States)

Chen, Pengju; Yao, Yunfeng; Zhang, Dakui; Gu, Jin

2015-10-01

To explore the clinicopathological characteristics and prognosis of colon cancer patients with extremely elevated serum carcinoembryonic antigen(CEA) level before operation(>50 μg/L). Clinicopathological and follow-up data of 1250 patients with colonic adenocarcinoma undergoing primary tumor resection between January 2001 and December 2011 were retrospectively analyzed. All the patients were divided into three groups according to the preoperative serum CEA levels as normal group (0-5 μg/L, 721 cases), elevated group(5-50 μg/L, 408 cases) and extremely elevated(>50 μg/L, 121 cases). Kaplan-Meier method was used to analyze the overall survival and disease-free survival. Log-rank test was used to compare the survival between groups. Cox regression was used to screen the independent prognostic factors of colon cancer. Compared with normal and elevated groups, patients with extremely elevated CEA had more advanced T,N,M stages (Pcolon cancer (all PColon cancer patients with extremely elevated preoperative CEA levels are associated with more unfavorable pathological factors, advanced TNM stage and more distant metastases (especially the liver metastases) during the follow-up. The elevated degree of preoperative CEA level is an independent poor prognostic factor of patients with colon cancer.

A single pH fluorescent probe for biosensing and imaging of extreme acidity and extreme alkalinity.

Science.gov (United States)

Chao, Jian-Bin; Wang, Hui-Juan; Zhang, Yong-Bin; Li, Zhi-Qing; Liu, Yu-Hong; Huo, Fang-Jun; Yin, Cai-Xia; Shi, Ya-Wei; Wang, Juan-Juan

2017-07-04

A simple tailor-made pH fluorescent probe 2-benzothiazole (N-ethylcarbazole-3-yl) hydrazone (Probe) is facilely synthesized by the condensation reaction of 2-hydrazinobenzothiazole with N-ethylcarbazole-3-formaldehyde, which is a useful fluorescent probe for monitoring extremely acidic and alkaline pH, quantitatively. The pH titrations indicate that Probe displays a remarkable emission enhancement with a pK a of 2.73 and responds linearly to minor pH fluctuations within the extremely acidic range of 2.21-3.30. Interestingly, Probe also exhibits strong pH-dependent characteristics with pK a 11.28 and linear response to extreme-alkalinity range of 10.41-12.43. In addition, Probe shows a large Stokes shift of 84 nm under extremely acidic and alkaline conditions, high selectivity, excellent sensitivity, good water-solubility and fine stability, all of which are favorable for intracellular pH imaging. The probe is further successfully applied to image extremely acidic and alkaline pH values fluctuations in E. coli cells. Copyright © 2017 Elsevier B.V. All rights reserved.

Climate Change, Extreme Weather Events, and Fungal Disease Emergence and Spread

Science.gov (United States)

Tucker, Compton J.; Yager, Karina; Anyamba, Assaf; Linthicum, Kenneth J.

2011-01-01

Empirical evidence from multiple sources show the Earth has been warming since the late 19th century. More recently, evidence for this warming trend is strongly supported by satellite data since the late 1970s from the cryosphere, atmosphere, oceans, and land that confirms increasing temperature trends and their consequences (e.g., reduced Arctic sea ice, rising sea level, ice sheet mass loss, etc.). At the same time, satellite observations of the Sun show remarkably stable solar cycles since the late 1970s, when direct observations of the Sun's total solar irradiance began. Numerical simulation models, driven in part by assimilated satellite data, suggest that future-warming trends will lead to not only a warmer planet, but also a wetter and drier climate depending upon location in a fashion consistent with large-scale atmospheric processes. Continued global warming poses new opportunities for the emergence and spread of fungal disease, as climate systems change at regional and global scales, and as animal and plant species move into new niches. Our contribution to this proceedings is organized thus: First, we review empirical evidence for a warming Earth. Second, we show the Sun is not responsible for the observed warming. Third, we review numerical simulation modeling results that project these trends into the future, describing the projected abiotic environment of our planet in the next 40 to 50 years. Fourth, we illustrate how Rift Valley fever outbreaks have been linked to climate, enabling a better understanding of the dynamics of these diseases, and how this has led to the development of an operational predictive outbreak model for this disease in Africa. Fifth, We project how this experience may be applicable to predicting outbreaks of fungal pathogens in a warming world. Lastly, we describe an example of changing species ranges due to climate change, resulting from recent warming in the Andes and associated glacier melt that has enabled amphibians to

Near-extreme system condition and near-extreme remaining useful time for a group of products

International Nuclear Information System (INIS)

Wang, Hai-Kun; Li, Yan-Feng; Huang, Hong-Zhong; Jin, Tongdan

2017-01-01

When a group of identical products is operating in field, the aggregation of failures is a catastrophe to engineers and customers who strive to develop reliable and safe products. In order to avoid a swarm of failures in a short time, it is essential to measure the degree of dispersion from different failure times in a group of products to the first failure time. This phenomenon is relevant to the crowding of system conditions near the worst one among a group of products. The group size in this paper represents a finite number of products, instead of infinite number or a single product. We evaluate the reliability of the product fleet from two aspects. First, we define near-extreme system condition and near-extreme failure time for offline solutions, which means no online observations. Second, we apply them to a continuous degradation system that breaks down when it reaches a soft failure threshold. By using particle filtering in the framework of prognostics and health management for a group of products, we aim to estimate near-extreme system condition and further predict the remaining useful life (RUL) using online solutions. Numerical examples are provided to demonstrate the effectiveness of the proposed method. - Highlights: • The aggregation of failures is measured for a group of identical products. • The crowding of failures is quantitated by the near-extreme evaluations. • Near-extreme system condition are given for offline solutions. • Near-extreme remaining useful time are provided for online solutions.

Book review: Extreme ocean waves

Science.gov (United States)

Geist, Eric L.

2011-01-01

‘‘Extreme Ocean Waves’’ is a collection of ten papers edited by Efim Pelinovsky and Christian Kharif that followed the April 2007 meeting of the General Assembly of the European Geosciences Union. A note on terminology: extreme waves in this volume broadly encompass different types of waves, includ- ing deep-water and shallow-water rogue waves (alternatively termed freak waves), storm surges from cyclones, and internal waves. Other types of waves such as tsunamis or rissaga (meteotsunamis) are not discussed in this volume. It is generally implied that ‘‘extreme’’ has a statistical connotation relative to the average or significant wave height specific to each type of wave. Throughout the book, in fact, the reader will find a combination of theoretical and statistical/ empirical treatment necessary for the complete examination of this subject. In the introduction, the editors underscore the importance of studying extreme waves, documenting several dramatic instances of damaging extreme waves that occurred in 2007. 

Pathologic features of lower extremity arterial lesions in diabetes mellitus:an analysis of 162 patients

International Nuclear Information System (INIS)

Guo Xiangjiang; Zhang Jiwei

2010-01-01

Objective: To investigate the angiographic manifestations of lower extremity atherosclerotic occlusion in patients with diabetes mellitus. Methods: The angiographic findings of lower extremity in 162 patients with diabetes mellitus were retrospectively analyzed. (1) The arteries of lower extremity were divided into the following four segments: iliac, femoral, popliteal and crural artery. The involvements of these arteries were documented. (2) Based on the lesion's number, location, nature (stricture or occlusion) and length ( 5 cm), the diabetic arterial diseases were categorized. Results: (1) Of 162 diabetic lower limbs, multiple segmental lesions were seen in 131, superficial femoral arterial lesions in 130, and crural arterial lesions in 139, of which 130 arterial lesions had at least two below-the-knee arteries being involved. (2) Based on segmental angiographic classification, a total of 660 vascular lesions were detected, including stricture lesions (33.8%) and occlusive lesions (66.2%). Of the 437 occlusions, 70.5% were located in below-the-knee arteries, and most of which were longer than 10 cm and located in anterior and posterior tibial arteries, while only a few peroneal arteries were involved (P < 0.0001). One hundred and fifty-two lesions were detected in superficial femoral arteries, of which 49 (31.2%) were located at the origin of the superficial femoral artery and 56 (35.7) were in the adductor canal hiatus. Conclusion: The main feature of peripheral arterial disease of lower extremity caused by diabetes mellitus is multi-level atherosclerotic occlusion, the superficial femoral and the crural arteries are most likely to be involved. The lesions of superficial femoral artery are often located at the arterial origin and in the adductor canal hiatus, while the deep femoral artery and the femoral artery are less involved. Long occlusive lesions are more prevalent in crural arteries, especially in anterior and posterior tibial arteries. (J Intervent

[Meta-analysis of percutaneous transluminal atherectomy in the treatment for in-stent restenosis of lower extremity peripheral artery disease].

Science.gov (United States)

Li, Weihao; Zhang, Tao; Liu, Yunfeng; Zhang, Yongbao; Li, Qingle; Zhang, Xiaoming; Shen, Chenyang

2015-11-24

To evaluate the clinical safety and efficacy of percutaneous transluminal atherectomy for in-stent restenosis (ISR) in patients with low extremity peripheral arterial diseases (PAD). PubMed, Elsevier, EBSCO, Spring databases and Cochrane Library were searched for relevant articles. Based on the different mechanisms of atherectomy, the patients were divided into mechanic atherectomy group and laser atherectomy group. The safety end points included the rate of distal embolism and severe arterial wall injuries. And the efficacy end points included primary patency rate and freedom from target vessel revascularization (TVR-free) 6 months and 12 months after surgery. A total of 9 studies and 620 patients (published between 2006 and 2014) were accepted. The rate of distal embolism was 4.2% (95% confidence interval (CI): 1.7%-6.7%), while that of severe arterial wall injuries was 1.9% (95%CI: 0.9%-3.0%), respectively. Laser atherectomy was responsible for more distal embolism (6.8%) compared to mechanic atherectomy (2.0%), which was significantly different (Q=21.66, P=0.010). At 6-month follow-up, primary patency rate and rate of TVR-free were 63.0% (95% CI: 55.5%-70.6%) and 80.4% (95% CI: 70.5%-90.3%), while at 12-month follow-up were 43.5% (95%CI: 32.2%-54.9%) and 58.0% (95% CI: 52.1%-63.9%), respectively. The free-TVR rate at 6 months follow-up in mechanical atherectomy group was 77.9%, and was inferior to that in laser atherectomy group (80.8%, Q=13.49, P=0.009). Published bias was discovered at the analysis of 12-month TVR-free rate by means of Begg Test (P=0.039). Meta analysis concerned about the 3 randomized controlled trials demonstrated that there was no significant improvement using atherectomy for ISR comparing to standard balloon at 6-month TVR-free rate (OR=1.34, 95% CI: 0.86-2.07, P=0.196). To treat ISR lesion in lower extremities, laser atherectomy has a lower free-TVR rate in the middle term follow-up.A higher rate of distal embolism is noted though. On

Cross-cultural adaptation and validation of the Japanese version of the Toronto Extremity Salvage Score (TESS) for patients with malignant musculoskeletal tumors in the upper extremities.

Science.gov (United States)

Akiyama, Toru; Uehara, Kosuke; Ogura, Koichi; Shinoda, Yusuke; Iwata, Shintaro; Saita, Kazuo; Tanzawa, Yoshikazu; Nakatani, Fumihiko; Yonemoto, Tsukasa; Kawano, Hirotaka; Davis, Aileen M; Kawai, Akira

2017-01-01

The Toronto Extremity Salvage Score (TESS) is a widely used disease-specific patient-completed questionnaire for the assessment of physical function in patients with musculoskeletal tumors; however, there had not been the validated Japanese version of the TESS. The aim of this study was to validate the Japanese version of the TESS in patients with musculoskeletal tumors in the upper extremity. After developing a Japanese version of the TESS, the questionnaire was administered to 53 patients to examine its reliability and validity in comparison with the Musculoskeletal Tumor Society (MSTS) scoring system and Short Form-36 (SF-36). Test-retest reliability with intraclass correlation coefficient (0.93) and internal consistency with Cronbach's alpha (0.90) were excellent. Factor analysis showed that the construct structure consisted of 3-item clusters, and the Akaike Information Criterion network also demonstrated that the items could be divided into 3 domains according to their content. The TESS strongly correlated with the MSTS rating scale (r = 0.750; P TESS had low correlations with the SF-36 mental health and role-emotional subscales and the MSTS scoring system manual dexterity domain. Our study suggests that the TESS is a reliable and valid instrument to measure patient-reported physical functioning in patients with upper extremity sarcoma. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

The personal dispositions of violent extremism

Directory of Open Access Journals (Sweden)

Davydov D.G.

2017-04-01

Full Text Available The paper presents the differences in the nature of extremism and radicalism, and the necessity of introducing the concept of "violent extremism." It is shown that the ideology is the explanation of extremist behavior, rather than its cause. The ideology of extremism often eclectic, contradictory and can easily be transformed by changing the object of hostility, depending on the situation. For the description of the psychological causes of extremism it is proposed to use the concept of personal disposition. Disposition is the preferred way to subjective interpretation of reality and reflects both the specific needs of a person as well the typical social situations where it realized and personal experience. Considered the following dispositions of violent extremism: the Cult of force and aggression, Intolerance, Out-group hostility Conventional coercion, Social pessimism and destructiveness, Mystical, Fighting and overcoming, Nihilism to law, Anti-subjectivism. It is proposed to use these dispositions as diagnostic criteria and for preventing and correcting.

[Autologous transfusion of UV-irradiated blood in the complex treatment of children with dysplasia of deep veins of the extremities].

Science.gov (United States)

Levanovich, V V; Kupatadze, D D; Endzhibadze, Iu G; Nabokov, V V; Mazurova, E V; Ivanov, A P; Chirovich, M

1991-02-01

Under examination there were 12 patients aged from 5 till 14 years. An investigation of hemostatic potential of blood in the diseased extremity and peripheral blood was performed. A mosaic character of blood coagulative alterations in this category of patients was detected. Autotransfusion of UV-irradiated blood is a pathogenetically grounded and accessible method of correction of hemocoagulation and may be included in the complex treatment of patients with dysplasia of the profound veins of lower extremities.

Statistics of extremes theory and applications

CERN Document Server

Beirlant, Jan; Segers, Johan; Teugels, Jozef; De Waal, Daniel; Ferro, Chris

2006-01-01

Research in the statistical analysis of extreme values has flourished over the past decade: new probability models, inference and data analysis techniques have been introduced; and new application areas have been explored. Statistics of Extremes comprehensively covers a wide range of models and application areas, including risk and insurance: a major area of interest and relevance to extreme value theory. Case studies are introduced providing a good balance of theory and application of each model discussed, incorporating many illustrated examples and plots of data. The last part of the book covers some interesting advanced topics, including  time series, regression, multivariate and Bayesian modelling of extremes, the use of which has huge potential.  

Measuring Cross-Cultural Competence in Soldiers and Cadets: A Comparison of Existing Instruments

Science.gov (United States)

2010-11-01

Choi, 2005; Matsumoto , Yoo, Hirayama, & Petrova, 2005) or attitudes toward specific cultural groups using Implicit Association Tests (e.g., Park, Felix...findings, Ward et al. (2009) found that CQ failed to show incremental validity beyond emotional intelligence in predicting psychological , socio- cultural ...Cracking the nonverbal code: Intercultural competence and gesture recognition across cultures . Journal of Cross- Cultural Psychology , 36, 380-395

Modulation of extreme temperatures in Europe under extreme values of the North Atlantic Oscillation Index.

Science.gov (United States)

Beniston, Martin

2018-03-10

This paper reports on the influence that extreme values in the tails of the North Atlantic Oscillation (NAO) Index probability density function (PDF) can exert on temperatures in Europe. When the NAO Index enters into its lowest (10% quantile or less) and highest (90% quantile or higher) modes, European temperatures often exhibit large negative or positive departures from their mean values, respectively. Analyses of the joint quantiles of the Index and temperatures (i.e., the simultaneous exceedance of particular quantile thresholds by the two variables) show that temperatures enter into the upper or lower tails of their PDF when the NAO Index also enters into its extreme tails, more often that could be expected from random statistics. Studies of this nature help further our understanding of the manner by which mechanisms of decadal-scale climate variability can influence extremes of temperature-and thus perhaps improve the forecasting of extreme temperatures in weather and climate models. © 2018 New York Academy of Sciences.

Climate change, climatic variation and extreme biological responses.

Science.gov (United States)

Palmer, Georgina; Platts, Philip J; Brereton, Tom; Chapman, Jason W; Dytham, Calvin; Fox, Richard; Pearce-Higgins, James W; Roy, David B; Hill, Jane K; Thomas, Chris D

2017-06-19

Extreme climatic events could be major drivers of biodiversity change, but it is unclear whether extreme biological changes are (i) individualistic (species- or group-specific), (ii) commonly associated with unusual climatic events and/or (iii) important determinants of long-term population trends. Using population time series for 238 widespread species (207 Lepidoptera and 31 birds) in England since 1968, we found that population 'crashes' (outliers in terms of species' year-to-year population changes) were 46% more frequent than population 'explosions'. (i) Every year, at least three species experienced extreme changes in population size, and in 41 of the 44 years considered, some species experienced population crashes while others simultaneously experienced population explosions. This suggests that, even within the same broad taxonomic groups, species are exhibiting individualistic dynamics, most probably driven by their responses to different, short-term events associated with climatic variability. (ii) Six out of 44 years showed a significant excess of species experiencing extreme population changes (5 years for Lepidoptera, 1 for birds). These 'consensus years' were associated with climatically extreme years, consistent with a link between extreme population responses and climatic variability, although not all climatically extreme years generated excess numbers of extreme population responses. (iii) Links between extreme population changes and long-term population trends were absent in Lepidoptera and modest (but significant) in birds. We conclude that extreme biological responses are individualistic, in the sense that the extreme population changes of most species are taking place in different years, and that long-term trends of widespread species have not, to date, been dominated by these extreme changes.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'. © 2017 The Authors.

On the Extreme Wave Height Analysis

DEFF Research Database (Denmark)

Burcharth, H. F.; Liu, Zhou

1994-01-01

The determination of the design wave height is usually based on the statistical analysis of long-term extreme wave height measurements. After an introduction to the procedure of the extreme wave height analysis, the paper presents new development concerning various aspects of the extreme wave...... height analysis. Finally, the paper gives a practical example based on a data set of the hindcasted wave heights for a deep water location in the Mediterranean Sea....

Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda.

Science.gov (United States)

Prasher, Bhavana; Negi, Sapna; Aggarwal, Shilpi; Mandal, Amit K; Sethi, Tav P; Deshmukh, Shailaja R; Purohit, Sudha G; Sengupta, Shantanu; Khanna, Sangeeta; Mohammad, Farhan; Garg, Gaurav; Brahmachari, Samir K; Mukerji, Mitali

2008-09-09

housekeeping, disease related and hub genes were observed in these extreme constitution types. Ayurveda based method of phenotypic classification of extreme constitutional types allows us to uncover genes that may contribute to system level differences in normal individuals which could lead to differential disease predisposition. This is a first attempt towards unraveling the clinical phenotyping principle of a traditional system of medicine in terms of modern biology. An integration of Ayurveda with genomics holds potential and promise for future predictive medicine.

Performance testing of extremity dosimeters, Study 2

International Nuclear Information System (INIS)

Harty, R.; Reece, W.D.; Hooker, C.D.

1990-04-01

The Health Physics Society Standards Committee (HPSSC) Working Group on Performance Testing of Extremity Dosimeters has issued a draft of a proposed standard for extremity dosimeters. The draft standard proposes methods to be used for testing dosimetry systems that determine occupational radiation dose to the extremities and the performance criterion used to determine compliance with the standard. Pacific Northwest Laboratory (PNL) has conducted two separate evaluations of the performance of extremity dosimeter processors to determine the appropriateness of the draft standard, as well as to obtain information regarding the performance of extremity dosimeters. Based on the information obtained during the facility visits and the results obtained from the performance testing, it was recommended that changes be made to ensure that the draft standard is appropriate for extremity dosimeters. The changes include: subdividing the mixture category and the beta particle category; eliminating the neutron category until appropriate flux-to-dose equivalent conversion factors are derived; and changing the tolerance level for the performance criterion to provide consistency with the performance criterion for whole body dosimeters, and to avoid making the draft standard overly difficult for processors of extremity dosimeters to pass. 20 refs., 10 figs., 6 tabs

Usefulness of abdominal aortic calcification for screening of peripheral vascular disease

International Nuclear Information System (INIS)

Park, Chul Hi; Kim, Jeong Ho; Choi, Soo Jin; Kim, Hyung Sik; Jin, Wook; Yang, Dal Mo

2006-01-01

We wanted to evaluate the value of abdominal aortic calcification (AAC), as detected on CT, as a predictor of atherosclerotic stenotic disease of the lower extremity arteries. One hundred three patients who had CT angiography performed for the evaluation of peripheral vascular disease were enrolled in this retrospective study. The volume (mm 3 ) of the AAC was measured on CT. Each lower extremity was divided into 8 segments. The extent of stenosis of the lower extremity artery was manifested as the sum of the stenosis scores for 16 segments (total stenosis score: TSS). The significant stenosis scores (SSS-50 and SSS-75) were defined as the sum of scores for the lower extremity artery segments that had significant stenosis of more than 50% and 75%, respectively. AAC was correlated to the TSS, SSS-50 and SSS-75 with using Spearman's correlation coefficient. The diagnostic performance of AAC for stenosis of a lower extremity artery of more than 50% and 75%, respectively, was evaluated by using the receiver operating characteristic (ROC) curve. The Spearman's correlation coefficients were 0.728 (AAC vs. TSS), 0.662 (AAC vs. SSS-50), and 0.602 (AAC vs. SSS-75), respectively. For significant stenosis more than 50% and 75%, the areas under the ROC curve were 0.898 and 0.866, respectively. The cutoff value, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 1030 mm 3 , 87%, 88%, 89%. 86% and 87% for stenosis more than 50% and 1030 mm 3 , 87%, 80%, 79%, 88% and 84% for stenosis more than 75%, respectively. Abdominal aortic calcification detected on CT may be a useful predictor of atherosclerotic stenotic disease of lower extremity arteries

X-ray atlas of rheumatic diseases

International Nuclear Information System (INIS)

Dihlmann, W.

1986-01-01

This atlas comprises instructive X-rays of the various inflammatory rheumatic joint diseases in all stages at the extremities and the spinal column. In addition, the complex pattern of the wide range of arthroses, also known as degenerative rheumatic disease is included. Besides the instructive pointers to X-ray diagnosis, the book is also a guide to differential diagnosis. Hence, this book is actually an X-ray atlas of joint diseases in general. Selected Contents: Introduction: What Does ''Rheumatism'' Actually Mean?/Radiographic Methodology in Rheumatic Diseases of the Locomotor System/The Mosaic of Arthritis/Adult Rheumatoid Arthritis/Seronegative Spondylarthritis/Classic Collagen Diseases/Enthesiopathies/Gout-Pseudogout

DIRECTIONS OF EXTREME TOURISM IN UKRAINE

Directory of Open Access Journals (Sweden)

L. V. Martseniuk

2016-02-01

Full Text Available Purpose. In the world market of tourist services the extreme tourism is very popular, as it does not require the significant financial costs and enables year on year to increase the offers of holiday packages, associated with active travel. Ukraine has significant potential for the development of extreme kinds of rest, but it is not developed enough. Forms of extreme tourism are unknown for domestic tourists, and therefore, they formed a negative attitude. The aim of the article is the analysis of extreme resort potential of Ukraine and promotion of the development of extreme tourism destinations in the travel market. Theoretical and methodological basis of research is the system analysis of the problems of ensuring the competitiveness of the tourism industry, theoretical principles of economic science in the field of the effectiveness of extreme tourism and management of tourist flows. Methodology. The author offers the directions of tourist flows control, which differ from the current expansion of services to tourists in Ukraine. The development of extreme tourism with the help of co-operation of railways and sport federations was proposed. Findings. During the research the author proved that the implementation of the tasks will be promote: 1 increase in budget revenues at all levels of the inner extreme tourism; 2 raise the image of Ukraine and Ukrainian Railways; 3 increase the share of tourism and resorts in the gross domestic product to the level of developed countries; 4 bringing the number of employees in tourism and resorts to the level of developed countries; 5 the creation of an effective system of monitoring the quality of tourist services; 6 the creation of an attractive investment climate for attracting the investment in the broad development of tourism, engineering and transport and municipal infrastructure; 7 improvement the safety of tourists, ensure the effective protection of their rights and legitimate interests and

Angiography of the upper extremity

International Nuclear Information System (INIS)

Janevski, B.K.

1982-01-01

This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

Acclimatization to extreme heat

Science.gov (United States)

Warner, M. E.; Ganguly, A. R.; Bhatia, U.

2017-12-01

Heat extremes throughout the globe, as well as in the United States, are expected to increase. These heat extremes have been shown to impact human health, resulting in some of the highest levels of lives lost as compared with similar natural disasters. But in order to inform decision makers and best understand future mortality and morbidity, adaptation and mitigation must be considered. Defined as the ability for individuals or society to change behavior and/or adapt physiologically, acclimatization encompasses the gradual adaptation that occurs over time. Therefore, this research aims to account for acclimatization to extreme heat by using a hybrid methodology that incorporates future air conditioning use and installation patterns with future temperature-related time series data. While previous studies have not accounted for energy usage patterns and market saturation scenarios, we integrate such factors to compare the impact of air conditioning as a tool for acclimatization, with a particular emphasis on mortality within vulnerable communities.

Risk of lower extremity arterial disease in a cohort of workers occupationally exposed to ionizing radiation over a prolonged period

Energy Technology Data Exchange (ETDEWEB)

Azizova, Tamara V.; Bannikova, Maria V.; Grigorieva, Evgenia S.; Bagaeva, Yaroslava P.; Azizova, Elena V. [Southern Urals Biophysics Institute, Ozyorsk Chelyabinsk Region (Russian Federation)

2016-05-15

In this study the incidence risk of lower extremity arterial disease (LEAD; international classification of diseases version 9 code 440.2) was assessed in a cohort of workers occupationally exposed to radiation over a prolonged period. The study cohort includes 22,377 workers of the Mayak Production Association (25 % of whom are females) first employed at one of the main facilities in 1948-1982 and followed up to the end of 2008. Dose estimates used in the study are provided by Mayak Worker Dosimetry System 2008. The mean total dose from external gamma-rays is 0.54 Gy for males and 0.44 Gy for females. The mean absorbed liver dose from internal alpha-radiation due to incorporated plutonium is 0.23 Gy in males and 0.44 Gy in females. Relative risks and excess relative risks per unit dose (ERR/Gy) are calculated based on maximum likelihood. A total of 943 cases of LEAD are registered in the study cohort during the follow-up of 512,801 person-years. A significant association of LEAD incidence with total dose from external gamma-rays (based on a linear model) was revealed, and the ERR/Gy is 0.27 (95 % confidence interval (CI) 0.11; 0.48). It turned out that a linear-exponential model provides a better fit of the data (∇AIC = 9.957). Inclusion of an adjustment for internal alpha-radiation dose resulted in the reduction of the ERR/Gy to 0.19 (95 % CI 0.05; 0.39), but the risk remains significant. No association of LEAD incidence with dose from internal alpha-radiation was found in the study worker cohort. It is concluded that this study provides evidence for an association of LEAD incidence with dose from external gamma-rays taking non-radiation factors into account. (orig.)

Examine Precipitation Extremes in Terms of Storm Properties

Science.gov (United States)

Jiang, P.; Yu, Z.; Chen, L.; Gautam, M. R.; Acharya, K.

2017-12-01

The increasing potential of the extreme precipitation is of significant societal concern. Changes in precipitation extremes have been mostly examined using extreme precipitation indices or Intensity-Duration-Frequency (IDF) analyses, which often fail to reveal the characteristics of an integrated precipitation event. In this study, we will examine the precipitation extremes in terms of storm properties including storm duration, storm intensity, total storm precipitation, and within storm pattern. Single storm event will be identified and storm properties will be determined based on the hourly precipitation time series in the selected locations in southwest United States. Three types of extreme precipitation event will be recognized using the criteria as (1) longest storm duration; (2) Highest storm intensity; and (3) largest total precipitation over a storm. The trend and variation of extreme precipitation events will be discussed for each criterion. Based on the comparisons of the characteristics of extreme precipitation events identified using different criteria, we will provide guidelines for choosing proper criteria for extreme precipitation analysis in specific location.

[Injury mechanisms in extreme violence settings].

Science.gov (United States)

Arcaute-Velazquez, Fernando Federico; García-Núñez, Luis Manuel; Noyola-Vilallobos, Héctor Faustino; Espinoza-Mercado, Fernando; Rodríguez-Vega, Carlos Eynar

2016-01-01

Extreme violence events are consequence of current world-wide economic, political and social conditions. Injury patterns found among victims of extreme violence events are very complex, obeying several high-energy injury mechanisms. In this article, we present the basic concepts of trauma kinematics that regulate the clinical approach to victims of extreme violence events, in the hope that clinicians increase their theoretical armamentarium, and reflecting on obtaining better outcomes. Copyright © 2016. Published by Masson Doyma México S.A.

Extremely low temperature properties of epoxy GFRP

International Nuclear Information System (INIS)

Kadotani, Kenzo; Nagai, Matao; Aki, Fumitake.

1983-01-01

The examination of fiber-reinforced plastics, that is, plastics such as epoxy, polyester and polyimide reinforced with high strength fibers such as glass, carbon, boron and steel, for extremely low temperature use began from the fuel tanks of rockets. Therafter, the trial manufacture of superconducting generators and extremely low temperature transformers and the manufacture of superconducting magnets for nuclear fusion experimental setups became active, and high performance FRPs have been adopted, of which the extremely low temperature properties have been sufficiently grasped. Recently, the cryostats made of FRPs have been developed, fully utilizing such features of FRPs as high strength, high rigidity, non-magnetic material, insulation, low heat conductivity, light weight and the freedom of molding. In this paper, the mechanical properties at extremely low temperature of the plastic composite materials used as insulators and structural materials for extremely low temperature superconducting equipment is outlined, and in particular, glass fiber-reinforced epoxy laminates are described somewhat in detail. The fracture strain of GFRP at extremely low temperature is about 1.3 times as large as that at room temperature, but at extremely low temperature, clear cracking occurred at 40% of the fracture strain. The linear thermal contraction of GFRP showed remarkable anisotropy. (Kako, I.)

Paget disease of the male nipple.

Science.gov (United States)

El Harroudi, T; Tijami, F; El Otmany, A; Jalil, A

2010-01-01

Breast cancer occurring in the mammary gland of men is infrequent. It accounts for 0.8% of all breast cancers, which is less than one per cent of all newly diagnosed male cancers and 0.2% of male cancer deaths. However, Paget disease of the male nipple is extremely rare. We report a single case of Paget disease with infiltrative ductal carcinoma of the breast in a 61-year-old man.

Arterial tortuosity syndrome: An extremely rare disease presenting as a mimic of pulmonary sling

Directory of Open Access Journals (Sweden)

Amy Farkas, MD

2018-02-01

Full Text Available Pulmonary sling is the anatomic variant defined by the aberrant origin of the left pulmonary artery from the right pulmonary artery. This patient presented with a mimic of pulmonary sling as a result of an extremely rare condition, arterial tortuosity syndrome (ATS. The patient was first diagnosed with pulmonary sling on prenatal echocardiogram performed by cardiology. Computed tomography angiography of the chest obtained at birth to evaluate respiratory depression demonstrated ATS. The early detection of ATS has been demonstrated to improve patient outcome. This case provides an overview of the typical imaging features of ATS to aid radiologists in making this uncommon diagnosis.

Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

Directory of Open Access Journals (Sweden)

Al Kaissi, Ali

2014-09-01

Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

Disease: H01625 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available small and medium-sized arteries and veins in the upper and lower extremities. Cigarette smoking has been im...chemic ulcerations and eventually gangrene. Abstinence from smoking is the defini...erapy has shown promising results. Vascular disease ... Cigarette smoking ... Hepronicate [DR:D01882] Pentoxifyl

Stellar extreme ultraviolet astronomy

International Nuclear Information System (INIS)

Cash, W.C. Jr.

1978-01-01

The design, calibration, and launch of a rocket-borne imaging telescope for extreme ultraviolet astronomy are described. The telescope, which employed diamond-turned grazing incidence optics and a ranicon detector, was launched November 19, 1976, from the White Sands Missile Range. The telescope performed well and returned data on several potential stellar sources of extreme ultraviolet radiation. Upper limits ten to twenty times more sensitive than previously available were obtained for the extreme ultraviolet flux from the white dwarf Sirius B. These limits fall a factor of seven below the flux predicted for the star and demonstrate that the temperature of Sirius B is not 32,000 K as previously measured, but is below 30,000 K. The new upper limits also rule out the photosphere of the white dwarf as the source of the recently reported soft x-rays from Sirius. Two other white dwarf stars, Feige 24 and G191-B2B, were observed. Upper limits on the flux at 300 A were interpreted as lower limits on the interstellar hydrogen column densities to these stars. The lower limits indicate interstellar hydrogen densitites of greater than .02 cm -3 . Four nearby stars (Sirius, Procyon, Capella, and Mirzam) were observed in a search for intense low temperature coronae or extended chromospheres. No extreme ultraviolet radiation from these stars was detected, and upper limits to their coronal emisson measures are derived

Two case studies on NARCCAP precipitation extremes

Science.gov (United States)

Weller, Grant B.; Cooley, Daniel; Sain, Stephan R.; Bukovsky, Melissa S.; Mearns, Linda O.

2013-09-01

We introduce novel methodology to examine the ability of six regional climate models (RCMs) in the North American Regional Climate Change Assessment Program (NARCCAP) ensemble to simulate past extreme precipitation events seen in the observational record over two different regions and seasons. Our primary objective is to examine the strength of daily correspondence of extreme precipitation events between observations and the output of both the RCMs and the driving reanalysis product. To explore this correspondence, we employ methods from multivariate extreme value theory. These methods require that we account for marginal behavior, and we first model and compare climatological quantities which describe tail behavior of daily precipitation for both the observations and model output before turning attention to quantifying the correspondence of the extreme events. Daily precipitation in a West Coast region of North America is analyzed in two seasons, and it is found that the simulated extreme events from the reanalysis-driven NARCCAP models exhibit strong daily correspondence to extreme events in the observational record. Precipitation over a central region of the United States is examined, and we find some daily correspondence between winter extremes simulated by reanalysis-driven NARCCAP models and those seen in observations, but no such correspondence is found for summer extremes. Furthermore, we find greater discrepancies among the NARCCAP models in the tail characteristics of the distribution of daily summer precipitation over this region than seen in precipitation over the West Coast region. We find that the models which employ spectral nudging exhibit stronger tail dependence to observations in the central region.

Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

International Nuclear Information System (INIS)

Daghighi, Mohammad Hossein; Poureisa, Masoud; Arablou, Farid; Fouladi, Daniel F.

2015-01-01

Highlights: • MR imaging with straightened lower extremities was tested in spondylolisthesis. • This technique is more accurate than conventional MR imaging in detecting slip. • Level of spondylolisthesis is the only independent predictor of severity of slip. - Abstract: Objectives: To compare the degree of slip in spondylolisthesis on supine magnetic resonance (MR) images obtained with flexed and straightened lower extremities. Methods: Supine spinal MR studies were performed in 100 cases of symptomatic spondylolisthesis with flexed and then straightened lower extremities. The angle of lumbar lordosis (by Cobb's method) and the degree of slip (by Taillard's method) were compared between the two sets of images. Results: The mean angle of lumbar lordosis increased from 51.65 ± 8.57° on MR images with flexed lower limbs to 57.39 ± 9.05° on MR images with straightened lower limbs (p < 0.001; mean percent increase: 11.51%). Similar change was also observed for the mean degree of slip (from 25.80 ± 7.74% to 28.68 ± 7.93%, p < 0.001; mean percent increase: 12.60%). After MR imaging with straightened lower extremities 22 out of 54 initially grade I cases had grade II disease (p < 0.001). Conclusions: Supine magnetic resonance imaging with straightened lower extremities detects higher degree of slippage in symptomatic patients with spondylolisthesis compared to conventional MRI with flexed lower extremities

Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

Energy Technology Data Exchange (ETDEWEB)

Daghighi, Mohammad Hossein; Poureisa, Masoud; Arablou, Farid [Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz (Iran, Islamic Republic of); Fouladi, Daniel F., E-mail: medicorelax@yahoo.com [Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz (Iran, Islamic Republic of)

2015-05-15

Highlights: • MR imaging with straightened lower extremities was tested in spondylolisthesis. • This technique is more accurate than conventional MR imaging in detecting slip. • Level of spondylolisthesis is the only independent predictor of severity of slip. - Abstract: Objectives: To compare the degree of slip in spondylolisthesis on supine magnetic resonance (MR) images obtained with flexed and straightened lower extremities. Methods: Supine spinal MR studies were performed in 100 cases of symptomatic spondylolisthesis with flexed and then straightened lower extremities. The angle of lumbar lordosis (by Cobb's method) and the degree of slip (by Taillard's method) were compared between the two sets of images. Results: The mean angle of lumbar lordosis increased from 51.65 ± 8.57° on MR images with flexed lower limbs to 57.39 ± 9.05° on MR images with straightened lower limbs (p < 0.001; mean percent increase: 11.51%). Similar change was also observed for the mean degree of slip (from 25.80 ± 7.74% to 28.68 ± 7.93%, p < 0.001; mean percent increase: 12.60%). After MR imaging with straightened lower extremities 22 out of 54 initially grade I cases had grade II disease (p < 0.001). Conclusions: Supine magnetic resonance imaging with straightened lower extremities detects higher degree of slippage in symptomatic patients with spondylolisthesis compared to conventional MRI with flexed lower extremities.

How does public opinion become extreme?

Science.gov (United States)

Ramos, Marlon; Shao, Jia; Reis, Saulo D S; Anteneodo, Celia; Andrade, José S; Havlin, Shlomo; Makse, Hernán A

2015-05-19

We investigate the emergence of extreme opinion trends in society by employing statistical physics modeling and analysis on polls that inquire about a wide range of issues such as religion, economics, politics, abortion, extramarital sex, books, movies, and electoral vote. The surveys lay out a clear indicator of the rise of extreme views. The precursor is a nonlinear relation between the fraction of individuals holding a certain extreme view and the fraction of individuals that includes also moderates, e.g., in politics, those who are "very conservative" versus "moderate to very conservative" ones. We propose an activation model of opinion dynamics with interaction rules based on the existence of individual "stubbornness" that mimics empirical observations. According to our modeling, the onset of nonlinearity can be associated to an abrupt bootstrap-percolation transition with cascades of extreme views through society. Therefore, it represents an early-warning signal to forecast the transition from moderate to extreme views. Moreover, by means of a phase diagram we can classify societies according to the percolative regime they belong to, in terms of critical fractions of extremists and people's ties.

How does public opinion become extreme?

Science.gov (United States)

Ramos, Marlon; Shao, Jia; Reis, Saulo D. S.; Anteneodo, Celia; Andrade, José S.; Havlin, Shlomo; Makse, Hernán A.

2015-05-01

We investigate the emergence of extreme opinion trends in society by employing statistical physics modeling and analysis on polls that inquire about a wide range of issues such as religion, economics, politics, abortion, extramarital sex, books, movies, and electoral vote. The surveys lay out a clear indicator of the rise of extreme views. The precursor is a nonlinear relation between the fraction of individuals holding a certain extreme view and the fraction of individuals that includes also moderates, e.g., in politics, those who are “very conservative” versus “moderate to very conservative” ones. We propose an activation model of opinion dynamics with interaction rules based on the existence of individual “stubbornness” that mimics empirical observations. According to our modeling, the onset of nonlinearity can be associated to an abrupt bootstrap-percolation transition with cascades of extreme views through society. Therefore, it represents an early-warning signal to forecast the transition from moderate to extreme views. Moreover, by means of a phase diagram we can classify societies according to the percolative regime they belong to, in terms of critical fractions of extremists and people’s ties.

‘Paving the way for Extremism: How Preventing the Symptoms Does Not Cure the Disease of Terrorism’

Directory of Open Access Journals (Sweden)

Imran Awan

2011-11-01

Full Text Available The British government’s controversial counter-terrorism strategies and policies have come under fierce opposition with critics arguing it has not actually prevented extremism but has manifested itself into a political and ideological campaign that unfairly targets the Muslim community. Moreover, such strategies have marginalised the Muslim community in the UK from wider civic society and created an atmosphere of hate and anger. The Prime Minister of Great Britain, David Cameron in 2010, spoke at a conference in Munich about security, radicalisation, and multi-culturalism, sparking a debate about how the UK monitors and deals with extremism. Blaming the doctrine of ‘state-multiculturalism’ the British coalition government argued for a more ‘active muscular liberalism’ which would identify the root causes of extremist ideologies.  Moreover, this paranoia and hysteria has led to a social, political, moral and theological debate about Islamism, Muslims, and terrorism which is fuelled by the way Britain is portrayed across the world as a country where extremist organisations employ tactics of persuasion, indoctrination, radicalisation and the promotion of religious intolerance.

Sequences of extremal radially excited rotating black holes.

Science.gov (United States)

Blázquez-Salcedo, Jose Luis; Kunz, Jutta; Navarro-Lérida, Francisco; Radu, Eugen

2014-01-10

In the Einstein-Maxwell-Chern-Simons theory the extremal Reissner-Nordström solution is no longer the single extremal solution with vanishing angular momentum, when the Chern-Simons coupling constant reaches a critical value. Instead a whole sequence of rotating extremal J=0 solutions arises, labeled by the node number of the magnetic U(1) potential. Associated with the same near horizon solution, the mass of these radially excited extremal solutions converges to the mass of the extremal Reissner-Nordström solution. On the other hand, not all near horizon solutions are also realized as global solutions.

Complex Plasma Research Under Extreme Conditions

International Nuclear Information System (INIS)

Ishihara, Osamu

2008-01-01

Complex plasma research under extreme conditions is described. The extreme conditions include low-dimensionality for self-organized structures of dust particles, dust magnetization in high magnetic field, criticality in phase transition, and cryogenic environment for Coulomb crystals and dust dynamics.

Portable upper extremity robotics is as efficacious as upper extremity rehabilitative therapy: a randomized controlled pilot trial.

Science.gov (United States)

Page, Stephen J; Hill, Valerie; White, Susan

2013-06-01

To compare the efficacy of a repetitive task-specific practice regimen integrating a portable, electromyography-controlled brace called the 'Myomo' versus usual care repetitive task-specific practice in subjects with chronic, moderate upper extremity impairment. Sixteen subjects (7 males; mean age 57.0 ± 11.02 years; mean time post stroke 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Subjects were administered repetitive task-specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30 minutes in duration, occurring 3 days/week for eight weeks. One group participated in repetitive task-specific practice entirely while wearing the portable robotic, while the other performed the same activity regimen manually. The upper extremity Fugl-Meyer, Canadian Occupational Performance Measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. After intervention, groups exhibited nearly identical Fugl-Meyer score increases of ≈2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian Occupational Performance Measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Findings suggest that therapist-supervised repetitive task-specific practice integrating robotics is as efficacious as manual practice in subjects with moderate upper extremity impairment.

Extreme project. Progress report 2006; Projet EXTREME. Rapport d'avancement 2006

Energy Technology Data Exchange (ETDEWEB)

Eyrolle, F.; Masson, O.; Charmasson, S

2007-07-01

The E.X.T.R.E.M.E. project introduced in 2005 to the S.E.S.U.R.E. / L.E.R.C.M. has for objectives to acquire data on the consequences of the extreme climatic meteorological episodes on the distribution of the artificial radioisotopes within the various compartments of the geosphere. This report presents the synthesis of the actions developed in 2006 in positioning and in co financing of the project by means of regional or national research programs (C.A.R.M.A., E.X.T.R.E.M.A., E.C.C.O.R.E.V.I.), of data acquisition, valuation and scientific collaboration. (N.C.)

Modeling extreme PM10 concentration in Malaysia using generalized extreme value distribution

Science.gov (United States)

Hasan, Husna; Mansor, Nadiah; Salleh, Nur Hanim Mohd

2015-05-01

Extreme PM10 concentration from the Air Pollutant Index (API) at thirteen monitoring stations in Malaysia is modeled using the Generalized Extreme Value (GEV) distribution. The data is blocked into monthly selection period. The Mann-Kendall (MK) test suggests a non-stationary model so two models are considered for the stations with trend. The likelihood ratio test is used to determine the best fitted model and the result shows that only two stations favor the non-stationary model (Model 2) while the other eleven stations favor stationary model (Model 1). The return level of PM10 concentration that is expected to exceed the maximum once within a selected period is obtained.

Event-adjusted evaluation of weather and climate extremes

Czech Academy of Sciences Publication Activity Database

Müller, Miloslav; Kašpar, Marek

2014-01-01

Roč. 14, č. 2 (2014), s. 473-483 ISSN 1561-8633 R&D Projects: GA ČR(CZ) GAP209/11/1990 Institutional support: RVO:68378289 Keywords : weather extreme * climate extreme * extremity evaluation * return period * generalized extreme value distribution * region of influence Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 1.735, year: 2014 http://www.nat-hazards- earth -syst-sci.net/14/473/2014/nhess-14-473-2014.pdf

Bilateral Testicular Tumors Resulting in Recurrent Cushing Disease After Bilateral Adrenalectomy

NARCIS (Netherlands)

Puar, T.; Engels, M.; Herwaarden, A.E. van; Sweep, F.C.; Hulsbergen-van de Kaa, C.A.; Kamphuis-van Ulzen, K.; Chortis, V.; Arlt, W.; Stikkelbroeck, N.; Claahsen-van der Grinten, H.L.; Hermus, A.R.M.M.

2017-01-01

Context: Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing disease is extremely rare. Patient: We present a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing disease with complete clinical resolution. Cushingoid features recurred 12 years

Prevention of Lower Extremity Injuries in Basketball

Science.gov (United States)

Taylor, Jeffrey B.; Ford, Kevin R.; Nguyen, Anh-Dung; Terry, Lauren N.; Hegedus, Eric J.

2015-01-01

Context: Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates. Objective: To analyze the effectiveness of current lower extremity injury prevention programs in basketball athletes, focusing on injury rates of (1) general lower extremity injuries, (2) ankle sprains, and (3) anterior cruciate ligament (ACL) tears. Data Sources: PubMed, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Register of Controlled Trials were searched in January 2015. Study Selection: Studies were included if they were randomized controlled or prospective cohort trials, contained a population of competitive basketball athletes, and reported lower extremity injury incidence rates specific to basketball players. In total, 426 individual studies were identified. Of these, 9 met the inclusion criteria. One other study was found during a hand search of the literature, resulting in 10 total studies included in this meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 2. Data Extraction: Details of the intervention (eg, neuromuscular vs external support), size of control and intervention groups, and number of injuries in each group were extracted from each study. Injury data were classified into 3 groups based on the anatomic diagnosis reported (general lower extremity injury, ankle sprain, ACL rupture). Results: Meta-analyses were performed independently for each injury classification. Results indicate that prophylactic programs significantly reduced the incidence of general lower extremity injuries (odds ratio [OR], 0.69; 95% CI, 0.57-0.85; P basketball athletes. Conclusion: In basketball players, prophylactic programs may be effective in reducing the risk of general lower extremity injuries and ankle sprains, yet not ACL injuries. PMID:26502412

Extreme Weather Events and Climate Change Attribution

Energy Technology Data Exchange (ETDEWEB)

Thomas, Katherine [National Academy of Sciences, Washington, DC (United States)

2016-03-31

A report from the National Academies of Sciences, Engineering, and Medicine concludes it is now possible to estimate the influence of climate change on some types of extreme events. The science of extreme event attribution has advanced rapidly in recent years, giving new insight to the ways that human-caused climate change can influence the magnitude or frequency of some extreme weather events. This report examines the current state of science of extreme weather attribution, and identifies ways to move the science forward to improve attribution capabilities. Confidence is strongest in attributing types of extreme events that are influenced by climate change through a well-understood physical mechanism, such as, the more frequent heat waves that are closely connected to human-caused global temperature increases, the report finds. Confidence is lower for other types of events, such as hurricanes, whose relationship to climate change is more complex and less understood at present. For any extreme event, the results of attribution studies hinge on how questions about the event's causes are posed, and on the data, modeling approaches, and statistical tools chosen for the analysis.

Sensitivity of European wheat to extreme weather

DEFF Research Database (Denmark)

Mäkinen, H; Kaseva, J; Trnka, M

2018-01-01

The frequency and intensity of extreme weather is increasing concomitant with changes in the global climate change. Although wheat is the most important food crop in Europe, there is currently no comprehensive empirical information available regarding the sensitivity of European wheat to extreme...... weather. In this study, we assessed the sensitivity of European wheat yields to extreme weather related to phenology (sowing, heading) in cultivar trials across Europe (latitudes 37.21° to 61.34° and longitudes −6.02° to 26.24°) during the period 1991–2014. All the observed agro-climatic extremes (≥31 °C...... wheat cultivars that responded positively (+10%) to drought after sowing, or frost during winter (−15 °C and −20 °C). Positive responses to extremes were often shown by cultivars associated with specific regions, such as good performance under high temperatures by southern-origin cultivars. Consequently...

[Crossing borders. The motivation of extreme sportsmen].

Science.gov (United States)

Opaschowski, H W

2005-08-01

In his article "Crossing borders -- the motivation of extreme sportsmen" the author gets systematically to the bottom of the question of why extreme sportsmen voluntarily take risks and endanger themselves. Within the scope of a representative sampling 217 extreme sportsmen -- from the fields of mountain biking, trekking and free climbing, canoyning, river rafting and deep sea diving, paragliding, parachuting, bungee jumping and survival training -- give information about their personal motives. What fascinates them? The attraction of risk? The search for sensation? Or the drop out of everyday life? And what comes afterwards? Does in the end the whole life become an extreme sport? Fact is: they live extremely, because they want to move beyond well-trodden paths. To escape the boredom of everyday life they are searching for the kick, the thrill, the no-limit experience. It's about calculated risk between altitude flight and deep sea adventure.

Is prescribed lower extremity weight-bearing status after geriatric lower extremity trauma associated with increased mortality?

Science.gov (United States)

Gitajn, Ida Leah; Connelly, Daniel; Mascarenhas, Daniel; Breazeale, Stephen; Berger, Peter; Schoonover, Carrie; Martin, Brook; O'Toole, Robert V; Pensy, Raymond; Sciadini, Marcus

2018-02-01

Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p bearing as tolerated on BLE, restricted weight-bearing on one lower extremity had a hazard ratio (HR) of 0.97 (95% confidence interval 0.78 to 1.20, p = 0.76) and restricted weight-bearing in BLE had a HR of 0.91 (95% confidence interval 0.60 to 1.36, p = 0.73). In geriatric patients, prescribed weight-bearing status did not have a statistically significant association with mortality after discharge, when controlling for age, sex, body mass index, medical comorbidities, Injury Severity Scale (ISS), mechanism of injury, nonoperative treatment and admission GCS. This remained true in when the analysis was restricted to operative injuries only. Copyright © 2017 Elsevier Ltd. All rights reserved.

Variable ultrasonography findings of extremity lymphangioma: Pathologic correlation

International Nuclear Information System (INIS)

Oh, Jong Young; Nam, Kyung Jin; Lee, Ki Nam; Kim, Chan Sung; Lee, Jin Hwa; Kim, Dae Chul

2002-01-01

The great majority of lymphangiomas occur in the neck (75%) and axilla (20%), but extremity lymphangioma is rare. We correlate variable sonographic features of extremity lymphangioma with pathologic findings. We reviewed the sonographic findings of extremity lymphangioma in 14 patients (M:F=8:6). The all cases were histologically confirmed by operation. The variable sonographic features of extremity lymphangioma were compared to pathologic findings. The multilocular cystic mass with ill defined boundaries was distinctive sonographic appearance of extremity lymphangioma. But there were variable sonographic findings such as heterogeneous echogenic mass or homogeneous echogenic portion. The histologic section of echogenic lesion reveals clusters of abnormal

Are extreme hydro-meteorological events a prerequisite for extreme water quality impacts? Exploring climate impacts on inland and coastal waters

Science.gov (United States)

Michalak, A. M.; Balaji, V.; Del Giudice, D.; Sinha, E.; Zhou, Y.; Ho, J. C.

2017-12-01

Questions surrounding water sustainability, climate change, and extreme events are often framed around water quantity - whether too much or too little. The massive impacts of extreme water quality impairments are equally compelling, however. Recent years have provided a host of compelling examples, with unprecedented harmful algal blooms developing along the West coast, in Utah Lake, in Lake Erie, and off the Florida coast, and huge hypoxic dead zones continuing to form in regions such as Lake Erie, the Chesapeake Bay, and the Gulf of Mexico. Linkages between climate change, extreme events, and water quality impacts are not well understood, however. Several factors explain this lack of understanding, including the relative complexity of underlying processes, the spatial and temporal scale mismatch between hydrologists and climatologists, and observational uncertainty leading to ambiguities in the historical record. Here, we draw on a number of recent studies that aim to quantitatively link meteorological variability and water quality impacts to test the hypothesis that extreme water quality impairments are the result of extreme hydro-meteorological events. We find that extreme hydro-meteorological events are neither always a necessary nor a sufficient condition for the occurrence of extreme water quality impacts. Rather, extreme water quality impairments often occur in situations where multiple contributing factors compound, which complicates both attribution of historical events and the ability to predict the future incidence of such events. Given the critical societal importance of water quality projections, a concerted program of uncertainty reduction encompassing observational and modeling components will be needed to examine situations where extreme weather plays an important, but not solitary, role in the chain of cause and effect.

A Fourier analysis of extremal events

DEFF Research Database (Denmark)

Zhao, Yuwei

is the extremal periodogram. The extremal periodogram shares numerous asymptotic properties with the periodogram of a linear process in classical time series analysis: the asymptotic distribution of the periodogram ordinates at the Fourier frequencies have a similar form and smoothed versions of the periodogram...

Spectral density regression for bivariate extremes

KAUST Repository

Castro Camilo, Daniela

2016-05-11

We introduce a density regression model for the spectral density of a bivariate extreme value distribution, that allows us to assess how extremal dependence can change over a covariate. Inference is performed through a double kernel estimator, which can be seen as an extension of the Nadaraya–Watson estimator where the usual scalar responses are replaced by mean constrained densities on the unit interval. Numerical experiments with the methods illustrate their resilience in a variety of contexts of practical interest. An extreme temperature dataset is used to illustrate our methods. © 2016 Springer-Verlag Berlin Heidelberg

Modeling, Forecasting and Mitigating Extreme Earthquakes

Science.gov (United States)

Ismail-Zadeh, A.; Le Mouel, J.; Soloviev, A.

2012-12-01

Recent earthquake disasters highlighted the importance of multi- and trans-disciplinary studies of earthquake risk. A major component of earthquake disaster risk analysis is hazards research, which should cover not only a traditional assessment of ground shaking, but also studies of geodetic, paleoseismic, geomagnetic, hydrological, deep drilling and other geophysical and geological observations together with comprehensive modeling of earthquakes and forecasting extreme events. Extreme earthquakes (large magnitude and rare events) are manifestations of complex behavior of the lithosphere structured as a hierarchical system of blocks of different sizes. Understanding of physics and dynamics of the extreme events comes from observations, measurements and modeling. A quantitative approach to simulate earthquakes in models of fault dynamics will be presented. The models reproduce basic features of the observed seismicity (e.g., the frequency-magnitude relationship, clustering of earthquakes, occurrence of extreme seismic events). They provide a link between geodynamic processes and seismicity, allow studying extreme events, influence of fault network properties on seismic patterns and seismic cycles, and assist, in a broader sense, in earthquake forecast modeling. Some aspects of predictability of large earthquakes (how well can large earthquakes be predicted today?) will be also discussed along with possibilities in mitigation of earthquake disasters (e.g., on 'inverse' forensic investigations of earthquake disasters).

Instability of extremal relativistic charged spheres

International Nuclear Information System (INIS)

Anninos, Peter; Rothman, Tony

2002-01-01

With the question 'Can relativistic charged spheres form extremal black holes?' in mind, we investigate the properties of such spheres from a classical point of view. The investigation is carried out numerically by integrating the Oppenheimer-Volkov equation for relativistic charged fluid spheres and finding interior Reissner-Nordstroem solutions for these objects. We consider both constant density and adiabatic equations of state, as well as several possible charge distributions, and examine stability by both a normal mode and an energy analysis. In all cases, the stability limit for these spheres lies between the extremal (Q=M) limit and the black hole limit (R=R + ). That is, we find that charged spheres undergo gravitational collapse before they reach Q=M, suggesting that extremal Reissner-Nordstroem black holes produced by collapse are ruled out. A general proof of this statement would support a strong form of the cosmic censorship hypothesis, excluding not only stable naked singularities, but stable extremal black holes. The numerical results also indicate that although the interior mass-energy m(R) obeys the usual m/R + as Q→M. In the Appendix we also argue that Hawking radiation will not lead to an extremal Reissner-Nordstroem black hole. All our results are consistent with the third law of black hole dynamics, as currently understood

Colour atlas on forest disease. Diagnosis of tree diseases. Farbatlas Waldschaeden. Diagnose von Baumkrankheiten

Energy Technology Data Exchange (ETDEWEB)

Hartmann, G.; Winter, K.; Nienhaus, F.; Butin, H.

1988-01-01

The 'Colour Atlas on Forest Disease' facilitates the diagnosis of syndromes due to different causes in 16 genera or species of forest trees. It contains a selection of more than 200 important, frequent, or conspicuous disease phenomena. These include: in a ratio of 8 percent partly novel, complex diseases due to causes not entirely elucidated, 35 percent known forms of damage of abiotic origin (extreme weather conditions, nutrient deficiency, classical damage due to environmental pollution and de-icing salt, damage through herbicides), and 57 percent diseases and harm of biotic origin (fungal infections, infestation with insect pest, bacterial, mycoplasmal, rickettsia-type and viral diseases, other damage). 418 colour photographs show characteristic features of tree diseases and provide clues to causes and possible alternative diseases liable to be mixed up with the actual one. The selection decided on is restricted to symptoms visible externally in the area of the crowns as far as they are distinguishable in the field. (orig./MG) With 418 colour photographs.

Modelling of extreme minimum rainfall using generalised extreme value distribution for Zimbabwe

Directory of Open Access Journals (Sweden)

Delson Chikobvu

2015-09-01

Full Text Available We modelled the mean annual rainfall for data recorded in Zimbabwe from 1901 to 2009. Extreme value theory was used to estimate the probabilities of meteorological droughts. Droughts can be viewed as extreme events which go beyond and/or below normal rainfall occurrences, such as exceptionally low mean annual rainfall. The duality between the distribution of the minima and maxima was exploited and used to fit the generalised extreme value distribution (GEVD to the data and hence find probabilities of extreme low levels of mean annual rainfall. The augmented Dickey Fuller test confirmed that rainfall data were stationary, while the normal quantile-quantile plot indicated that rainfall data deviated from the normality assumption at both ends of the tails of the distribution. The maximum likelihood estimation method and the Bayesian approach were used to find the parameters of the GEVD. The Kolmogorov-Smirnov and Anderson-Darling goodnessof- fit tests showed that the Weibull class of distributions was a good fit to the minima mean annual rainfall using the maximum likelihood estimation method. The mean return period estimate of a meteorological drought using the threshold value of mean annual rainfall of 473 mm was 8 years. This implies that if in the year there is a meteorological drought then another drought of the same intensity or greater is expected after 8 years. It is expected that the use of Bayesian inference may better quantify the level of uncertainty associated with the GEVD parameter estimates than with the maximum likelihood estimation method. The Markov chain Monte Carlo algorithm for the GEVD was applied to construct the model parameter estimates using the Bayesian approach. These findings are significant because results based on non-informative priors (Bayesian method and the maximum likelihood method approach are expected to be similar.

AN EXTREMELY CARBON-RICH, EXTREMELY METAL-POOR STAR IN THE SEGUE 1 SYSTEM

International Nuclear Information System (INIS)

Norris, John E.; Yong, David; Gilmore, Gerard; Wyse, Rosemary F. G.; Frebel, Anna

2010-01-01

We report the analysis of high-resolution, high signal-to-noise ratio, spectra of an extremely metal-poor, extremely C-rich red giant, Seg 1-7, in Segue 1-described in the literature alternatively as an unusually extended globular cluster or an ultra-faint dwarf galaxy. The radial velocity of Seg 1-7 coincides precisely with the systemic velocity of Segue 1, and its chemical abundance signature of [Fe/H] = -3.52, [C/Fe] = +2.3, [N/Fe] = +0.8, [Na/Fe] = +0.53, [Mg/Fe] = +0.94, [Al/Fe] = +0.23, and [Ba/Fe] < -1.0 is similar to that of the rare and enigmatic class of Galactic halo objects designated CEMP-no (carbon-rich, extremely metal-poor with no enhancement (over solar ratios) of heavy neutron-capture elements). This is the first star in a Milky Way 'satellite' that unambiguously lies on the metal-poor, C-rich branch of the Aoki et al. bimodal distribution of field halo stars in the ([C/Fe], [Fe/H])-plane. Available data permit us only to identify Seg 1-7 as a member of an ultra-faint dwarf galaxy or as debris from the Sgr dwarf spheroidal galaxy. In either case, this demonstrates that at extremely low abundance, [Fe/H ] <-3.0, star formation and associated chemical evolution proceeded similarly in the progenitors of both the field halo and satellite systems. By extension, this is consistent with other recent suggestions that the most metal-poor dwarf spheroidal and ultra-faint dwarf satellites were the building blocks of the Galaxy's outer halo.

Modeling of the blood flow in the lower extremities for dynamic diffuse optical tomography of peripheral artery disease

Science.gov (United States)

Marone, A.; Hoi, J. W.; Khalil, M. A.; Kim, H. K.; Shrikhande, G.; Dayal, R.; Hielscher, A. H.

2015-07-01

Peripheral Arterial Disease (PAD) is caused by a reduction of the internal diameters of the arteries in the upper or lower extremities mainly due to atherosclerosis. If not treated, its worsening may led to a complete occlusion, causing the death of the cells lacking proper blood supply, followed by gangrene that may require chirurgical amputation. We have recently performed a clinical study in which good sensitivities and specificities were achieved with dynamic diffuse optical tomography. To gain a better understanding of the physiological foundations of many of the observed effects, we started to develop a mathematical model for PAD. The model presented in this work is based on a multi-compartment Windkessel model, where the vasculature in the leg and foot is represented by resistors and capacitors, the blood pressure with a voltage drop, and the blood flow with a current. Unlike existing models, the dynamics induced by a thigh-pressure-cuff inflation and deflation during the measurements are taken into consideration. This is achieved by dynamically varying the resistances of the large veins and arteries. By including the effects of the thigh-pressure cuff, we were able to explain many of the effects observed during our dynamic DOT measurements, including the hemodynamics of oxy- and deoxy-hemoglobin concentration changes. The model was implemented in MATLAB and the simulations were normalized and compared with the blood perfusion obtained from healthy, PAD and diabetic patients. Our preliminary results show that in unhealthy patients the total system resistance is sensibly higher than in healthy patients.

Extremism from the perspective of a system approach

Directory of Open Access Journals (Sweden)

Zinchenko, Yury P.

2014-03-01

Full Text Available Extremism is seen as a complex, multilevel, and multicomponent phenomenon. The problems of modern science in understanding extremism are revealed. The following bases of extremism as a system phenomenon are singled out: social factors, latent extremism, and extremist acts. It is demonstrated that a system approach makes it possible to shape a notion of a subject as a system, to identify patterns of the manifestations of the given phenomenon, and to translate them into concrete practices.

Extremity x-ray

Science.gov (United States)

... page: //medlineplus.gov/ency/article/003461.htm Extremity x-ray To use the sharing features on this page, ... in the body Risks There is low-level radiation exposure. X-rays are monitored and regulated to provide the ...

Statistics of Extremes

KAUST Repository

Davison, Anthony C.; Huser, Raphaë l

2015-01-01

Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event

Motor relearning program and Bobath method improve motor function of the upper extremities in patients with stroke

Institute of Scientific and Technical Information of China (English)

Jinjing Liu; Fengsheng Li; Guihua Liu

2006-01-01

BACKGROUND: In the natural evolution of cerebrovascular disease, unconscious use of affected extremity during drug treatment and daily life can improve the function of affected upper extremity partially, but it is very slow and alsc accompanied by the formation of abnormal mode. Therefore, functional training should be emphasized in recovering the motor function of extremity.OBJECTIVE: To observe the effects of combination of motor relearning program and Bobath method on motor function of upper extremity of patients with stroke.DESIGN: Comparison of therapeutic effects taking stroke patients as observation subjects.SETTING: Department of Neurology, General Hospital of Beijing Jingmei Group.PARTICIPANTS: Totally 120 stroke patients, including 60 males and 60 females, averaged (59±3) years, who hospitalized in the Department of Neurology, General Hospital of Beijing Jingmei Group between January 2005 and June 2006 were recruited. The involved patients met the following criteria: Stroke attack within 2 weeks;diagnosis criteria of cerebral hemorrhage or infarction made in the 4th National Cerebrovascular Disease Conference; confirmed by skull CT or MRI; Informed consents of therapeutic regimen were obtained. The patients were assigned into 2 groups according to their wills: rehabilitation group and control group, with 30 males and 30 females in each group. Patients in rehabilitation group averaged (59±2)years old, and those in the control group averaged (58±2)years old.METHODS: ① Patients in two groups received routine treatment in the Department of Neurology. When the vital signs of patients in the rehabilitation group were stable, individualized treatment was conducted by combined application of motor relearning program and Bobath method. Meanwhile, training of activity of daily living was performed according to the disease condition changes of patients at different phases, including the nursing and instruction of body posture, the maintenance of good extremity

MR manifestation of lower extremity rhabdomyolysis caused by crush injury in earthquake

International Nuclear Information System (INIS)

Li Zhengyan; Zou Ling; Song Bin; Liu Chang; Sun Jiayu; Zhang Weiwei; Zhang Cuiping

2008-01-01

Objective: Rhabdomyolysis (RM) is a common disorder resulting from a large variety of causes. Acute injury is one of the main reasons. The purpose is to describe the MRI manifestations of rhabdomyolysis caused by 5.12 Wenchuan earthquake in Sichuan province and to discuss their importance in diagnosis and treatment of rhabdomyolysison in clinic practice. Methods: Three patients with rhabdomyolysis caused by earthquake were studied via 1.5 T MRI. In all the patients, T 1 and T 2 weighted sequences with and without fat suppression, and short time inversion recovery (STIR) of both lower extremities were obtained in axial, coronal and sagittal planes. All patients were given contrast material during imaging, and MRA (magnetic resonance angiography) of both lower extremity vessels were performed. The MRI characteristics of damaged extremities in 3 cases were studied. Results: MRI showed swelling of the affected muscles and subcutaneous fat tissue on both T 1 and T 2 weighted images. The margins of involved muscles were blurred. On T 1 weighted images, swollen muscles showed equal or slightly decreased intensity with small patterns of increased intensity in some local areas. On T 2 weighted and STIR sequences, the affected muscles showed inhomogeneous increased signal intensity with clearer margin. Slight fluid collection in spatium intermusculare was observed. Contrast-enhanced scanning showed nonhomologous intensification of damaged muscles, the enhancement inside the muscles was decreased when compared with normal muscles. The locations of all these abnormal intensity were correlated with the injury history and clinic physical examinations. MRA showed no lower extremity vessels were affected. Conclusion: MRI has very high sensitivity in detecting the injury of muscles. It's very useful in evaluating the extent and severity of muscles affected in rhabdomyolysis caused by trauma. Also it's very valuable to evaluate the condition of blood vessels in involved extremity

Seasonal temperature extremes in Potsdam

Science.gov (United States)

Kundzewicz, Zbigniew; Huang, Shaochun

2010-12-01

The awareness of global warming is well established and results from the observations made on thousands of stations. This paper complements the large-scale results by examining a long time-series of high-quality temperature data from the Secular Meteorological Station in Potsdam, where observation records over the last 117 years, i.e., from January 1893 are available. Tendencies of change in seasonal temperature-related climate extremes are demonstrated. "Cold" extremes have become less frequent and less severe than in the past, while "warm" extremes have become more frequent and more severe. Moreover, the interval of the occurrence of frost has been decreasing, while the interval of the occurrence of hot days has been increasing. However, many changes are not statistically significant, since the variability of temperature indices at the Potsdam station has been very strong.

Extensive Thrombophlebitis in a patient with Behçet's disease ...

African Journals Online (AJOL)

Behçet's disease (BD) is a systemic vasculitis of unknown origin. It is well established that Behçet's disease predisposes strongly to venous and arterial thrombosis and recurrent superficial and deep thrombophlebitis of the lower extremities. There are different considerations about the pathogenesis of the vascular ...

Krabbe disease: in a Nigerian child | Frank-Briggs | Port Harcourt ...

African Journals Online (AJOL)

Aim: To report an extremely rare inheritable neurodegenerative disease (Krabbe disease). Case report: A five-year-old male presented to the Paediatric Neurology unit with a history of sudden loss of vision, deafness and impaired motor function. He had difficulty in walking, sudden blindness and deafness which were ...

Brazil's neglected tropical diseases: an overview and a report card.

Science.gov (United States)

Hotez, Peter J; Fujiwara, Ricardo T

2014-08-01

Today, the nation of Brazil leads the Western Hemisphere in terms of the number of its citizens living with neglected tropical diseases (NTDs). These diseases continue to trap Brazil's "bottom 20 million" in extreme poverty. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

(When and where) Do extreme climate events trigger extreme ecosystem responses? - Development and initial results of a holistic analysis framework

Science.gov (United States)

Hauber, Eva K.; Donner, Reik V.

2015-04-01

In the context of ongoing climate change, extremes are likely to increase in magnitude and frequency. One of the most important consequences of these changes is that the associated ecological risks and impacts are potentially rising as well. In order to better anticipate and understand these impacts, it therefore becomes more and more crucial to understand the general connection between climate extremes and the response and functionality of ecosystems. Among other region of the world, Europe presents an excellent test case for studies concerning the interaction between climate and biosphere, since it lies in the transition region between cold polar and warm tropical air masses and thus covers a great variety of different climatic zones and associated terrestrial ecosystems. The large temperature differences across the continent make this region particularly interesting for investigating the effects of climate change on biosphere-climate interactions. However, previously used methods for defining an extreme event typically disregard the necessity of taking seasonality as well as seasonal variance appropriately into account. Furthermore, most studies have focused on the impacts of individual extreme events instead of considering a whole inventory of extremes with their respective spatio-temporal extents. In order to overcome the aforementioned research gaps, this work introduces a new approach to studying climate-biosphere interactions associated with extreme events, which comprises three consecutive steps: (1) Since Europe exhibits climatic conditions characterized by marked seasonality, a novel method is developed to define extreme events taking into account the seasonality in all quantiles of the probability distribution of the respective variable of interest. This is achieved by considering kernel density estimates individually for each observation date during the year, including the properly weighted information from adjacent dates. By this procedure, we obtain

Extreme value paradigm for the effect of size of target volume on end results in radiation oncology

International Nuclear Information System (INIS)

Herbert, D.E.

1983-01-01

In clinical radiation oncology, it is commonly reported that complications of normal tissue occur more readily at larger field sizes for a given dose and recurrence of disease is observed more frequently from the larger tumors for a given dose. Cognate phenomena have long been observed in the study of the strength of materials. That is, the larger specimens will fracture under less applied stress, breakdown under less applied voltage, corrode in a shorter time, etc. The statistical theory of extreme values has provided both a rational explanation and a technique for exploitation of these ''size effects'' on the likelihood of specimen failure. This theory describes the relation which exists between the parameters (in particular, the location parameter) of the frequency distributions of the extreme values [smallest x(1) and largest x(n)] in a sample from a population of observations xi and the sample size n. It is shown in the present paper that the clinical failure phenomena are not inconsistent with the statistical theory of extreme values. The paper presents heuristic comparisons of the predictions of this theory with the received clinical observations of the effect of the size of the volume of irradiated tissues on the likelihood of occurrence of the misadventures of clinical radiation oncology: recurrence of disease and complication of normal tissue. The concordance of observations and predictions is acceptable. The quality and quantity of the currently available data have precluded the construction of any apodictic representations

Extremely low-frequency magnetic exposure appears to have no effect on pathogenesis of Alzheimer's disease in aluminum-overloaded rat.

Directory of Open Access Journals (Sweden)

Cheng Zhang

Full Text Available OBJECTIVE: Extremely low-frequency magnetic field (ELF-MF has been reported to be of potential pathogenetic relevance to Alzheimer's disease (AD for years. However, evidence confirming this function remains inconclusive. Chronic Al treatment has been identified as a contributing factor to cognitive function impairment in AD. This study aims to examine whether or not ELF-MF and Al have synergistic effects toward AD pathogenesis by investigating the effects of ELF-MF with or without chronic Al treatment on SD rats. METHODS: Sprague-Dawley (SD rats were subjected one of the following treatments: sham (control group, oral Al (Al group, ELF-MF (100 µT at 50 Hz with oral Al (MF+Al group, or ELF-MF (100 µT at 50 Hz without oral Al (MF group. RESULTS: After 12 wk of treatment, oral Al treatment groups (Al and MF+Al groups showed learning and memory impairment as well as morphological hallmarks, including neuronal cell loss and high density of amyloid-β (Aβ in the hippocampus and cerebral cortex. ELF-MF without Al treatment showed no significant effect on AD pathogenesis. ELF-MF+Al treatment induced no more damage than Al treatment did. CONCLUSIONS: Our results showed no evidence of any association between ELF-MF exposure (100 µT at 50 Hz and AD, and ELF-MF exposure does not influence the pathogenesis of AD induced by Al overload.

Comparison of the Effects of Walking with and without Nordic Pole on Upper Extremity and Lower Extremity Muscle Activation.

Science.gov (United States)

Shim, Je-Myung; Kwon, Hae-Yeon; Kim, Ha-Roo; Kim, Bo-In; Jung, Ju-Hyeon

2013-12-01

[Purpose] The aim of this study was to assess the effect of Nordic pole walking on the electromyographic activities of upper extremity and lower extremity muscles. [Subjects and Methods] The subjects were randomly divided into two groups as follows: without Nordic pole walking group (n=13) and with Nordic pole walking group (n=13). The EMG data were collected by measurement while the subjects walking on a treadmill for 30 minutes by measuring from one heel strike to the next. [Results] Both the average values and maximum values of the muscle activity of the upper extremity increased in both the group that used Nordic poles and the group that did not use Nordic poles, and the values showed statistically significant differences. There was an increase in the average value for muscle activity of the latissimus dorsi, but the difference was not statistically significant, although there was a statistically significant increase in its maximum value. The average and maximum values for muscle activity of the lower extremity did not show large differences in either group, and the values did not show any statistically significant differences. [Conclusion] The use of Nordic poles by increased muscle activity of the upper extremity compared with regular walking but did not affect the lower extremity.

Adventure and Extreme Sports.

Science.gov (United States)

Gomez, Andrew Thomas; Rao, Ashwin

2016-03-01

Adventure and extreme sports often involve unpredictable and inhospitable environments, high velocities, and stunts. These activities vary widely and include sports like BASE jumping, snowboarding, kayaking, and surfing. Increasing interest and participation in adventure and extreme sports warrants understanding by clinicians to facilitate prevention, identification, and treatment of injuries unique to each sport. This article covers alpine skiing and snowboarding, skateboarding, surfing, bungee jumping, BASE jumping, and whitewater sports with emphasis on epidemiology, demographics, general injury mechanisms, specific injuries, chronic injuries, fatality data, and prevention. Overall, most injuries are related to overuse, trauma, and environmental or microbial exposure. Copyright © 2016 Elsevier Inc. All rights reserved.

Atomic collisions under extreme conditions in space

International Nuclear Information System (INIS)

Itikawa, Yukikazu

1987-01-01

In space, atoms and molecules are often placed under the extreme conditions which are very difficult to be realized on Earth. For instance, extremely hot and dense plasmas are found in and around various stellar objects (e.g., neutron stars) on one hand and extremely cold and diffuse gases prevail in interstellar space on the other. There is so strong a magnetic field that electron clouds in atoms and molecules are distorted. The study of atomic collisions under the extreme conditions is not only helpful in understanding the astrophysical environment but also reveals new aspects of the physics of atoms and molecules. This paper is an invitation to the study. (References are not exhaustive but only provide a clue with which more details can be found.) (author)

Multidecadal oscillations in rainfall and hydrological extremes

Science.gov (United States)

Willems, Patrick

2013-04-01

Many studies have anticipated a worldwide increase in the frequency and intensity of precipitation extremes and floods since the last decade(s). Natural variability by climate oscillations partly determines the observed evolution of precipitation extremes. Based on a technique for the identification and analysis of changes in extreme quantiles, it is shown that hydrological extremes have oscillatory behaviour at multidecadal time scales. Results are based on nearly independent extremes extracted from long-term historical time series of precipitation intensities and river flows. Study regions include Belgium - The Netherlands (Meuse basin), Ethiopia (Blue Nile basin) and Ecuador (Paute basin). For Belgium - The Netherlands, the past 100 years showed larger and more hydrological extremes around the 1910s, 1950-1960s, and more recently during the 1990-2000s. Interestingly, the oscillations for southwestern Europe are anti-correlated with these of northwestern Europe, thus with oscillation highs in the 1930-1940s and 1970s. The precipitation oscillation peaks are explained by persistence in atmospheric circulation patterns over the North Atlantic during periods of 10 to 15 years. References: Ntegeka V., Willems P. (2008), 'Trends and multidecadal oscillations in rainfall extremes, based on a more than 100 years time series of 10 minutes rainfall intensities at Uccle, Belgium', Water Resources Research, 44, W07402, doi:10.1029/2007WR006471 Mora, D., Willems, P. (2012), 'Decadal oscillations in rainfall and air temperature in the Paute River Basin - Southern Andes of Ecuador', Theoretical and Applied Climatology, 108(1), 267-282, doi:0.1007/s00704-011-0527-4 Taye, M.T., Willems, P. (2011). 'Influence of climate variability on representative QDF predictions of the upper Blue Nile Basin', Journal of Hydrology, 411, 355-365, doi:10.1016/j.jhydrol.2011.10.019 Taye, M.T., Willems, P. (2012). 'Temporal variability of hydro-climatic extremes in the Blue Nile basin', Water

Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the pelvis and lower extremity: Diagnosis and treatment. Part 3

Directory of Open Access Journals (Sweden)

A. E. Karateev

2015-01-01

Full Text Available Pain associated with rheumatic diseases of juxta-articular soft tissues (RDJAST of the pelvis and lower extremity is a frequent reason for seeking advice from general practitioners and rheumatologists. However, the true cause of painful sensations is often overlooked by a physician and the patient is long and frequently treated unsuccessfully for lumbago, coxarthrosis, or gonarthrosis.The complexities of topical diagnosis are largely associated with the fact that instrumental methods virtually always determine these or those degenerative changes in the lumbar spine and hip joint (HJ, which formally supports the presence of nonspecific low back pain and coxarthrosis. Differential diagnosis can be made between these conditions if their clinical features are considered, by discriminating symptoms, such as pains in the back or buttock, and those located predominantly in the hip and groin area.The most known forms of RDJAST of the pelvis and HJ may include trochanteritis, hip abductor and adductor syndromes, iliopectineal bursitis, and ischial tuberosity bursitis.This review briefly describes the major forms of RDJAST of the mentioned area, their clinical manifestations, and topical diagnostic techniques. It also considers main therapeutic approaches: the administration of nonsteroidal antiinflammatory drugs, local injections of glucocorticoids and plateletrich plasma, and physiotherapy.

Enhancing the Extreme Climate Index (ECI) to monitor climate extremes for an index-based insurance scheme across Africa

Science.gov (United States)

Helmschrot, J.; Malherbe, J.; Chamunorwa, M.; Muthige, M.; Petitta, M.; Calmanti, S.; Cucchi, M.; Syroka, J.; Iyahen, E.; Engelbrecht, F.

2017-12-01

Climate services are a key component of National Adaptation Plan (NAP) processes, which require the analysis of current climate conditions, future climate change scenarios and the identification of adaptation strategies, including the capacity to finance and implement effective adaptation options. The Extreme Climate Facility (XCF) proposed by the African Risk Capacity (ARC) developed a climate index insurance scheme, which is based on the Extreme Climate Index (ECI): an objective, multi-hazard index capable of tracking changes in the frequency or magnitude of extreme weather events, thus indicating possible shifts to a new climate regime in various regions. The main hazards covered by ECI are extreme dry, wet and heat events, with the possibility of adding other region-specific risk events. The ECI is standardized across broad geographical regions, so that extreme events occurring under different climatic regimes in Africa can be compared. Initially developed by an Italian company specialized in Climate Services, research is now conducted at the CSIR and SASSCAL, to verify and further develop the ECI for application in southern African countries, through a project initiated by the World Food Programme (WFP) and ARC. The paper will present findings on the most appropriate definitions of extremely wet and dry conditions in Africa, in terms of their impact across a multitude of sub-regional climates of the African continent. Findings of a verification analysis of the ECI, as determined through vegetation monitoring data and the SASSCAL weather station network will be discussed. Changes in the ECI under climate change will subsequently be projected, using detailed regional projections generated by the CSIR and through the Coordinated Regional Downscaling Experiment (CORDEX). This work will be concluded by the development of a web-based climate service informing African Stakeholders on climate extremes.

Outcome for the extremely premature neonate: how far do we push the edge?

Science.gov (United States)

Boat, Anne C; Sadhasivam, Senthilkumar; Loepke, Andreas W; Kurth, Charles D

2011-07-01

Significant advances in perinatal and neonatal medicine over the last 20 years and the recent emergence of fetal surgery has resulted in anesthesia providers caring for a growing number of infants born at the margin of viability. Anesthetic management in this patient population has to take into consideration the immature function of many vital organ systems as well as the effects of the underlying disease processes, which can frequently lead to severe physiological derangements. Accordingly, premature infants presenting for major surgeries early in life can represent a significant anesthetic challenge. However, even with advanced anesthetic and surgical management and optimal intensive care, extremely premature infants face substantial postoperative morbidity and mortality, as well as prolonged hospital courses. In this article, we will discuss the following questions: How far have we come in improving outcomes of extreme prematurity? And what will the future medical and societal challenges be, as we continue to redefine the limits of viability? © 2011 Blackwell Publishing Ltd.

Quantification of Foot-and-mouth Disease Virus Transmission Rates Using Published Data

NARCIS (Netherlands)

Goris, N.E.; Eble, P.L.; Jong, de M.C.M.; Clercq, K.

2009-01-01

Foot-and-mouth disease is an extremely infectious and devastating disease affecting all species of cloven-hoofed animals. To understand the epidemiology of the causative virus and predict viral transmission dynamics, quantified transmission parameters are essential to decision makers and modellers

Climate change & extreme weather vulnerability assessment framework.

Science.gov (United States)

2012-12-01

The Federal Highway Administrations (FHWAs) Climate Change and Extreme Weather Vulnerability : Assessment Framework is a guide for transportation agencies interested in assessing their vulnerability : to climate change and extreme weather event...

Spatial extreme value analysis to project extremes of large-scale indicators for severe weather.

Science.gov (United States)

Gilleland, Eric; Brown, Barbara G; Ammann, Caspar M

2013-09-01

Concurrently high values of the maximum potential wind speed of updrafts ( W max ) and 0-6 km wind shear (Shear) have been found to represent conducive environments for severe weather, which subsequently provides a way to study severe weather in future climates. Here, we employ a model for the product of these variables (WmSh) from the National Center for Atmospheric Research/United States National Center for Environmental Prediction reanalysis over North America conditioned on their having extreme energy in the spatial field in order to project the predominant spatial patterns of WmSh. The approach is based on the Heffernan and Tawn conditional extreme value model. Results suggest that this technique estimates the spatial behavior of WmSh well, which allows for exploring possible changes in the patterns over time. While the model enables a method for inferring the uncertainty in the patterns, such analysis is difficult with the currently available inference approach. A variation of the method is also explored to investigate how this type of model might be used to qualitatively understand how the spatial patterns of WmSh correspond to extreme river flow events. A case study for river flows from three rivers in northwestern Tennessee is studied, and it is found that advection of WmSh from the Gulf of Mexico prevails while elsewhere, WmSh is generally very low during such extreme events. © 2013 The Authors. Environmetrics published by JohnWiley & Sons, Ltd.

Stream Response to an Extreme Defoliation Event

Science.gov (United States)

Gold, A.; Loffredo, J.; Addy, K.; Bernhardt, E. S.; Berdanier, A. B.; Schroth, A. W.; Inamdar, S. P.; Bowden, W. B.

2017-12-01

Extreme climatic events are known to profoundly impact stream flow and stream fluxes. These events can also exert controls on insect outbreaks, which may create marked changes in stream characteristics. The invasive Gypsy Moth (Lymantria dispar dispar) experiences episodic infestations based on extreme climatic conditions within the northeastern U.S. In most years, gypsy moth populations are kept in check by diseases. In 2016 - after successive years of unusually warm, dry spring and summer weather -gypsy moth caterpillars defoliated over half of Rhode Island's 160,000 forested ha. No defoliation of this magnitude had occurred for more than 30 years. We examined one RI headwater stream's response to the defoliation event in 2016 compared with comparable data in 2014 and 2015. Stream temperature and flow was gauged continuously by USGS and dissolved oxygen (DO) was measured with a YSI EXO2 sonde every 30 minutes during a series of deployments in the spring, summer and fall from 2014-2016. We used the single station, open channel method to estimate stream metabolism metrics. We also assessed local climate and stream temperature data from 2009-2016. We observed changes in stream responses during the defoliation event that suggest changes in ET, solar radiation and heat flux. Although the summer of 2016 had more drought stress (PDSI) than previous years, stream flow occurred throughout the summer, in contrast to several years with lower drought stress when stream flow ceased. Air temperature in 2016 was similar to prior years, but stream temperature was substantially higher than the prior seven years, likely due to the loss of canopy shading. DO declined dramatically in 2016 compared to prior years - more than the rising stream temperatures would indicate. Gross Primary Productivity was significantly higher during the year of the defoliation, indicating more total fixation of inorganic carbon from photo-autotrophs. In 2016, Ecosystem Respiration was also higher and Net

Nutrition security under extreme events

Science.gov (United States)

Martinez, A.

2017-12-01

Nutrition security under extreme events. Zero hunger being one of the Sustainable Development Goal from the United Nations, food security has become a trending research topic. However extreme events impact on global food security is not yet 100% understood and there is a lack of comprehension of the underlying mechanisms of global food trade and nutrition security to improve countries resilience to extreme events. In a globalized world, food is still a highly regulated commodity and a strategic resource. A drought happening in a net food-exporter will have little to no effect on its own population but the repercussion on net food-importers can be extreme. In this project, we propose a methodology to describe and quantify the impact of a local drought to human health at a global scale. For this purpose, nutrition supply and global trade data from FAOSTAT have been used with domestic food production from national agencies and FAOSTAT, global precipitation from the Climate Research Unit and health data from the World Health Organization. A modified Herfindahl-Hirschman Index (HHI) has been developed to measure the level of resilience of one country to a drought happening in another country. This index describes how a country is dependent of importation and how diverse are its importation. Losses of production and exportation due to extreme events have been calculated using yield data and a simple food balance at country scale. Results show that countries the most affected by global droughts are the one with the highest dependency to one exporting country. Changes induced by droughts also disturbed their domestic proteins, fat and calories supply resulting most of the time in a higher intake of calories or fat over proteins.

Extreme Hypofractionated Image-Guided Radiotherapy for Prostate Cancer

Directory of Open Access Journals (Sweden)

Carlo Greco

2013-09-01

Full Text Available An emerging body of data suggests that hypofractionated radiation schedules, where a higher dose per fraction is delivered in a smaller number of sessions, may be superior to conventional fractionation schemes in terms of both tumour control and toxicity profile in the management of adenocarcinoma of the prostate. However, the optimal hypofractionation scheme is still the subject of scientific debate. Modern computer-driven technology enables the safe implementation of extreme hypo fractionation (often referred to as stereotactic body radiation therapy [SBRT]. Several studies are currently being conducted to clarify the yet unresolved issues regarding treatment techniques and fractionation regimens. Recently, the American Society for Radiation Oncology (ASTRO issued a model policy indicating that data supporting the use of SBRT for prostate cancer have matured to a point where SBRT could be considered an appropriate alternative for select patients with low-to-intermediate risk disease. The present article reviews some of the currently available data and examines the impact of tracking technology to mitigate intra-fraction target motion, thus, potentially further improving the clinical outcomes of extreme hypofractionated radiation therapy in appropriately selected prostate cancer patients. The Champalimaud Centre for the Unknown (CCU’s currently ongoing Phase I feasibility study is described; it delivers 45 Gy in five fractions using prostate fixation via a rectal balloon, and urethral sparing via catheter placement with on-line intra-fractional motion tracking through beacon transponder technology.

Superior Lower Extremity Vein Graft Bypass Patency among Married Patients with Peripheral Artery Disease.

Science.gov (United States)

Lagergren, Emily; Kempe, Kelly; Craven, Timothy E; Kornegay, Susan T; Hurie, Justin B; Garg, Nitin; Velazquez-Ramirez, Gabriela; Edwards, Matthew S; Corriere, Matthew A

2017-10-01

Outcome disparities associated with lower extremity bypass (LEB) for peripheral artery disease (PAD) have been identified but are poorly understood. Marital status may affect outcomes through factors related to health risk behaviors, adherence, and access to care but has not been characterized as a predictor of surgical outcomes and is often omitted from administrative data sets. We evaluated associations between marital status and vein graft patency following LEB using multivariable models adjusting for established risk factors. Consecutive patients undergoing autogenous LEB for PAD were identified and analyzed. Survival analysis and Cox proportional hazards models were used to evaluate patency stratified by marital status (married versus single, divorced, or widow[er]) adjusting for demographic, comorbidity, and anatomic factors in multivariable models. Seventy-three participants who underwent 79 autogenous vein LEB had complete data and were analyzed. Forty-three patients (58.9%) were married, and 30 (41.1%) were unmarried. Compared with unmarried patients, married patients were older at the time of their bypass procedure (67.3 ± 10.8 years vs. 62.2 ± 10.6 years; P = 0.05). Married patients also had a lower prevalence of female gender (11.6% vs. 33.3%; P = 0.02). Diabetes, hypertension, hyperlipidemia, and smoking were common among both married and unmarried patients. Minimum great saphenous vein conduit diameters were larger in married versus unmarried patients (2.82 ± 0.57 mm vs. 2.52 ± 0.65 mm; P = 0.04). Twenty-four-month primary patency was 66% for married versus 38% for unmarried patients. In a multivariable proportional hazards model adjusting for proximal and distal graft inflow/outflow, medications, gender, age, race, smoking, diabetes, and minimum vein graft diameter, married status was associated with superior primary patency (hazard ratio [HR] = 0.33; 95% confidence limits [0.11, 0.99]; P = 0.05); other predictive covariates

Superradiantly stable non-extremal Reissner-Nordstroem black holes

Energy Technology Data Exchange (ETDEWEB)

Huang, Jia-Hui [School of Physics and Telecommunication Engineering, South China Normal University, Laboratory of Quantum Engineering and Quantum Materials, Guangzhou (China); Mai, Zhan-Feng [Beijing Normal University, Department of Physics, Center for Advanced Quantum Studies, Beijing (China)

2016-06-15

The superradiant stability is investigated for non-extremal Reissner-Nordstroem black holes. We use an algebraic method to demonstrate that all non-extremal Reissner-Nordstroem black holes are superradiantly stable against a charged massive scalar perturbation. This improves the results obtained before for non-extremal Reissner-Nordstroem black holes. (orig.)

Risk assessment of precipitation extremes in northern Xinjiang, China

Science.gov (United States)

Yang, Jun; Pei, Ying; Zhang, Yanwei; Ge, Quansheng

2018-05-01

This study was conducted using daily precipitation records gathered at 37 meteorological stations in northern Xinjiang, China, from 1961 to 2010. We used the extreme value theory model, generalized extreme value (GEV) and generalized Pareto distribution (GPD), statistical distribution function to fit outputs of precipitation extremes with different return periods to estimate risks of precipitation extremes and diagnose aridity-humidity environmental variation and corresponding spatial patterns in northern Xinjiang. Spatiotemporal patterns of daily maximum precipitation showed that aridity-humidity conditions of northern Xinjiang could be well represented by the return periods of the precipitation data. Indices of daily maximum precipitation were effective in the prediction of floods in the study area. By analyzing future projections of daily maximum precipitation (2, 5, 10, 30, 50, and 100 years), we conclude that the flood risk will gradually increase in northern Xinjiang. GEV extreme value modeling yielded the best results, proving to be extremely valuable. Through example analysis for extreme precipitation models, the GEV statistical model was superior in terms of favorable analog extreme precipitation. The GPD model calculation results reflect annual precipitation. For most of the estimated sites' 2 and 5-year T for precipitation levels, GPD results were slightly greater than GEV results. The study found that extreme precipitation reaching a certain limit value level will cause a flood disaster. Therefore, predicting future extreme precipitation may aid warnings of flood disaster. A suitable policy concerning effective water resource management is thus urgently required.

Cardiovascular consequences of extreme prematurity: the EPICure study.

Science.gov (United States)

McEniery, Carmel M; Bolton, Charlotte E; Fawke, Joseph; Hennessy, Enid; Stocks, Janet; Wilkinson, Ian B; Cockcroft, John R; Marlow, Neil

2011-07-01

The long-term consequences of extreme prematurity are becoming increasingly important, given recent improvements in neonatal intensive care. The aim of the current study was to examine the cardiovascular consequences of extreme prematurity in 11-year-olds born at or before 25 completed weeks of gestation. Age and sex-matched classmates were recruited as controls. Information concerning perinatal and maternal history was collected, and current anthropometric characteristics were measured in 219 children born extremely preterm and 153 classmates. A subset of the extremely preterm children (n = 68) and classmates (n = 90) then underwent detailed haemodynamic investigations, including measurement of supine blood pressure (BP), aortic pulse wave velocity (aPWV, a measure of aortic stiffness) and augmentation index (AIx, a measure of arterial pressure wave reflections). Seated brachial systolic and diastolic BP were not different between extremely preterm children and classmates (P = 0.3 for both), although there was a small, significant elevation in supine mean and diastolic BP in the extremely preterm children (P prematurity is associated with altered arterial haemodynamics in children, not evident from the examination of brachial BP alone. Moreover, the smaller, preresistance and resistance vessels rather than large elastic arteries appear to be most affected. Children born extremely preterm may be at increased future cardiovascular risk.

A compliant mechanism for inspecting extremely confined spaces

Science.gov (United States)

Mascareñas, David; Moreu, Fernando; Cantu, Precious; Shields, Daniel; Wadden, Jack; El Hadedy, Mohamed; Farrar, Charles

2017-11-01

We present a novel, compliant mechanism that provides the capability to navigate extremely confined spaces for the purpose of infrastructure inspection. Extremely confined spaces are commonly encountered during infrastructure inspection. Examples of such spaces can include pipes, conduits, and ventilation ducts. Often these infrastructure features go uninspected simply because there is no viable way to access their interior. In addition, it is not uncommon for extremely confined spaces to possess a maze-like architecture that must be selectively navigated in order to properly perform an inspection. Efforts by the imaging sensor community have resulted in the development of imaging sensors on the millimeter length scale. Due to their compact size, they are able to inspect many extremely confined spaces of interest, however, the means to deliver these sensors to the proper location to obtain the desired images are lacking. To address this problem, we draw inspiration from the field of endoscopic surgery. Specifically we consider the work that has already been done to create long flexible needles that are capable of being steered through the human body. These devices are typically referred to as ‘steerable needles.’ Steerable needle technology is not directly applicable to the problem of navigating maze-like arrangements of extremely confined spaces, but it does provide guidance on how this problem should be approached. Specifically, the super-elastic nitinol tubing material that allows steerable needles to operate is also appropriate for the problem of navigating maze-like arrangements of extremely confined spaces. Furthermore, the portion of the mechanism that enters the extremely confined space is completely mechanical in nature. The mechanical nature of the device is an advantage when the extremely confined space features environmental hazards such as radiation that could degrade an electromechanically operated mechanism. Here, we present a compliant mechanism

Importance of cutaneous silent period in fibromyalgia and its relationship with disease characteristics, psychological disorders and quality of life of patients.

Science.gov (United States)

Umay, Ebru; Ulas, Umit; Unlu, Ece; Akgun, Hakan; Cakci, Aytul; Odabasi, Zeki

2013-01-01

Cutaneous silent period (CSP) is an inhibitory spinal protective reflex and its afferents consist of A-delta nerve fibers. We aimed to evaluate patients with fibromyalgia (FM) and healthy controls to determine any differences between the groups in terms of CSP duration and latency, and if present, to determine whether there is any relationship with disease characteristics, psychological disorders and quality of life. Thirty-two patients with FM and 32 healthy volunteers were included in the study. The patient and control groups were compared in terms of CSP latency and duration in both upper and lower extremities. Disease characteristics, psychological disorders and quality of life of patients were assessed using the Fibromyalgia Impact Questionnaire (FIQ) and Short Form-36 (SF-36). Patients with CSP measurements equal to or lower than those of the control group were compared with those with higher values than controls in terms of disease characteristics, psychological status and quality of life. Significantly prolonged CSP latencies in both upper and lower extremities were determined in patients compared to controls. We found that prolongation of CSP latency in the lower extremity is associated with disease severity and functional disability. CSP latencies in both upper and lower extremities in patients with FM are longer than in healthy volunteers. Moreover, prolongation of CSP latency in the lower extremity is associated with disease severity and physical functional disability.

PREDICTION OF THE EXTREMAL SHAPE FACTOR OF SPHEROIDAL PARTICLES

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Daniel Hlubinka

2011-05-01

Full Text Available In the stereological unfolding problem for spheroidal particles the extremal shape factor is predicted. The theory of extreme values has been used to show that extremes of the planar shape factor of particle sections tend to the same limit distribution as extremes of the original shape factor for both the conditional and marginal distribution. Attention is then paid to the extreme shape factor conditioned by the particle size. Normalizing constants are evaluated for a parametric model and the numerical procedure is tested on real data from metallography.

CFT duals for extreme black holes

International Nuclear Information System (INIS)

Hartman, Thomas; Strominger, Andrew; Murata, Keiju; Nishioka, Tatsuma

2009-01-01

It is argued that the general four-dimensional extremal Kerr-Newman-AdS-dS black hole is holographically dual to a (chiral half of a) two-dimensional CFT, generalizing an argument given recently for the special case of extremal Kerr. Specifically, the asymptotic symmetries of the near-horizon region of the general extremal black hole are shown to be generated by a Virasoro algebra. Semiclassical formulae are derived for the central charge and temperature of the dual CFT as functions of the cosmological constant, Newton's constant and the black hole charges and spin. We then show, assuming the Cardy formula, that the microscopic entropy of the dual CFT precisely reproduces the macroscopic Bekenstein-Hawking area law. This CFT description becomes singular in the extreme Reissner-Nordstrom limit where the black hole has no spin. At this point a second dual CFT description is proposed in which the global part of the U(1) gauge symmetry is promoted to a Virasoro algebra. This second description is also found to reproduce the area law. Various further generalizations including higher dimensions are discussed.

Extreme waves at Filyos, southern Black Sea

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E. Bilyay

2011-03-01

Full Text Available A wave measurement project was carried out for a new port planned in Filyos, in the Western Black Sea region of Turkey. The measurement at a depth of 12.5 m lasted for a period of two years and 7949 records were obtained. During the analysis, it was noticed that there were 209 records in which H/H_s ratio was higher than 2.0. These higher waves in a record are called extreme waves in this study. Although the purpose of wave measurement is not to investigate extreme waves, it is believed that studying these unexpected waves could be interesting. Therefore, detailed statistical and spectral analyses on the extreme waves were done for the records. The analyses results show that the distribution of surface profiles of the records containing extreme waves deviates from Gaussian distribution with the negative skewness changing between –0.01 and –0.4 and with the high kurtosis in the range of 3.1–4.2. Although the probability of occurrence of the extreme waves is over-predicted by the Rayleigh distribution, a higher ratio of H_s/η_rms indicates that the wave height distribution can be represented by Rayleigh. The average value of the slope of the frequency spectrum at the high frequency range is proportional to f^–9 which is much steeper than the typical wind-wave frequency power law, f^{–4, –5}. The directional spreading is measured with the parameter S_max and it is in the range of 5–70 for the extreme wave records. The wave and current interaction was also investigated and it was found that in most cases, extreme waves occur when the wave and the current are almost aligned. Furthermore, it is observed that extreme waves appear within a group of high waves.

Hygienic diagnosis in extreme conditions

International Nuclear Information System (INIS)

Sofronov, G.A.

1997-01-01

Review for book by M.P. Zakharchenko, S.A. Lopatin, G.N. Novozhilov, V.I. Zakharov Hygienic diagnosis in extreme conditions is presented discussing the problem of people health preservation under extreme conditions. Hygienic diagnosis is considered illustrated by cases of hostilities (Afghan War), earthquake response in Armenia (1988) and Chernobyl accident response. Attention is paid to the estimation of radiation doses to people and characteristics of main types of dosimeters. The high scientific level of the book is marked

Extreme event statistics in a drifting Markov chain

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Kindermann, Farina; Hohmann, Michael; Lausch, Tobias; Mayer, Daniel; Schmidt, Felix; Widera, Artur

2017-07-01

We analyze extreme event statistics of experimentally realized Markov chains with various drifts. Our Markov chains are individual trajectories of a single atom diffusing in a one-dimensional periodic potential. Based on more than 500 individual atomic traces we verify the applicability of the Sparre Andersen theorem to our system despite the presence of a drift. We present detailed analysis of four different rare-event statistics for our system: the distributions of extreme values, of record values, of extreme value occurrence in the chain, and of the number of records in the chain. We observe that, for our data, the shape of the extreme event distributions is dominated by the underlying exponential distance distribution extracted from the atomic traces. Furthermore, we find that even small drifts influence the statistics of extreme events and record values, which is supported by numerical simulations, and we identify cases in which the drift can be determined without information about the underlying random variable distributions. Our results facilitate the use of extreme event statistics as a signal for small drifts in correlated trajectories.

Recent and future extreme precipitation over Ukraine

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Vyshkvarkova, Olena; Voskresenskaya, Elena

2014-05-01

The aim of study is to analyze the parameters of precipitation extremes and inequality over Ukraine in recent climate epoch and their possible changes in the future. Data of observations from 28 hydrometeorological stations over Ukraine and output of GFDL-CM3 model (CMIP5) for XXI century were used in the study. The methods of concentration index (J. Martin-Vide, 2004) for the study of precipitation inequality while the extreme precipitation indices recommended by the ETCCDI - for the frequency of events. Results. Precipitation inequality on the annual and seasonal scales was studied using estimated CI series for 1951-2005. It was found that annual CI ranges vary from 0.58 to 0.64. They increase southward from the north-west (forest zone) and the north-east (forest steppe zone) of Ukraine. CI maxima are located in the coastal regions of the Black Sea and the Sea of Azov. Annual CI spatial distribution indicates that the contribution of extreme precipitation into annual totals is most significant at the boundary zone between steppe and marine regions. At the same time precipitation pattern at the foothill of Carpathian Mountains is more homogenous. The CI minima (0.54) are typical for the winter season in foothill of Ukrainian Carpathians. The CI maxima reach 0.71 in spring at the steppe zone closed to the Black Sea coast. It should be noted that the greatest ranges of CI maximum and CI minimum deviation are typical for spring. It is associated with patterns of cyclone trajectories in that season. The most territory is characterized by tendency to decrease the contribution of extreme precipitation into the total amount (CI linear trends are predominantly negative in all seasons). Decadal and interdecadal variability of precipitation inequality associated with global processes in ocean-atmosphere system are also studied. It was shown that precipitation inequality over Ukraine on 10 - 15 % stronger in negative phase of Pacific Decadal Oscillation and in positive phase

Changes in the probability of co-occurring extreme climate events

Science.gov (United States)

Diffenbaugh, N. S.

2017-12-01

Extreme climate events such as floods, droughts, heatwaves, and severe storms exert acute stresses on natural and human systems. When multiple extreme events co-occur, either in space or time, the impacts can be substantially compounded. A diverse set of human interests - including supply chains, agricultural commodities markets, reinsurance, and deployment of humanitarian aid - have historically relied on the rarity of extreme events to provide a geographic hedge against the compounded impacts of co-occuring extremes. However, changes in the frequency of extreme events in recent decades imply that the probability of co-occuring extremes is also changing, and is likely to continue to change in the future in response to additional global warming. This presentation will review the evidence for historical changes in extreme climate events and the response of extreme events to continued global warming, and will provide some perspective on methods for quantifying changes in the probability of co-occurring extremes in the past and future.

Wound Complications in Preoperatively Irradiated Soft-Tissue Sarcomas of the Extremities

Energy Technology Data Exchange (ETDEWEB)

Rosenberg, Lewis A. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Esther, Robert J. [Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina (United States); Erfanian, Kamil [Department of Surgery, University of North Carolina, Chapel Hill, North Carolina (United States); Green, Rebecca [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Kim, Hong Jin; Sweeting, Raeshell [Department of Surgery, University of North Carolina, Chapel Hill, North Carolina (United States); Tepper, Joel E., E-mail: tepper@med.unc.edu [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)

2013-02-01

Purpose: To determine whether the involvement of plastic surgery and the use of vascularized tissue flaps reduces the frequency of major wound complications after radiation therapy for soft-tissue sarcomas (STS) of the extremities. Methods and Materials: This retrospective study evaluated patients with STS of the extremities who underwent radiation therapy before surgery. Major complications were defined as secondary operations with anesthesia, seroma/hematoma aspirations, readmission for wound complications, or persistent deep packing. Results: Between 1996 and 2010, 73 patients with extremity STS were preoperatively irradiated. Major wound complications occurred in 32% and secondary operations in 16% of patients. Plastic surgery closed 63% of the wounds, and vascularized tissue flaps were used in 22% of closures. When plastic surgery performed closure the frequency of secondary operations trended lower (11% vs 26%; P=.093), but the frequency of major wound complications was not different (28% vs 38%; P=.43). The use of a vascularized tissue flap seemed to have no effect on the frequency of complications. The occurrence of a major wound complication did not affect disease recurrence or survival. For all patients, 3-year local control was 94%, and overall survival was 72%. Conclusions: The rates of wound complications and secondary operations in this study were very similar to previously published results. We were not able to demonstrate a significant relationship between the involvement of plastic surgery and the rate of wound complications, although there was a trend toward reduced secondary operations when plastic surgery was involved in the initial operation. Wound complications were manageable and did not compromise outcomes.

Wound Complications in Preoperatively Irradiated Soft-Tissue Sarcomas of the Extremities

International Nuclear Information System (INIS)

Rosenberg, Lewis A.; Esther, Robert J.; Erfanian, Kamil; Green, Rebecca; Kim, Hong Jin; Sweeting, Raeshell; Tepper, Joel E.

2013-01-01

Purpose: To determine whether the involvement of plastic surgery and the use of vascularized tissue flaps reduces the frequency of major wound complications after radiation therapy for soft-tissue sarcomas (STS) of the extremities. Methods and Materials: This retrospective study evaluated patients with STS of the extremities who underwent radiation therapy before surgery. Major complications were defined as secondary operations with anesthesia, seroma/hematoma aspirations, readmission for wound complications, or persistent deep packing. Results: Between 1996 and 2010, 73 patients with extremity STS were preoperatively irradiated. Major wound complications occurred in 32% and secondary operations in 16% of patients. Plastic surgery closed 63% of the wounds, and vascularized tissue flaps were used in 22% of closures. When plastic surgery performed closure the frequency of secondary operations trended lower (11% vs 26%; P=.093), but the frequency of major wound complications was not different (28% vs 38%; P=.43). The use of a vascularized tissue flap seemed to have no effect on the frequency of complications. The occurrence of a major wound complication did not affect disease recurrence or survival. For all patients, 3-year local control was 94%, and overall survival was 72%. Conclusions: The rates of wound complications and secondary operations in this study were very similar to previously published results. We were not able to demonstrate a significant relationship between the involvement of plastic surgery and the rate of wound complications, although there was a trend toward reduced secondary operations when plastic surgery was involved in the initial operation. Wound complications were manageable and did not compromise outcomes.

Lymphoscintigraphy of the lower extremity

International Nuclear Information System (INIS)

Abbasi, N.Z.

1990-01-01

Fifty one lower extremities of 26 normal healthy volunteers and 26 extremities of 13 patients with oedema have been studied. Dynamic quantitative lymphoscintigraphy using 99Tc-m antimony sulphide colloid during passive exercise as well as before and after active exercise was performed. parameters of lymphatic function including percentage of radioactivity cleared from the injection site, the percentage uptake by the inguinal lymph nodes, the time of arrival of activity at the regional lymph nodes and the lymphatic reserve index have been evaluated. The percentage clearance of activity from the injection site was found technically difficult to standardize and proved to be an unreliable parameter of lymphatic function. However, the quantitation of nodal uptake, the lymphatic transit time and the lymphatic reserve capacity accurately depicted the lymphatic functional status of an individual. The physiologic parameters of lymphatic function of the contralateral lower extremities were compared and a physiologic difference in the lymphatic capacity of the two limbs was scintigraphically documented. (author)

Within-summer variation in out-of-hospital cardiac arrest due to extremely long sunshine duration.

Science.gov (United States)

Onozuka, Daisuke; Hagihara, Akihito

2017-03-15

Although several studies have reported the impacts of extremely high temperatures on cardiovascular diseases, no studies have examined whether variation in out-of-hospital cardiac arrest (OHCA) due to extremely long sunshine duration changes during the summer. We obtained daily data on all cases of OHCA and weather variations for all 47 prefectures of Japan during the summer (June to September) between 2005 and 2014. A distributed lag non-linear model combined with a quasi-Poisson regression model was used to estimate within-summer variation in OHCA due to extremely long sunshine duration for each prefecture. Then, multivariate random-effects meta-analysis was performed to derive overall effect estimates of sunshine duration at the national level. A total of 166,496 OHCAs of presumed cardiac origin met the inclusion criteria. The minimum morbidity percentile (MMP) was the 0th percentile of sunshine duration at the national level. The overall cumulative relative risk (RR) at the 99th percentile vs. the MMP was 1.15 (95% CI: 1.05-1.27) during the summer. The effect of extremely long sunshine duration on OHCA in early summer was acute and did not persist, whereas an identical effect was observed in late summer, but it was delayed and lasted for several days. During summer periods, excessive sunshine duration could increase the risk of OHCA. Timely preventive measures to reduce the OHCA risk due to extremely long sunshine duration are important in early summer, whereas these measures could include a wider time window of several days to reduce the risk in late summer. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Is southwestern China experiencing more frequent precipitation extremes?

International Nuclear Information System (INIS)

Liu, Meixian; Xu, Xianli; Wang, Kelin; Sun, Alexander Y; Liu, Wen; Zhang, Xiaoyan

2014-01-01

Climate extremes have and will continue to cause severe damages to buildings and natural environments around the world. A full knowledge of the probability of the climate extremes is important for the management and mitigation of natural hazards. Based on Mann–Kendall trend test and copulas, this study investigated the characteristics of precipitation extremes as well as their implications in southwestern China (Yunnan, Guangxi and Guizhou Province), through analyzing the changing trends and probabilistic characteristics of six indices, including the consecutive dry days, consecutive wet days, annual total wet day precipitation, heavy precipitation days (R25), max 5 day precipitation amount (Rx5) and the rainy days (RDs). Results showed that the study area had generally become drier (regional mean annual precipitation decreased by 11.4 mm per decade) and experienced enhanced precipitation extremes in the past 60 years. Relatively higher risk of drought in Yuanan and flood in Guangxi was observed, respectively. However, the changing trends of the precipitation extremes were not spatially uniform: increasing risk of extreme wet events for Guangxi and Guizhou, and increasing probability of concurrent extreme wet and dry events for Yunnan. Meanwhile, trend analyses of the 10 year return levels of the selected indices implied that the severity of droughts decreased in Yunnan but increased significantly in Guangxi and Guizhou, and the severity of floods increased in Yunnan and Guangxi in the past decades. Hence, the policy-makers need to be aware of the different characterizations and the spatial heterogeneity of the precipitation extremes. (letters)

Frequently Asked Questions (FAQ) about Extreme Heat

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... Extreme Heat Older Adults (Aged 65+) Infants and Children Chronic Medical Conditions Low Income Athletes Outdoor Workers Pets Hot Weather Tips Warning Signs and Symptoms FAQs Social Media How to Stay Cool Missouri Cooling Centers Extreme ...

Community responses to extreme climatic conditions

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Frédéric JIGUET, Lluis BROTONS, Vincent DEVICTOR

2011-06-01

Full Text Available Species assemblages and natural communities are increasingly impacted by changes in the frequency and severity of extreme climatic events. Here we propose a brief overview of expected and demonstrated direct and indirect impacts of extreme events on animal communities. We show that differential impacts on basic biological parameters of individual species can lead to strong changes in community composition and structure with the potential to considerably modify the functional traits of the community. Sudden disequilibria have even been shown to induce irreversible shifts in marine ecosystems, while cascade effects on various taxonomic groups have been highlighted in Mediterranean forests. Indirect effects of extreme climatic events are expected when event-induced habitat changes (e.g. soil stability, vegetation composition, water flows altered by droughts, floods or hurricanes have differential consequences on species assembled within the communities. Moreover, in increasing the amplitude of trophic mismatches, extreme events are likely to turn many systems into ecological traps under climate change. Finally, we propose a focus on the potential impacts of an extreme heat wave on local assemblages as an empirical case study, analysing monitoring data on breeding birds collected in France. In this example, we show that despite specific populations were differently affected by local temperature anomalies, communities seem to be unaffected by a sudden heat wave. These results suggest that communities are tracking climate change at the highest possible rate [Current Zoology 57 (3: 406–413, 2011].

Rhabdomyosarcoma of the extremity

International Nuclear Information System (INIS)

Rao, Bhaskar N

1997-01-01

Rhabdomyosarcoma is the most common soft tissue sarcoma accounting for almost 55%. These tumors arise from unsegmented mesoderm or primitive mesenchyma, which have the capacity to differentiate into muscle. Less than 5% occur in the first year of life. Extremity rhabdomyosarcoma are mainly seen in the adolescent years. The most common histologic subtype is the alveolar variant. Other characteristics of extremity rhabdomyosarcoma include a predilection for lymph node metastasis, a high local failure, and a relatively low survival rate. They often present as slow painless masses; however, lesions in the hand and foot often present as painful masses and imaging studies may show invasion of the bone. Initial diagnostic approaches include needle biopsy or incisional biopsy for larger lesions. Excisional biopsy is indicated preferably for lesions less than 2.5 cm. following this in most instances therapy is initiated with multi agent chemotherapy depending upon response, the next modality may be either surgery with intent to cure or radiation therapy. Amputation of an extremity for local control is not considered in most instances. Prognostic factors that have been determined over the years to be of significance by multi variant analysis have included age, tumor size, invasiveness, presence of either nodal or distant metastasis, and complete excision whenever feasible, with supplemental radiation therapy for local control

Exome sequencing in schizophrenic patients with high levels of homozygosity identifies novel and extremely rare mutations in the GABA/glutamatergic pathways.

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Edoardo Giacopuzzi

Full Text Available Inbreeding is a known risk factor for recessive Mendelian diseases and previous studies have suggested that it could also play a role in complex disorders, such as psychiatric diseases. Recent inbreeding results in the presence of long runs of homozygosity (ROHs along the genome, which are also defined as autozygosity regions. Genetic variants in these regions have two alleles that are identical by descent, thus increasing the odds of bearing rare recessive deleterious mutations due to a homozygous state. A recent study showed a suggestive enrichment of long ROHs in schizophrenic patients, suggesting that recent inbreeding could play a role in the disease. To better understand the impact of autozygosity on schizophrenia risk, we selected, from a cohort of 180 Italian patients, seven subjects with extremely high numbers of large ROHs that were likely due to recent inbreeding and characterized the mutational landscape within their ROHs using Whole Exome Sequencing and, gene set enrichment analysis. We identified a significant overlap (17%; empirical p-value = 0.0171 between genes inside ROHs affected by low frequency functional homozygous variants (107 genes and the group of most promising candidate genes mutated in schizophrenia. Moreover, in four patients, we identified novel and extremely rare damaging mutations in the genes involved in neurodevelopment (MEGF8 and in GABA/glutamatergic synaptic transmission (GAD1, FMN1, ANO2. These results provide insights into the contribution of rare recessive mutations and inbreeding as risk factors for schizophrenia. ROHs that are likely due to recent inbreeding harbor a combination of predisposing low-frequency variants and extremely rare variants that have a high impact on pivotal biological pathways implicated in the disease. In addition, this study confirms that focusing on patients with high levels of homozygosity could be a useful prioritization strategy for discovering new high-impact mutations in

Exome sequencing in schizophrenic patients with high levels of homozygosity identifies novel and extremely rare mutations in the GABA/glutamatergic pathways.

Science.gov (United States)

Giacopuzzi, Edoardo; Gennarelli, Massimo; Minelli, Alessandra; Gardella, Rita; Valsecchi, Paolo; Traversa, Michele; Bonvicini, Cristian; Vita, Antonio; Sacchetti, Emilio; Magri, Chiara

2017-01-01

Inbreeding is a known risk factor for recessive Mendelian diseases and previous studies have suggested that it could also play a role in complex disorders, such as psychiatric diseases. Recent inbreeding results in the presence of long runs of homozygosity (ROHs) along the genome, which are also defined as autozygosity regions. Genetic variants in these regions have two alleles that are identical by descent, thus increasing the odds of bearing rare recessive deleterious mutations due to a homozygous state. A recent study showed a suggestive enrichment of long ROHs in schizophrenic patients, suggesting that recent inbreeding could play a role in the disease. To better understand the impact of autozygosity on schizophrenia risk, we selected, from a cohort of 180 Italian patients, seven subjects with extremely high numbers of large ROHs that were likely due to recent inbreeding and characterized the mutational landscape within their ROHs using Whole Exome Sequencing and, gene set enrichment analysis. We identified a significant overlap (17%; empirical p-value = 0.0171) between genes inside ROHs affected by low frequency functional homozygous variants (107 genes) and the group of most promising candidate genes mutated in schizophrenia. Moreover, in four patients, we identified novel and extremely rare damaging mutations in the genes involved in neurodevelopment (MEGF8) and in GABA/glutamatergic synaptic transmission (GAD1, FMN1, ANO2). These results provide insights into the contribution of rare recessive mutations and inbreeding as risk factors for schizophrenia. ROHs that are likely due to recent inbreeding harbor a combination of predisposing low-frequency variants and extremely rare variants that have a high impact on pivotal biological pathways implicated in the disease. In addition, this study confirms that focusing on patients with high levels of homozygosity could be a useful prioritization strategy for discovering new high-impact mutations in genetically

Variability of extreme wet events over Malawi

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Libanda Brigadier

2017-01-01

Full Text Available Adverse effects of extreme wet events are well documented by several studies around the world. These effects are exacerbated in developing countries like Malawi that have insufficient risk reduction strategies and capacity to cope with extreme wet weather. Ardent monitoring of the variability of extreme wet events over Malawi is therefore imperative. The use of the Expert Team on Climate Change Detection and Indices (ETCCDI has been recommended by many studies as an effective way of quantifying extreme wet events. In this study, ETCCDI indices were used to examine the number of heavy, very heavy, and extremely heavy rainfall days; daily and five-day maximum rainfall; very wet and extremely wet days; annual wet days and simple daily intensity. The Standard Normal Homogeneity Test (SNHT was employed at 5% significance level before any statistical test was done. Trend analysis was done using the nonparametric Mann-Kendall statistical test. All stations were found to be homogeneous apart from Mimosa. Trend results show high temporal and spatial variability with the only significant results being: increase in daily maximum rainfall (Rx1day over Karonga and Bvumbwe, increase in five-day maximum rainfall (Rx5day over Bvumbwe. Mzimba and Chileka recorded a significant decrease in very wet days (R95p while a significant increase was observed over Thyolo. Chileka was the only station which observed a significant trend (decrease in extremely wet rainfall (R99p. Mzimba was the only station that reported a significant trend (decrease in annual wet-day rainfall total (PRCPTOT and Thyolo was the only station that reported a significant trend (increase in simple daily intensity (SDII. Furthermore, the findings of this study revealed that, during wet years, Malawi is characterised by an anomalous convergence of strong south-easterly and north-easterly winds. This convergence is the main rain bringing mechanism to Malawi.

Tukey max-stable processes for spatial extremes

KAUST Repository

Xu, Ganggang; Genton, Marc G.

2016-01-01

We propose a new type of max-stable process that we call the Tukey max-stable process for spatial extremes. It brings additional flexibility to modeling dependence structures among spatial extremes. The statistical properties of the Tukey max

Evaluation of the National Weather Service Extreme Cold Warning Experiment in North Dakota.

Science.gov (United States)

Chiu, Cindy H; Vagi, Sara J; Wolkin, Amy F; Martin, John Paul; Noe, Rebecca S

2014-01-01

Dangerously cold weather threatens life and property. During periods of extreme cold due to wind chill, the National Weather Service (NWS) issues wind chill warnings to prompt the public to take action to mitigate risks. Wind chill warnings are based on ambient temperatures and wind speeds. Since 2010, NWS has piloted a new extreme cold warning issued for cold temperatures in wind and nonwind conditions. The North Dakota Department of Health, NWS, and the Centers for Disease Control and Prevention collaborated in conducting household surveys in Burleigh County, North Dakota, to evaluate this new warning. The objectives of the evaluation were to assess whether residents heard the new warning and to determine if protective behaviors were prompted by the warning. This was a cross-sectional survey design using the Community Assessment for Public Health Emergency Response (CASPER) methodology to select a statistically representative sample of households from Burleigh County. From 10 to 11 April 2012, 188 door-to-door household interviews were completed. The CASPER methodology uses probability sampling with weighted analysis to estimate the number and percentage of households with a specific response within Burleigh County. The majority of households reported having heard both the extreme cold and wind chill warnings, and both warnings prompted protective behaviors. These results suggest this community heard the new warning and took protective actions after hearing the warning.

Lower extremity muscle activation during baseball pitching.

Science.gov (United States)

Campbell, Brian M; Stodden, David F; Nixon, Megan K

2010-04-01

The purpose of this study was to investigate muscle activation levels of select lower extremity muscles during the pitching motion. Bilateral surface electromyography data on 5 lower extremity muscles (biceps femoris, rectus femoris, gluteus maximus, vastus medialis, and gastrocnemius) were collected on 11 highly skilled baseball pitchers and compared with individual maximal voluntary isometric contraction (MVIC) data. The pitching motion was divided into 4 distinct phases: phase 1, initiation of pitching motion to maximum stride leg knee height; phase 2, maximum stride leg knee height to stride foot contact (SFC); phase 3, SFC to ball release; and phase 4, ball release to 0.5 seconds after ball release (follow-through). Results indicated that trail leg musculature elicited moderate to high activity levels during phases 2 and 3 (38-172% of MVIC). Muscle activity levels of the stride leg were moderate to high during phases 2-4 (23-170% of MVIC). These data indicate a high demand for lower extremity strength and endurance. Specifically, coaches should incorporate unilateral and bilateral lower extremity exercises for strength improvement or maintenance and to facilitate dynamic stabilization of the lower extremities during the pitching motion.

Near-horizon symmetries of extremal black holes

International Nuclear Information System (INIS)

Kunduri, Hari K; Lucietti, James; Reall, Harvey S

2007-01-01

Recent work has demonstrated an attractor mechanism for extremal rotating black holes subject to the assumption of a near-horizon SO(2, 1) symmetry. We prove the existence of this symmetry for any extremal black hole with the same number of rotational symmetries as known four- and five-dimensional solutions (including black rings). The result is valid for a general two-derivative theory of gravity coupled to Abelian vectors and uncharged scalars, allowing for a non-trivial scalar potential. We prove that it remains valid in the presence of higher-derivative corrections. We show that SO(2, 1)-symmetric near-horizon solutions can be analytically continued to give SU(2)-symmetric black hole solutions. For example, the near-horizon limit of an extremal 5D Myers-Perry black hole is related by analytic continuation to a non-extremal cohomogeneity-1 Myers-Perry solution

Meaning and Forms of Political Extremism

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Uwe Backes

2007-12-01

Full Text Available The article seeks to contribute to the conceptualisation of political extremism and to lay a foundation for further theoretical studies which are explanatory in nature. A sketch of the history of the concepts follows a discussion of structural characteristics and then a typological examination of forms of extremism, particularly those of the 20th and 21st century.

Extremely strict ideals in Banach spaces

Indian Academy of Sciences (India)

Abstract. Motivated by the notion of an ideal introduced by Godefroy et al. (Stu- dia Math. 104 (1993) 13–59), in this article, we introduce and study the notion of an extremely strict ideal. For a Poulsen simplex K, we show that the space of affine contin- uous functions on K is an extremely strict ideal in the space of continuous ...

Long term oscillations in Danish rainfall extremes

DEFF Research Database (Denmark)

Gregersen, Ida Bülow; Madsen, Henrik; Rosbjerg, Dan

The frequent flooding of European cities within the last decade has motivated a vast number of studies, among others addressing the non-stationary behaviour of hydrological extremes driven by anthropogenic climate change. However, when considering future extremes it also becomes relevant to search...... for and understand natural variations on which the anthropogenic changes are imposed. This study identifies multi-decadal variations in six 137-years-long diurnal rainfall series from Denmark and southern Sweden, focusing on extremes with a reoccurrence level relevant for Danish drainage design. By means of a Peak...

The assessment of psychological factors on upper extremity disability: A scoping review.

Science.gov (United States)

MacDermid, Joy C; Valdes, Kristin; Szekeres, Mike; Naughton, Nancy; Algar, Lori

2017-11-29

The primary purpose of this scoping review was to describe the nature and extent of the published research that assesses the relationship between psychological features and patient-reported outcome following surgery or rehabilitation of upper extremity disease or injury. Twenty-two included studies were examined for quantitative study design, outcome measure, inclusion/exclusion criteria, follow-up and recruitment strategy. Patient population and psychological assessment tools were examined for validity. Twenty-two studies met the inclusion criteria for this study. Only 7 of the 22 studies were longitudinal and the rest were cross sectional studies. Depression was the most common psychological status of interest and was included in 17 studies. Pain catastrophizing was the psychological status of interest in 5 of the studies. Four studies considered anxiety, 3 considered pain anxiety, 3 considered distress, 2 considered coping, 2 considered catastrophic thinking, and 2 considered fear avoidance beliefs. The majority of studies in this review were cross-sectional studies. Cross-sectional studies may not provide conclusive information about cause-and-effect relationships. This review encourages clinicians to be mindful of the psychological implications found in rehabilitation of individuals with upper extremity disease or injury along with being cognizant of choosing appropriate measurement tools that best represent each patient's characteristics and diagnoses. The nature of the research addressing psychological factors affecting outcomes after hand injury focus on negative traits and have limited strength to suggest causation as most have used cross-sectional designs. Stronger longitudinal designs and consideration of positive traits are needed in future studies. Copyright © 2017. Published by Elsevier Inc.

Airway disease: similarities and differences between asthma, COPD and bronchiectasis

Directory of Open Access Journals (Sweden)

Rodrigo Athanazio

2012-11-01

Full Text Available Airway diseases are highly prevalent worldwide; however, the prevalence of these diseases is underestimated. Although these diseases present several common characteristics, they have different clinical outcomes. The differentiation between asthma, chronic obstructive pulmonary disease and bronchiectasis in the early stage of disease is extremely important for the adoption of appropriate therapeutic measures. However, because of the high prevalence of these diseases and the common pathophysiological pathways, some patients with different diseases may present with similar symptoms. The objective of this review is to highlight the similarities and differences between these diseases in terms of the risk factors, pathophysiology, symptoms, diagnosis and treatment.

Aspectos Tafonômicos de Testudines da Formação Santana (Cretáceo Inferior,Bacia do Araripe, Nordeste do Brasil.

Directory of Open Access Journals (Sweden)

Gustavo Ribeiro de Oliveira

2007-07-01

Full Text Available Araripe Basin is worldwide famous by diverse and exquisitely well preserved fossil assemblages in antana Formation. This lithostratigraphic unit is subdivided into three members: Crato, Ipubi and Romualdo. Up to date six species of turtles are known: Araripemys barretoi Price, 1973; Santanachelys gaffneyi, Hirayama,1998; Brasilemys josai Lapparent de Broin, 2000; Cearachelys placidoi Gaffney, Campos & Hirayama, 2001, Euraxemys essweini Gaffney, Tong & Meylan, 2006 and Caririemys violetae Oliveira & Kellner, 2007.Taphonomical features of turtles from Crato and Romualdo members are presents here. One specimen was examined in the Crato lagerstätte, (MN 4893-V Araripemys sp. (partial skull, axial and apendicular skeleton. This exemplar is preserved in light-beige colored laminated limestone from the Crato Member. Three specimenswere analized (MN 6743-V, MN 6744-V and MN 6760-V in the Romualdo lagerstätte, the two first are Araripemys barretoi specimens (shell and cervical vertebrae and the later is a Cearachelys placidoi specimen (fragmented shell. They are preserved in calcareous nodules. No data of collection of these specimens areavailable, however are possible to infer on aspects of preservation of these exemplares, since that these are preserved in the original sedimentary matrix. All specimens have shown the surface of bones without abrasion, what it allows to infer these turtles as autocthonous.

Rational Calibration of Four IEC 61400-1 Extreme External Conditions

DEFF Research Database (Denmark)

Larsen, Gunner Chr.; Hansen, Kurt Schaldemose

2008-01-01

Based on a set of asymptotic statistical models on closed form this paper presents a rational and consistent calibration of four extreme external conditions defined in the International Electrotechnical Commission (IEC) 61400-1 standard: extreme operating gust, extreme wind shear, extreme coheren...... and proposed specifications of the magnitudes of the extreme external wind conditions are highlighted and discussed using an illustrative example based on two selected terrain types. Copyright © 2008 John Wiley & Sons, Ltd....... gust with direction change and extreme wind direction change. These four extreme external conditions are used in the definition of six of the IEC 61400-1 ultimate load cases. The statistical models are based on simple and easily accessible mean wind speed and turbulence characteristics...

SPECIFICITY OF SELF-PRESERVATION MOTIVATION IN EXTREME SITUATION

Directory of Open Access Journals (Sweden)

Ekaterina Anatolevna Karacheva

2015-02-01

Full Text Available The article presents the results of the study motivation of self-preservation in an extreme situation. Usually extreme situation unfold from the point of view of functioning, health, high negative level mental stress and tension. The extreme situation is the situation of human activity to which man acts, carrying out certain activities. The article provides an overview of russian and foreign authors dealing with this problem. Theoretical models of motivation of self-preservation Z. Freud, A. Maslow, G. Murray, M. Magomed-Eminov. The study explores the leading motivation in an extreme situation and analyzed the levels of motivation of self-preservation. The study was conducted in the Afghan veterans, using a method of unfinished sentences and other. Identified two levels of motivation of self-preservation: individual and personal. Revealed that the motivation of self-preservation is the leading motivation in an extreme situation.

Statistical Model of Extreme Shear

DEFF Research Database (Denmark)

Hansen, Kurt Schaldemose; Larsen, Gunner Chr.

2005-01-01

In order to continue cost-optimisation of modern large wind turbines, it is important to continuously increase the knowledge of wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... by a model that, on a statistically consistent basis, describes the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of full-scale measurements recorded with a high sampling rate...

Extreme Conditions Modeling Workshop Report

Energy Technology Data Exchange (ETDEWEB)

Coe, R. G.; Neary, V. S.; Lawson, M. J.; Yu, Y.; Weber, J.

2014-07-01

Sandia National Laboratories (SNL) and the National Renewable Energy Laboratory (NREL) hosted the Wave Energy Converter (WEC) Extreme Conditions Modeling (ECM) Workshop in Albuquerque, NM on May 13th-14th, 2014. The objective of the workshop was to review the current state of knowledge on how to model WECs in extreme conditions (e.g. hurricanes and other large storms) and to suggest how U.S. Department of Energy (DOE) and national laboratory resources could be used to improve ECM methods for the benefit of the wave energy industry.

Constructions of identity through music in extreme-right subcultures

OpenAIRE

Stroud, Joseph James Iain

2014-01-01

This thesis examines the musical cultures associated with extreme-right politics, considering not only what this music projects about extreme-right ideology, but also the various ways in which music functions as part of a political subculture. This analysis extends beyond the stereotypical extreme-right music associated with the skinhead subculture, often referred to as Oi!, to incorporate extreme-right engagement with genres such as metal, folk, country and classical music. Th...

Relationship between manual dexterity and the unified parkinson's disease rating scale-motor exam.

Science.gov (United States)

Hwang, Sujin; Song, Chiang-Soon

2016-12-01

[Purpose] The purpose of this study was to examine the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam as a clinical tool for quantifying upper extremity function in persons with Parkinson's disease. [Subjects and Methods] Thirty-two persons with idiopathic Parkinson's disease participated in this study. This study measured two clinical outcomes, the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam, to investigate the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam. [Results] The box-and-block test on the more affected side was positive relationship with the box-and-block test on the less affected side. The Unified Parkinson's Disease Rating Scale-motor exam score had a negative correlation with the box-and-block test results for both sides. [Conclusion] A positive association was noted between manual dexterity and motor function in patients with idiopathic Parkinson disease. The results of this study suggest that the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam are good clinical measures that quantify upper extremity function and are necessary for the accurate evaluation of patients and to plan intervention strategies.

Developing a Framework for Seamless Prediction of Sub-Seasonal to Seasonal Extreme Precipitation Events in the United States.

Science.gov (United States)

Rosendahl, D. H.; Ćwik, P.; Martin, E. R.; Basara, J. B.; Brooks, H. E.; Furtado, J. C.; Homeyer, C. R.; Lazrus, H.; Mcpherson, R. A.; Mullens, E.; Richman, M. B.; Robinson-Cook, A.

2017-12-01

Extreme precipitation events cause significant damage to homes, businesses, infrastructure, and agriculture, as well as many injures and fatalities as a result of fast-moving water or waterborne diseases. In the USA, these natural hazard events claimed the lives of more than 300 people during 2015 - 2016 alone, with total damage reaching $24.4 billion. Prior studies of extreme precipitation events have focused on the sub-daily to sub-weekly timeframes. However, many decisions for planning, preparing and resilience-building require sub-seasonal to seasonal timeframes (S2S; 14 to 90 days), but adequate forecasting tools for prediction do not exist. Therefore, the goal of this newly funded project is an enhancement in understanding of the large-scale forcing and dynamics of S2S extreme precipitation events in the United States, and improved capability for modeling and predicting such events. Here, we describe the project goals, objectives, and research activities that will take place over the next 5 years. In this project, a unique team of scientists and stakeholders will identify and understand weather and climate processes connected with the prediction of S2S extreme precipitation events by answering these research questions: 1) What are the synoptic patterns associated with, and characteristic of, S2S extreme precipitation evens in the contiguous U.S.? 2) What role, if any, do large-scale modes of climate variability play in modulating these events? 3) How predictable are S2S extreme precipitation events across temporal scales? 4) How do we create an informative prediction of S2S extreme precipitation events for policymaking and planing? This project will use observational data, high-resolution radar composites, dynamical climate models and workshops that engage stakeholders (water resource managers, emergency managers and tribal environmental professionals) in co-production of knowledge. The overarching result of this project will be predictive models to reduce of

Prospect for extreme field science

Energy Technology Data Exchange (ETDEWEB)

Tajima, T. [Ludwig Maximilian Univ. and Max Planck Institute for Quantum Optics, Garching (Germany); Japan Atomic Energy Agency, Kyoto and KEK, Tsukuba (Japan)

2009-11-15

The kind of laser extreme light infrastructure (ELI) provides will usher in a class of experiments we have only dreamed of for years. The characteristics that ELI brings in include: the highest intensity ever, large fluence, and relatively high repetition rate. A personal view of the author on the prospect of harnessing this unprecedented opportunity for advancing science of extreme fields is presented. The first characteristic of ELI, its intensity, will allow us to access, as many have stressed already, extreme fields that hover around the Schwinger field or at the very least the neighboring fields in which vacuum begins to behave as a nonlinear medium. In this sense, we are seriously probing the 'material' property of vacuum and thus the property that theory of relativity itself described and will entail. We will probe both special theory and general theory of relativity in regimes that have been never tested so far. We may see a glimpse into the reach of relativity or even its breakdown in some extreme regimes. We will learn Einstein and may even go beyond Einstein, if our journey is led. Laser-driven acceleration both by the laser field itself and by the wakefield that is triggered in a plasma is huge. Energies, if not luminosity, we can access, may be unprecedented going far beyond TeV. The nice thing about ELI is that it has relatively high repetition rate and average fluence as compared with other extreme lasers. This high fluence can be a key element that leads to applications to high energy physics, such as gamma-gamma collider driver experiment, and some gamma ray experiments that may be relevant in the frontier of photo-nuclear physics, and atomic energy applications. Needless to say, high fluence is one of most important features that industrial and medical applications may need. If we are lucky, we may see a door opens at the frontier of novel physics that may not be available by any other means. (authors)

Plasma-assisted cleaning of extreme UV optics

NARCIS (Netherlands)

Dolgov, Alexandr Alexeevich

2018-01-01

Plasma-assisted cleaning of extreme UV optics EUV-induced surface plasma chemistry of photo-active agents The next generation of photolithography, extreme ultraviolet (EUV) lithography, makes use of 13.5 nm radiation. The ionizing photon flux, and vacuum requirements create a challenging operating

GoPro-kypäräkameran kuvakulmat extreme-urheiluvideoissa

OpenAIRE

Hypén, Anssi

2013-01-01

Opinnäytetyössä tutkitaan GoPro-valmistajan kypäräkameran tavallisimpia videoiden kuvakulmia extreme-urheilulajeissa. Kuvakulmia tutkitaan GoPro viralliseen Youtube-videopalveluun ladattujen videoiden kautta, josta on poimittu yleisimpiä kuvakulmia extreme-urheilulajeissa. GoPro-kypäräkamera on alunperin suunniteltu extreme- ja seikkailu-urheiluun, joten opinnäytetyössä tutkitut kuvakulmat on rajattu tarkastelemaan vain extreme-urheilulajeissa käytettyjä kuvakulmia. Extreme-urheiluvideois...

Missing rings in Pinus halepensis – the missing link to relate the tree-ring record to extreme climatic events

Science.gov (United States)

Klemen Novak; Martin de Luis; Miguel A. Saz; Luis A. Longares; Roberto Serrano-Notivoli; Josep Raventos; Katarina Cufar; Jozica Gricar; Alfredo Di Filippo; Gianluca Piovesan; Cyrille B.K. Rathgeber; Andreas Papadopoulos; Kevin T. Smith

2016-01-01

Climate predictions for the Mediterranean Basin include increased temperatures, decreased precipitation, and increased frequency of extreme climatic events (ECE). These conditions are associated with decreased tree growth and increased vulnerability to pests and diseases. The anatomy of tree rings responds to these environmental conditions. Quantitatively, the width of...

Extremal vacuum black holes in higher dimensions

International Nuclear Information System (INIS)

Figueras, Pau; Lucietti, James; Rangamani, Mukund; Kunduri, Hari K.

2008-01-01

We consider extremal black hole solutions to the vacuum Einstein equations in dimensions greater than five. We prove that the near-horizon geometry of any such black hole must possess an SO(2,1) symmetry in a special case where one has an enhanced rotational symmetry group. We construct examples of vacuum near-horizon geometries using the extremal Myers-Perry black holes and boosted Myers-Perry strings. The latter lead to near-horizon geometries of black ring topology, which in odd spacetime dimensions have the correct number of rotational symmetries to describe an asymptotically flat black object. We argue that a subset of these correspond to the near-horizon limit of asymptotically flat extremal black rings. Using this identification we provide a conjecture for the exact 'phase diagram' of extremal vacuum black rings with a connected horizon in odd spacetime dimensions greater than five.

Extreme values, regular variation and point processes

CERN Document Server

Resnick, Sidney I

1987-01-01

Extremes Values, Regular Variation and Point Processes is a readable and efficient account of the fundamental mathematical and stochastic process techniques needed to study the behavior of extreme values of phenomena based on independent and identically distributed random variables and vectors It presents a coherent treatment of the distributional and sample path fundamental properties of extremes and records It emphasizes the core primacy of three topics necessary for understanding extremes the analytical theory of regularly varying functions; the probabilistic theory of point processes and random measures; and the link to asymptotic distribution approximations provided by the theory of weak convergence of probability measures in metric spaces The book is self-contained and requires an introductory measure-theoretic course in probability as a prerequisite Almost all sections have an extensive list of exercises which extend developments in the text, offer alternate approaches, test mastery and provide for enj...

Extreme learning machines 2013 algorithms and applications

CERN Document Server

Toh, Kar-Ann; Romay, Manuel; Mao, Kezhi

2014-01-01

In recent years, ELM has emerged as a revolutionary technique of computational intelligence, and has attracted considerable attentions. An extreme learning machine (ELM) is a single layer feed-forward neural network alike learning system, whose connections from the input layer to the hidden layer are randomly generated, while the connections from the hidden layer to the output layer are learned through linear learning methods. The outstanding merits of extreme learning machine (ELM) are its fast learning speed, trivial human intervene and high scalability.   This book contains some selected papers from the International Conference on Extreme Learning Machine 2013, which was held in Beijing China, October 15-17, 2013. This conference aims to bring together the researchers and practitioners of extreme learning machine from a variety of fields including artificial intelligence, biomedical engineering and bioinformatics, system modelling and control, and signal and image processing, to promote research and discu...

Hidden conformal symmetry of extremal black holes

International Nuclear Information System (INIS)

Chen Bin; Long Jiang; Zhang Jiaju

2010-01-01

We study the hidden conformal symmetry of extremal black holes. We introduce a new set of conformal coordinates to write the SL(2,R) generators. We find that the Laplacian of the scalar field in many extremal black holes, including Kerr(-Newman), Reissner-Nordstrom, warped AdS 3 , and null warped black holes, could be written in terms of the SL(2,R) quadratic Casimir. This suggests that there exist dual conformal field theory (CFT) descriptions of these black holes. From the conformal coordinates, the temperatures of the dual CFTs could be read directly. For the extremal black hole, the Hawking temperature is vanishing. Correspondingly, only the left (right) temperature of the dual CFT is nonvanishing, and the excitations of the other sector are suppressed. In the probe limit, we compute the scattering amplitudes of the scalar off the extremal black holes and find perfect agreement with the CFT prediction.

Dedicated extremity MR imaging of the foot and ankle

International Nuclear Information System (INIS)

Hottya, G.A.; Peterfy, C.G.; Uffmann, M.; Haeckl, F.O.; LeHir, P.; Redei, J.; Gindele, A.U.; Dion, E.; Genant, H.K.

2000-01-01

The purpose of this review is to provide illustrative examples of diseases of the foot and ankle when imaged with a low-field MR imaging system. A retrospective review of 268 foot and ankle examinations, performed in our institution within the past 3 years with a 0.2-T (Artoscan Esaote, Genoa, Italy) dedicated extremity MR system was done. Additionally, illustrative comparison with conventional radiography and high-field MR imaging is presented in patients in whom these examinations were also performed. Although motion artifact limited the value of a few studies, in the majority of examinations low-field MR imaging provided diagnostic image quality for the full spectrum of disorders affecting the foot and ankle and seemed to be a feasible alternative to high-field MR imaging in establishing an accurate diagnosis. (orig.)

Type I Gaucher disease: extraosseous extension of skeletal disease

International Nuclear Information System (INIS)

Poll, L.W.; Koch, J.A.; Moedder, U.; Dahl, S. vom; Haeussinger, D.; Sarbia, M.; Niederau, C.

2000-01-01

Objective. To investigate the frequency and morphology of extraosseous extension in patients with Gaucher disease type I.Design and patients. MRI examinations of the lower extremities were analyzed in 70 patients with Gaucher disease type I. Additionally, the thoracic spine and the midface were investigated on MRI in two patients.Results. Four cases are presented in which patients with Gaucher disease type I and severe skeletal involvement developed destruction or protrusion of the cortex with extraosseous extension into soft tissues. In one patient, Gaucher cell deposits destroyed the cortex of the mandible and extended into the masseter muscle. In the second patient, multiple paravertebral masses with localized destruction of the cortex were apparent in the thoracic spine. In the third and fourth patient, cortical destruction with extraosseous tissue extending into soft tissues was seen in the lower limbs.Conclusions. Extraosseous extension is a rare manifestation of Gaucher bone disease. While an increased risk of cancer, especially hematopoietic in origin, is known in patients with Gaucher disease, these extraosseous benign manifestations that may mimic malignant processes should be considered in the differential diagnosis of extraosseous extension into soft tissues. A narrow neck of tissue was apparent in all cases connecting bone and extraosseous extensions. (orig.)

16 CFR 1500.133 - Extremely flammable contact adhesives; labeling.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Extremely flammable contact adhesives... REGULATIONS § 1500.133 Extremely flammable contact adhesives; labeling. (a) Extremely flammable contact adhesives, also known as contact bonding cements, when distributed in containers intended or suitable for...

Parsimonious Wavelet Kernel Extreme Learning Machine

Directory of Open Access Journals (Sweden)

Wang Qin

2015-11-01

Full Text Available In this study, a parsimonious scheme for wavelet kernel extreme learning machine (named PWKELM was introduced by combining wavelet theory and a parsimonious algorithm into kernel extreme learning machine (KELM. In the wavelet analysis, bases that were localized in time and frequency to represent various signals effectively were used. Wavelet kernel extreme learning machine (WELM maximized its capability to capture the essential features in “frequency-rich” signals. The proposed parsimonious algorithm also incorporated significant wavelet kernel functions via iteration in virtue of Householder matrix, thus producing a sparse solution that eased the computational burden and improved numerical stability. The experimental results achieved from the synthetic dataset and a gas furnace instance demonstrated that the proposed PWKELM is efficient and feasible in terms of improving generalization accuracy and real time performance.

Hypothyroid-induced acute compartment syndrome in all extremities.

Science.gov (United States)

Musielak, Matthew C; Chae, Jung Hee

2016-12-20

Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed. Postoperative Day 1, upper extremity motor function decreased significantly and paresthesias occurred. She therefore underwent bilateral forearm fasciotomies. The pathogenesis of hypothyroidism-induced compartment syndrome is unclear. Thyroid-stimulating hormone-induced fibroblast activation results in increased glycosaminoglycan deposition. The primary glycosaminoglycan in hypothyroid myxedematous changes is hyaluronic acid, which binds water causing edema. This increases vascular permeability, extravasation of proteins and impaired lymphatic drainage. These contribute to increased intra-compartmental pressure and subsequent ACS. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

Check List of Symptoms SCL - 90 - R at Persons with Extremities Amputations

Directory of Open Access Journals (Sweden)

Suada Kapidžić-Duraković

2006-02-01

Full Text Available Multidimensional Inventory Check List of Symptoms (SCL-90-r is based on self-evaluation and it has been used for determination of level of: somatisation, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobias, paranoia and psychosis at persons which are exposed to long term emotional and physical stress. Our goal was to determine relations of physical trauma and psychological changes at persons with lower extremities amputations and to determine factors which influence those changes. Thirty seven persons with lower extremities amputations were examined. The sample included 26 (70.2 % veterans and 11 (29.7 % civilians with diseases related amputations. They voluntarily filled Check List of Symptoms SCL-90-r. Symptoms Inventory includes 9 dimensions of primary symptoms: SCL1-somatisation, SCL2-obsessive-compulsive symptoms, SCL3-interpersonal sensitivity, SCL4-depression, SCL5-anxiety, SCL6-hostility, SCL7-phobias, SCL8-paranoia, SCL9-psychosis and SCL10-extra scale. Inventory includes 90 statements, each evaluated with five-level scale of disorder. Every answer is graded with 0-4 points. Thirty seven persons with lower extremities amputations and average chronological age 46.2 +/- 10.92 years were analyzed. Considering marital status 30 (81.1 % of them were married, 4 (10.8 % were not married and 3 (8.1 % were widowers. Considering level of amputation 27 of them (73.0 % had amputation below knee, 5 (13.5 % of them amputation above knee and 5 of them (13.5 % foot amputation. SCL-90-r in both groups determined high level of sensitivity, anxiety, hostility and paranoia. Veterans showed higher level of paranoia comparing to civilians (p<0.002, and younger veterans and married ones had higher level of paranoia comparing to other veterans (p<0.01. Persons with amputations below and above knee showed higher level of paranoia comparing those with foot amputation (p<0.001. Persons with lower extremities

Current concepts in repair of extremity venous injury.

Science.gov (United States)

Williams, Timothy K; Clouse, W Darrin

2016-04-01

Extremity venous injury management remains controversial. The purpose of this communication is to offer perspective as well as experiential and technical insight into extremity venous injury repair. Available literature is reviewed and discussed. Historical context is provided. Indication, the decision process for repair, including technical conduct, is delineated. In particular, the authors' experiences in both civilian and wartime injury are used for perspective. Extremity venous injury repair was championed within data from the Vietnam Vascular Registry. However, patterns of extremity venous injury differ between combat and civilian settings. Since Vietnam, civilian descriptive series opine the benefits and potential complications associated with both venous injury repair and ligation. These surround extremity edema, chronic venous insufficiency, thromboembolism, and limb loss. Whereas no clear superiority in either approach has been identified to date, there appears to be no increased risk of pulmonary embolism or chronic venous changes with repair. Newer data from the wars in Iraq and Afghanistan and meta-analysis have reinforced this and also have suggested limb salvage benefit for extremity venous repair in combined arterial and venous injuries in modern settings. The patient's physiologic state and associated injury drive five triage categories suggesting vein injury management. Vein repair thrombosis occurs in a significant proportion, yet many recanalize and possibly have a positive impact on limb venous return. Further, early decompression favors reduced blood loss, acute edema, and inflammation, supporting collateral development. Large soft tissue injury minimizing collateral capacity increases the importance of repair. Constructs of repair are varied with modest differences in patency. Venous shunting is feasible, but specific roles remain nebulous. An aggressive posture toward extremity venous injury repair seems justified today because of the likely

Attribution of climate extreme events

Science.gov (United States)

Trenberth, Kevin E.; Fasullo, John T.; Shepherd, Theodore G.

2015-08-01

There is a tremendous desire to attribute causes to weather and climate events that is often challenging from a physical standpoint. Headlines attributing an event solely to either human-induced climate change or natural variability can be misleading when both are invariably in play. The conventional attribution framework struggles with dynamically driven extremes because of the small signal-to-noise ratios and often uncertain nature of the forced changes. Here, we suggest that a different framing is desirable, which asks why such extremes unfold the way they do. Specifically, we suggest that it is more useful to regard the extreme circulation regime or weather event as being largely unaffected by climate change, and question whether known changes in the climate system's thermodynamic state affected the impact of the particular event. Some examples briefly illustrated include 'snowmaggedon' in February 2010, superstorm Sandy in October 2012 and supertyphoon Haiyan in November 2013, and, in more detail, the Boulder floods of September 2013, all of which were influenced by high sea surface temperatures that had a discernible human component.

Detection and attribution of extreme weather disasters

Science.gov (United States)

Huggel, Christian; Stone, Dáithí; Hansen, Gerrit

2014-05-01

Single disasters related to extreme weather events have caused loss and damage on the order of up to tens of billions US dollars over the past years. Recent disasters fueled the debate about whether and to what extent these events are related to climate change. In international climate negotiations disaster loss and damage is now high on the agenda, and related policy mechanisms have been discussed or are being implemented. In view of funding allocation and effective risk reduction strategies detection and attribution to climate change of extreme weather events and disasters is a key issue. Different avenues have so far been taken to address detection and attribution in this context. Physical climate sciences have developed approaches, among others, where variables that are reasonably sampled over climatically relevant time periods and related to the meteorological characteristics of the extreme event are examined. Trends in these variables (e.g. air or sea surface temperatures) are compared between observations and climate simulations with and without anthropogenic forcing. Generally, progress has been made in recent years in attribution of changes in the chance of some single extreme weather events to anthropogenic climate change but there remain important challenges. A different line of research is primarily concerned with losses related to the extreme weather events over time, using disaster databases. A growing consensus is that the increase in asset values and in exposure are main drivers of the strong increase of economic losses over the past several decades, and only a limited number of studies have found trends consistent with expectations from climate change. Here we propose a better integration of existing lines of research in detection and attribution of extreme weather events and disasters by applying a risk framework. Risk is thereby defined as a function of the probability of occurrence of an extreme weather event, and the associated consequences

Changes in observed climate extremes in global urban areas

International Nuclear Information System (INIS)

Mishra, Vimal; Ganguly, Auroop R; Nijssen, Bart; Lettenmaier, Dennis P

2015-01-01

Climate extremes have profound implications for urban infrastructure and human society, but studies of observed changes in climate extremes over the global urban areas are few, even though more than half of the global population now resides in urban areas. Here, using observed station data for 217 urban areas across the globe, we show that these urban areas have experienced significant increases (p-value <0.05) in the number of heat waves during the period 1973–2012, while the frequency of cold waves has declined. Almost half of the urban areas experienced significant increases in the number of extreme hot days, while almost 2/3 showed significant increases in the frequency of extreme hot nights. Extreme windy days declined substantially during the last four decades with statistically significant declines in about 60% in the urban areas. Significant increases (p-value <0.05) in the frequency of daily precipitation extremes and in annual maximum precipitation occurred at smaller fractions (17 and 10% respectively) of the total urban areas, with about half as many urban areas showing statistically significant downtrends as uptrends. Changes in temperature and wind extremes, estimated as the result of a 40 year linear trend, differed for urban and non-urban pairs, while changes in indices of extreme precipitation showed no clear differentiation for urban and selected non-urban stations. (letter)

The central nervous system manifestation and CT findings of Fabry's disease

International Nuclear Information System (INIS)

Toyonaga, Kazutaka; Nishihira, Takeo

1983-01-01

A case of Fabry's disease with central nervous system dysfunction is reported. This 27-year-old man had recurrent episodes of pains in the extremities when he was a child. Spontaneous clinical remission occured around puberty. He had been well until age 22 when he experienced transient weakness of the left arm. The following year he developed transient blindness of the right eye. Then, he developed weakness in the extremities, dysphagia, dysarthria, and was brought to the hospital in unconscious state. Several members of his family are affected with the same disease presenting leg pains, kidney disease and angiokeratoma. Physical examination disclosed an optic atrophy, pseudobulbar palsy with spastic weakness in the all extremities and multiple angiokeratoma in the flank, buttocks and thighs. Abnormal laboratory findings included leukocytosis, increased ESR and strongly positive CRP. Biopsy of the skin disclosed dilated capilaries with numerous vacuoles in the cytoplasm of the epithelial cells. Thin-layer chromatography of the urine sediment showed a marked increase in ceramide trihexoside. Leukocyte alphagalactosidase level was abnormally low. CT scan showed diffuse cerebral atrophy and multiple low density areas in the thalamus, ventral pons and centrum semiovale. The CT findings and possible mechanism of the response to predonisolone were also discussed. (author)

JPRS Report Science & Technology Europe Twenty-Fourth Isata International Symposium on Automotive Technology and Automation.

Science.gov (United States)

1991-09-05

Hirayama, Association of Electronic Technology for Automobile Traffic and Driving and Y Ishii, Oki Electric Industry, Japan " Mazda Car Communication...System" Mazda Car Corporation, FRG IMPROVING TRAFFIC FLOW "Strategies for Integrating Dynamic Route Guidance and Traffic Control Systems" MGH Bell...Chemical Structure by Means of Exafs" N Sato, Honda R&D Co. Ltd and T Minami, Honda Motor Co. Ltd, Japan 155 910904 "Microstructural and Hardness

Chronic Obstructive Pulmonary Disease Biomarkers

Directory of Open Access Journals (Sweden)

Tatsiana Beiko

2016-04-01

Full Text Available Despite significant decreases in morbidity and mortality of cardiovascular diseases (CVD and cancers, morbidity and cost associated with chronic obstructive pulmonary disease (COPD continue to be increasing. Failure to improve disease outcomes has been related to the paucity of interventions improving survival. Insidious onset and slow progression halter research successes in developing disease-modifying therapies. In part, the difficulty in finding new therapies is because of the extreme heterogeneity within recognized COPD phenotypes. Novel biomarkers are necessary to help understand the natural history and pathogenesis of the different COPD subtypes. A more accurate phenotyping and the ability to assess the therapeutic response to new interventions and pharmaceutical agents may improve the statistical power of longitudinal clinical studies. In this study, we will review known candidate biomarkers for COPD, proposed pathways of pathogenesis, and future directions in the field.

Extreme pressure differences at 0900 NZST and winds across New Zealand

Science.gov (United States)

Salinger, M. James; Griffiths, Georgina M.; Gosai, Ashmita

2005-07-01

Trends in extremes in station daily sea-level pressure differences at 0900 NZST are examined, and extreme daily wind gusts, across New Zealand, since the 1960s. Annual time series were examined (with indices of magnitude and frequency over threshold percentiles) from the daily indices selected. These follow from earlier indices of normalized monthly mean sea-level pressure differences between station pairs, except the daily indices are not normalized. The frequency statistics quantify the number of extreme zonal (westerly and easterly), or extreme meridional (southerly or northerly), pressure gradient events. The frequency and magnitude of extreme westerly episodes has increased slightly over New Zealand, with a significant increase in the westerly extremes to the south of New Zealand. In contrast, the magnitude and frequency of easterly extremes has decreased over New Zealand, but increased to the south, with some trends weakly significant. The frequency and magnitude of daily southerly extremes has decreased significantly in the region.Extreme daily wind gust events at key climate stations in New Zealand and at Hobart, Australia, are highly likely to be associated with an extreme daily pressure difference. The converse was less likely to hold: extreme wind gusts were not always observed on days with extreme daily pressure difference, probably due to the strong influence that topography has on localized station winds. Significant correlations exist between the frequency indices and both annual-average mean sea-level pressures around the Australasian region and annual-average sea surface temperature (SST) anomalies in the Southern Hemisphere. These correlations are generally stronger for indices of extreme westerly or extreme southerly airflows. Annual-average pressures in the Tasman Sea or Southern Ocean are highly correlated to zonal indices (frequency of extreme westerlies). SST anomalies in the NINO3 region or on either side of the South Island are

New Directions in Chronic Disease Management

Directory of Open Access Journals (Sweden)

Hun-Sung Kim

2015-06-01

Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

Extreme Ultraviolet Explorer Bright Source List

Science.gov (United States)

Malina, Roger F.; Marshall, Herman L.; Antia, Behram; Christian, Carol A.; Dobson, Carl A.; Finley, David S.; Fruscione, Antonella; Girouard, Forrest R.; Hawkins, Isabel; Jelinsky, Patrick

1994-01-01

Initial results from the analysis of the Extreme Ultraviolet Explorer (EUVE) all-sky survey (58-740 A) and deep survey (67-364 A) are presented through the EUVE Bright Source List (BSL). The BSL contains 356 confirmed extreme ultraviolet (EUV) point sources with supporting information, including positions, observed EUV count rates, and the identification of possible optical counterparts. One-hundred twenty-six sources have been detected longward of 200 A.

Plant volatiles in extreme terrestrial and marine environments.

Science.gov (United States)

Rinnan, Riikka; Steinke, Michael; McGenity, Terry; Loreto, Francesco

2014-08-01

This review summarizes the current understanding on plant and algal volatile organic compound (VOC) production and emission in extreme environments, where temperature, water availability, salinity or other environmental factors pose stress on vegetation. Here, the extreme environments include terrestrial systems, such as arctic tundra, deserts, CO₂ springs and wetlands, and marine systems such as sea ice, tidal rock pools and hypersaline environments, with mangroves and salt marshes at the land-sea interface. The emission potentials at fixed temperature and light level or actual emission rates for phototrophs in extreme environments are frequently higher than for organisms from less stressful environments. For example, plants from the arctic tundra appear to have higher emission potentials for isoprenoids than temperate species, and hypersaline marine habitats contribute to global dimethyl sulphide (DMS) emissions in significant amounts. DMS emissions are more widespread than previously considered, for example, in salt marshes and some desert plants. The reason for widespread VOC, especially isoprenoid, emissions from different extreme environments deserves further attention, as these compounds may have important roles in stress resistance and adaptation to extremes. Climate warming is likely to significantly increase VOC emissions from extreme environments both by direct effects on VOC production and volatility, and indirectly by altering the composition of the vegetation. © 2014 John Wiley & Sons Ltd.

Electromyographic evaluation of high-intensity elastic resistance exercises for lower extremity muscles during bed rest

DEFF Research Database (Denmark)

Vinstrup, Jonas; Skals, Sebastian; Calatayud, Joaquin

2017-01-01

PURPOSE: Prolonged hospital bed rest after severe injury or disease leads to rapid muscle atrophy and strength loss. Therefore, the main aim of this study was to evaluate the efficacy of lower extremity strengthening exercises using elastic resistance that can be performed while lying in a hospit......, the present study has the potential to provide a reference table of exercises to select from when individualizing and progressing strengthening exercises during the early rehabilitation of bedridden individuals....

The clinical efficacy observation of fluoroscopy-guided foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities

International Nuclear Information System (INIS)

Zhu Yongqiang; Xu Jingxuan; Chen Junying; Wu Yan; Zhang Chuanhong; Li Liang

2012-01-01

Objective: To assess the clinical efficacy of foam sclerotherapy with lauromacrogol for varicose veins of the lower extremities. Methods: During the period from February to July 2011, we retrospectively analyzed 20 patients with varicose veins of the lower extremities, who were treated with lauromacrogol foam sclerosing agent injected directly at varicose veins, and in 5 extremities injected at the great saphenous vein (GSV) through a catheter at the same time. Elastic bandages were applied at the site of the injected varicosities after the therapy. The clogging of the varicose veins, the improvement of the clinical symptoms and the adverse reaction were observed. Results: Lauromacrogol foam sclerosing agent was successfully injected under the guidance of fluoroscopy in 20 patients with 28 affected extremities. The average volume of foam sclerosing agent in each affected extremity was 7.8 ml. All patients presented self limiting minor complications, including swelling and pain, which was obviously alleviated by the externally applied Mucopolysaccharide Polysulfate Cream. Two patients presented cough that was relieved after inhaling oxygen. Most of treated varicosities demonstrated pigmentation after the first week, which gradually disappeared after the four-month use of vitamin E capsule. A second foam sclerotherapy was carried out for 3 affected extremities of 3 patients two months after the first therapy. Two cases of leg venous ulcer were healed within a few weeks. All patients could walk immediately with no deep vein thrombosis, pulmonary embolism, anaphylaxis, or transient visual disturbance. Obvious abnormal varicose veins as well as the soreness and fatigue of the lower extremities disappeared in all patients at the 10th-month follow-up. The grading of the disease was significantly improved by the treatment (Z=5.103, P<0.01). Conclusions: The efficacy of lauromacrogol foam sclerosing agent in the treatment of varicose veins of the lower extremities is

Economic Growth and the Rise of Political Extremism

OpenAIRE

Markus Bruckner; Hans Peter Gruner

2011-01-01

In many western democracies, political parties with extreme platforms challenge more moderate incumbents. This paper analyses the impact of economic growth on the support for extreme political platforms. We provide a theoretical argument in favor of growth effects (as opposed to level effects) on the support for extreme political parties and we empirically investigate the relationship between growth and extremist votes. Lower growth rates benefit right-wing and nationalist parties, but do not...

National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis With Policy Implications.

Science.gov (United States)

Harris, Catherine R; Osterberg, E Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W; McAninch, Jack W; McCulloch, Charles E; Breyer, Benjamin N

2016-08-01

To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality. We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear regression with sensitivity analysis was used to determine variables associated with increased costs. Extreme cost was defined as the top 20th percentile of expenditure, analyzed with logistic regression, and expressed as odds ratios (OR). A total of 2298 urethroplasties were recorded in NIS over the study period. The median (interquartile range) calculated cost was $7321 ($5677-$10,000). Patients with multiple comorbid conditions were associated with extreme costs [OR 1.56, 95% confidence interval (CI) 1.19-2.04, P = .02] compared with patients with no comorbid disease. Inpatient complications raised the odds of extreme costs (OR 3.2, CI 2.14-4.75, P costs (OR 1.78, 95% CI 1.2-2.64, P = .005). Variations in patient age, race, hospital region, bed size, teaching status, payor type, and volume of urethroplasty cases were not associated with extremes of cost. Cost variation for perioperative inpatient urethroplasty procedures is dependent on preoperative patient comorbidities, postoperative complications, and surgical complexity related to graft usage. Procedural cost and cost variation are critical for understanding which aspects of care have the greatest impact on cost. Copyright © 2016 Elsevier Inc. All rights reserved.

Digital subtraction angiography in pediatric cerebrovascular occlusive disease

International Nuclear Information System (INIS)

Faerber, E.N.; Griska, L.A.B.; Swartz, J.D.; Capitanio, M.A.; Popky, G.L.

1984-01-01

While conventional angiography has been used to demonstrate cerebrovascular occlusive disease in the past, digital subtraction angiography (DSA) is capable of showing progressive vascular involvement with ease, simplicity, and extremely low morbidity, making it particularly well suited for children and outpatients either alone or coordinated with computed tomography. The authors discuss the usefulness and advantages of DSA as demonstrated in 7 infants and children with hemiplegia, 4 of whom had sickle-cell disease

Automation Rover for Extreme Environments

Science.gov (United States)

Sauder, Jonathan; Hilgemann, Evan; Johnson, Michael; Parness, Aaron; Hall, Jeffrey; Kawata, Jessie; Stack, Kathryn

2017-01-01

Almost 2,300 years ago the ancient Greeks built the Antikythera automaton. This purely mechanical computer accurately predicted past and future astronomical events long before electronics existed1. Automata have been credibly used for hundreds of years as computers, art pieces, and clocks. However, in the past several decades automata have become less popular as the capabilities of electronics increased, leaving them an unexplored solution for robotic spacecraft. The Automaton Rover for Extreme Environments (AREE) proposes an exciting paradigm shift from electronics to a fully mechanical system, enabling longitudinal exploration of the most extreme environments within the solar system.

Dual Axis Controller for Extreme Environments, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — The Dual Axis Controller for Extreme Environments (DACEE) addresses a critical need of NASA's future exploration plans to investigate extreme environments within our...

Calculation of neutron fluence-to-dose conversion factors for extremities

International Nuclear Information System (INIS)

Stewart, R.D.; Harty, R.; McDonald, J.C.; Tanner, J.E.

1993-04-01

The Pacific Northwest Laboratory is developing a standard for the performance testing of personnel extremity dosimeters for the US Department of Energy. Part of this effort requires the calculation of neutron fluence-to-dose conversion factors for finger and wrist extremities. This study focuses on conversion factors for two types of extremity models: namely the polymethyl methacrylate (PMMA) phantom (as specified in the draft standard for performance testing of extremity dosimeters) and more realistic extremity models composed of tissue-and-bone. Calculations for each type of model are based on both bare and D 2 O-moderated 252 Cf sources. The results are then tabulated and compared with whole-body conversion factors. More appropriate energy-averaged quality factors for the extremity models have also been computed from the neutron fluence in 50 equally spaced energy bins with energies from 2.53 x 10 -8 to 15 MeV. Tabulated results show that conversion factors for both types of extremity phantom are 15 to 30% lower than the corresponcung whole-body phantom conversion factors for 252 Cf neutron sources. This difference in extremity and whole-body conversion factors is attributable to the proportionally smaller amount of back-scattering that occurs in the extremity phantoms compared with whole-body phantoms

Renal cystic disease: A practical overview

International Nuclear Information System (INIS)

Hartman, D.S.

1987-01-01

Renal cystic disease includes a group of lesions with extremely diverse clinical, radiographic, and pathologic findings. The recent development of multiple imaging systems to study renal cystic disease has resulted in considerable interest in correlating the images obtained by different modalities with each other and with the underlying gross pathology. A thorough knowledge of the disturbed morphology and natural history of these diseases will lead to a better understanding of their appearance on radiologic imaging. This refresher course correlates disturbed morphology with appearances on diagnostic imaging, urography, US, angiography, CT, and MR imaging. The advantages and limitations of each imaging method are detailed. A practical classification emphasizing differential features is presented. The presentation is divided into two parts. In the first part typical and atypical cystic masses, including acquired cystic disease (from dialysis), Von Hippel-Lindau disease, and the cystic disease of tuberous sclerosis are discussed. In the second part, polycystic kidney disease (dominant and recessive), medullary cystic disease, medullary sponge kidney, multicycle-dysplastic kidney, renal sinus cysts (peripelvic), and pluricystic kidney disease are discussed

Acute lower extremity ischaemia

African Journals Online (AJOL)

Acute lower extremity ischaemia. Acute lower limb ischaemia is a surgical emergency. ... is ~1.5 cases per 10 000 persons per year. Acute ischaemia ... Table 2. Clinical features discriminating embolic from thrombotic ALEXI. Clinical features.

Vertical structure of extreme currents in the Faroe-Bank Channel

Directory of Open Access Journals (Sweden)

C. Carollo

2005-09-01

Full Text Available Extreme currents are studied with the aim of understanding their vertical and spatial structures in the Faroe-Bank Channel. Acoustic Doppler Current Profiler time series recorded in 3 deployments in this channel were investigated. To understand the main features of extreme events, the measurements were separated into their components through filtering and tidal analysis before applying the extreme value theory to the surge component. The Generalized Extreme Value (GEV distribution and the Generalized Pareto Distribution (GPD were used to study the variation of surge extremes from near-surface to deep waters. It was found that this component alone is not able to explain the extremes measured in total currents, particularly below 500 m. Here the mean residual flow enhanced by tidal rectification was found to be the component feature dominating extremes. Therefore, it must be taken into consideration when applying the extreme value theory, not to underestimate the return level for total currents. Return value speeds up to 250 cm s–1 for 50/250 years return period were found for deep waters, where the flow is constrained by the topography at bearings near 300/330° It is also found that the UK Meteorological Office FOAM model is unable to reproduce either the magnitude or the form for the extremes, perhaps due to its coarse vertical and horizontal resolution, and is thus not suitable to model extremes on a regional scale. Keywords. Oceanography: Physical (Currents; General circulation; General or miscellaneous

Online transfer learning with extreme learning machine

Science.gov (United States)

Yin, Haibo; Yang, Yun-an

2017-05-01

In this paper, we propose a new transfer learning algorithm for online training. The proposed algorithm, which is called Online Transfer Extreme Learning Machine (OTELM), is based on Online Sequential Extreme Learning Machine (OSELM) while it introduces Semi-Supervised Extreme Learning Machine (SSELM) to transfer knowledge from the source to the target domain. With the manifold regularization, SSELM picks out instances from the source domain that are less relevant to those in the target domain to initialize the online training, so as to improve the classification performance. Experimental results demonstrate that the proposed OTELM can effectively use instances in the source domain to enhance the learning performance.

Upper-extremity phocomelia reexamined: a longitudinal dysplasia.

Science.gov (United States)

Goldfarb, Charles A; Manske, Paul R; Busa, Riccardo; Mills, Janith; Carter, Peter; Ezaki, Marybeth

2005-12-01

In contrast to longitudinal deficiencies, phocomelia is considered a transverse, intercalated segmental dysplasia. Most patients demonstrate severe, but not otherwise classifiable, upper-extremity deformities, which usually cannot be placed into one of three previously described phocomelia groups. Additionally, these phocomelic extremities do not demonstrate true segmental deficits; the limb is also abnormal proximal and distal to the segmental defect. The purpose of this investigation was to present evidence that upper-extremity abnormalities in patients previously diagnosed as having phocomelia in fact represent a proximal continuum of radial or ulnar longitudinal dysplasia. The charts and radiographs of forty-one patients (sixty extremities) diagnosed as having upper-extremity phocomelia were reviewed retrospectively. On the basis of the findings on the radiographs, the disorders were categorized into three groups: (1) proximal radial longitudinal dysplasia, which was characterized by an absent proximal part of the humerus, a nearly normal distal part of the humerus, a completely absent radius, and a radial-sided hand dysplasia; (2) proximal ulnar longitudinal dysplasia, characterized by a short one-bone upper extremity that bifurcated distally and by severe hand abnormalities compatible with ulnar dysplasia; and (3) severe combined dysplasia, with type A characterized by an absence of the forearm segment (i.e., the radius and ulna) and type B characterized by absence of the arm and forearm (i.e., the hand attached to the thorax). Twenty-nine limbs in sixteen patients could be classified as having proximal radial longitudinal dysplasia. Systemic medical conditions such as thrombocytopenia-absent radius syndrome were common in those patients, but additional musculoskeletal conditions were rare. Twenty limbs in seventeen patients could be classified as having proximal ulnar longitudinal dysplasia. Associated musculoskeletal abnormalities, such as proximal femoral

Injuries in an Extreme Conditioning Program

OpenAIRE

Aune, Kyle T.; Powers, Joseph M.

2016-01-01

Background: Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. Hypothesis: The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occ...

Covered Interest-Rate Parity Revisited: an Extreme Value Copula Analysis

Directory of Open Access Journals (Sweden)

Mikel Ugando-Peñate

2015-11-01

Full Text Available This article studied the covered interest-rate parity (CIP condition under extreme market movements using extreme value theory and extreme value copulas to characterize dependence between extreme interest rate differentials and forward premium. The empirical analysis for the CIP between interest rates for the US dollar and the British pound indicates that there is strong co-movement between interest rate differentials and forward premium at different maturities and in both upper and lower tails. This conclusion would support the existence of the CIP condition under extreme market movements.

Measures of serial extremal dependence and their estimation

DEFF Research Database (Denmark)

Davis, Richard A.; Mikosch, Thomas Valentin; Zhao, Yuwei

2013-01-01

extremal dependence is typically characterized by clusters of exceedances of high thresholds in the series. We start by discussing the notion of extremal index of a univariate sequence, i.e. the reciprocal of the expected cluster size, which has attracted major attention in the extremal value literature...... has attracted attention for modeling and statistical purposes. We apply the extremogram to max-stable processes. Finally, we discuss estimation of the extremogram both in the time and frequency domains....

Using Extreme Phenotype Sampling to Identify the Rare Causal Variants of Quantitative Traits in Association Studies

OpenAIRE

Li, Dalin; Lewinger, Juan Pablo; Gauderman, William J.; Murcray, Cassandra Elizabeth; Conti, David

2011-01-01

Variants identified in recent genome-wide association studies based on the common-disease common-variant hypothesis are far from fully explaining the hereditability of complex traits. Rare variants may, in part, explain some of the missing hereditability. Here, we explored the advantage of the extreme phenotype sampling in rare-variant analysis and refined this design framework for future large-scale association studies on quantitative traits. We first proposed a power calculation approach fo...

Quality improvement activity for improving pain management in acute extremity injuries in the emergency department.

Science.gov (United States)

Chang, Hyung Lan; Jung, Jin Hee; Kwak, Young Ho; Kim, Do Kyun; Lee, Jin Hee; Jung, Jae Yun; Kwon, Hyuksool; Paek, So Hyun; Park, Joong Wan; Shin, Jonghwan

2018-03-01

The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40-S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse's pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription. A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%. ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.

Methodology for featuring and assessing extreme climatic events

International Nuclear Information System (INIS)

Malleron, N.; Bernardara, P.; Benoit, M.; Parey, S.; Perret, C.

2013-01-01

The setting up of a nuclear power plant on a particular site requires the assessment of risks linked to extreme natural events like flooding or earthquakes. As a consequence of the Fukushima accident EDF proposes to take into account even rarer events in order to improve the robustness of the facility all over its operating life. This article presents the methodology used by EDF to analyse a set of data in a statistical way in order to extract extreme values. This analysis is based on the theory of extreme values and is applied to the extreme values of the flow rate in the case of a river overflowing. This methodology is made of 6 steps: 1) selection of the event, of its featuring parameter and of its probability, for instance the question is what is the flow rate of a flooding that has a probability of 10 -3 to happen, 2) to collect data over a long period of time (or to recover data from past periods), 3) to extract extreme values from the data, 4) to find an adequate statistical law that fits the spreading of the extreme values, 5) the selected statistical law must be validated through visual or statistical tests, and 6) the computation of the flow rate of the event itself. (A.C.)

Area spectra of near extremal black holes

International Nuclear Information System (INIS)

Chen, Deyou; Yang, Haitang; Zu, Xiaotao

2010-01-01

Motivated by Maggiore's new interpretation of quasinormal modes, we investigate area spectra of a near extremal Schwarzschild-de Sitter black hole and a higher-dimensional near extremal Reissner-Nordstrom-de Sitter black hole. The result shows that the area spectra are equally spaced and irrelevant to the parameters of the black holes. (orig.)

Predictability of Extreme Precipitations Over the Conterminous us, 1949-2010

Science.gov (United States)

Jiang, M.; Felzer, B. S.

2015-12-01

Extreme precipitation plays an important role in regulating ecosystem services. Precipitation extremes vary in magnitude and duration both spatially and temporally, making it one of the most challenging climate variables to comprehend and predict. Using information theory, we provide an attempt to improve understanding of the predictability of extreme precipitation in the conterminous U.S. over the period of 1949-2010. We define predictability as the recurrent likelihood of patterns described by the measures of constancy and contingency, with the former describing the inter-annual variability and the latter describing the seasonality. This study shows that there are clear west-east contrasts of predictability over the U.S. landscape, with a generally decreasing gradient from the Northeast to the Southwest for intensity-based extremes and a generally increasing gradient from the West to the East for duration-based extremes. We further identify spatially heterogeneous patterns of temporal changes in predictability over the investigated timeframe. Finally, it is evident that constancy plays a heavier role in regulating predictability increases for both intensity and duration-based extremes and for predictability decreases for duration-based extremes, while contingency contributes equally with constancy to determining the decreases in predictability for intensity-based extremes.

Extreme weather-related health needs of people who are homeless.

Science.gov (United States)

Cusack, Lynette; van Loon, Antonia; Kralik, Debbie; Arbon, Paul; Gilbert, Sandy

2013-01-01

To identify the extreme weather-related health needs of homeless people and the response by homeless service providers in Adelaide, South Australia, a five-phased qualitative interpretive study was undertaken. (1) Literature review, followed by semi-structured interviews with 25 homeless people to ascertain health needs during extreme weather events. (2) Identification of homeless services. (3) Semi-structured interviews with 16 homeless service providers regarding their response to the health needs of homeless people at times of extreme weather. (4) Gap analysis. (5) Suggestions for policy and planning. People experiencing homelessness describe adverse health impacts more from extreme cold, than extreme hot weather. They considered their health suffered more, because of wet bedding, clothes and shoes. They felt more depressed and less able to keep themselves well during cold, wet winters. However, homeless service providers were more focussed on planning for extra service responses during times of extreme heat rather than extreme cold. Even though a city may be considered to have a temperate climate with a history of very hot summers, primary homeless populations have health needs during winter months. The experiences and needs of homeless people should be considered in extreme weather policy and when planning responses.

Alternative measures of risk of extreme events in decision trees

International Nuclear Information System (INIS)

Frohwein, H.I.; Lambert, J.H.; Haimes, Y.Y.

1999-01-01

A need for a methodology to control the extreme events, defined as low-probability, high-consequence incidents, in sequential decisions is identified. A variety of alternative and complementary measures of the risk of extreme events are examined for their usability as objective functions in sequential decisions, represented as single- or multiple-objective decision trees. Earlier work had addressed difficulties, related to non-separability, with the minimization of some measures of the risk of extreme events in sequential decisions. In an extension of these results, it is shown how some non-separable measures of the risk of extreme events can be interpreted in terms of separable constituents of risk, thereby enabling a wider class of measures of the risk of extreme events to be handled in a straightforward manner in a decision tree. Also for extreme events, results are given to enable minimax- and Hurwicz-criterion analyses in decision trees. An example demonstrates the incorporation of different measures of the risk of extreme events in a multi-objective decision tree. Conceptual formulations for optimizing non-separable measures of the risk of extreme events are identified as an important area for future investigation

Extremely elevated erythrocyte sedimentation rate. Etiology at a tertiary care center in Saudi Arabia

International Nuclear Information System (INIS)

Muhammad Yousuf; Javed Akhter; Khalid Al-Khairy; Mohammed A. Al-Saadan; Salih Bin-Salih

2010-01-01

To evaluate the etiology of extremely elevated erythrocyte sedimentation rate (ESR) in adolescents and adults at a tertiary care center. This retrospective, cross-sectional, observational study was carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia using the Westergren method of determining ESR in adolescents and adults aged >/=12 years. The patients included inpatients and outpatients with medical, surgical, and gynecological problems. During a period from June 2007 to October 2008, consecutive, non-repetitive patients with ESR >/=100 mm/hour were evaluated for possible etiology by checking the electronic and paper data file of each patient. During the study period, out of the 44,366 ESR tests carried out at this center, 1864 (4.2%) had an ESR >/=100 mm/hour belonging to 567 patients. Out of 508 patients fulfilling the study criteria, the main associated causes included: infections (38.6%), autoimmune diseases (15.9%), malignancy (15.4%), miscellaneous causes (10.2%), ischemic tissue injury or trauma (8.7%), and renal diseases (8.4%). Ten common individual causes included: rheumatoid arthritis (7.3%), osteomyelitis (6.9%), tuberculosis (5.5%), trauma (5.3%), lymphoma and sepsis of unknown origin (5.1%) each, urinary tract infection (4.7%), septic arthritis (3.1%), abscesses (2.8%), and pregnancy (2.2%). Fourteen (2.4%) patients had no known cause. Most of the patients with extreme ESR elevation have an underlying cause and a focused evaluation of such patients needs to be carried out to reach a diagnosis.

Extreme Growth Failure is a Common Presentation of Ligase IV Deficiency

Science.gov (United States)

Murray, Jennie E; Bicknell, Louise S; Yigit, Gökhan; Duker, Angela L; van Kogelenberg, Margriet; Haghayegh, Sara; Wieczorek, Dagmar; Kayserili, Hülya; Albert, Michael H; Wise, Carol A; Brandon, January; Kleefstra, Tjitske; Warris, Adilia; van der Flier, Michiel; Bamforth, J Steven; Doonanco, Kurston; Adès, Lesley; Ma, Alan; Field, Michael; Johnson, Diana; Shackley, Fiona; Firth, Helen; Woods, C Geoffrey; Nürnberg, Peter; Gatti, Richard A; Hurles, Matthew; Bober, Michael B; Wollnik, Bernd; Jackson, Andrew P

2014-01-01

Ligase IV syndrome is a rare differential diagnosis for Nijmegen breakage syndrome owing to a shared predisposition to lympho-reticular malignancies, significant microcephaly, and radiation hypersensitivity. Only 16 cases with mutations in LIG4 have been described to date with phenotypes varying from malignancy in developmentally normal individuals, to severe combined immunodeficiency and early mortality. Here, we report the identification of biallelic truncating LIG4 mutations in 11 patients with microcephalic primordial dwarfism presenting with restricted prenatal growth and extreme postnatal global growth failure (average OFC −10.1 s.d., height −5.1 s.d.). Subsequently, most patients developed thrombocytopenia and leucopenia later in childhood and many were found to have previously unrecognized immunodeficiency following molecular diagnosis. None have yet developed malignancy, though all patients tested had cellular radiosensitivity. A genotype–phenotype correlation was also noted with position of truncating mutations corresponding to disease severity. This work extends the phenotypic spectrum associated with LIG4 mutations, establishing that extreme growth retardation with microcephaly is a common presentation of bilallelic truncating mutations. Such growth failure is therefore sufficient to consider a diagnosis of LIG4 deficiency and early recognition of such cases is important as bone marrow failure, immunodeficiency, and sometimes malignancy are long term sequelae of this disorder. PMID:24123394

[Ultrasound examination for lower extremity deep vein thrombosis].

Science.gov (United States)

Toyota, Kosaku

2014-09-01

Surgery is known to be a major risk factor of vein thrombosis. Progression from lower extremity deep vein thrombosis (DVT) to pulmonary embolism can lead to catastrophic outcome, although the incidence ratio is low. The ability to rule in or rule out DVT is becoming essential for anesthesiologists. Non-invasive technique of ultrasonography is a sensitive and specific tool for the assessment of lower extremity DVT. This article introduces the basics and practical methods of ultrasound examination for lower extremity DVT.

Vertical structure of extreme currents in the Faroe-Bank Channel

Directory of Open Access Journals (Sweden)

C. Carollo

2005-09-01

Full Text Available Extreme currents are studied with the aim of understanding their vertical and spatial structures in the Faroe-Bank Channel. Acoustic Doppler Current Profiler time series recorded in 3 deployments in this channel were investigated. To understand the main features of extreme events, the measurements were separated into their components through filtering and tidal analysis before applying the extreme value theory to the surge component. The Generalized Extreme Value (GEV distribution and the Generalized Pareto Distribution (GPD were used to study the variation of surge extremes from near-surface to deep waters. It was found that this component alone is not able to explain the extremes measured in total currents, particularly below 500 m. Here the mean residual flow enhanced by tidal rectification was found to be the component feature dominating extremes. Therefore, it must be taken into consideration when applying the extreme value theory, not to underestimate the return level for total currents. Return value speeds up to 250 cm s^–1 for 50/250 years return period were found for deep waters, where the flow is constrained by the topography at bearings near 300/330° It is also found that the UK Meteorological Office FOAM model is unable to reproduce either the magnitude or the form for the extremes, perhaps due to its coarse vertical and horizontal resolution, and is thus not suitable to model extremes on a regional scale.

Keywords. Oceanography: Physical (Currents; General circulation; General or miscellaneous

Risk Factors for Lower-Extremity Injuries Among Contemporary Dance Students.

Science.gov (United States)

van Seters, Christine; van Rijn, Rogier M; van Middelkoop, Marienke; Stubbe, Janine H

2017-10-10

To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers. Prospective cohort study. Codarts University of the Arts. Forty-five first-year students of Bachelor Dance and Bachelor Dance Teacher. At the beginning of the academic year, the injury history (only lower-extremity) and student characteristics (age, sex, educational program) were assessed using a questionnaire. Besides, lower-extremity kinematics [single-leg squat (SLS)], strength (countermovement jump) and height and weight (body mass index) were measured during a physical performance test. Substantial lower-extremity injuries during the academic year were defined as any problems leading to moderate or severe reductions in training volume or in performance, or complete inability to participate in dance at least once during follow-up as measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems. Injuries were recorded on a monthly basis using a questionnaire. Analyses on leg-level were performed using generalized estimating equations to test the associations between substantial lower-extremity injuries and potential risk factors. The 1-year incidence of lower-extremity injuries was 82.2%. Of these, 51.4% was a substantial lower-extremity injury. Multivariate analyses identified that ankle dorsiflexion during the SLS (OR 1.25; 95% confidence interval, 1.03-1.52) was a risk factor for a substantial lower-extremity injury. The findings indicate that contemporary dance students are at high risk for lower-extremity injuries. Therefore, the identified risk factor (ankle dorsiflexion) should be considered for prevention purposes.

Analysis of extreme events

CSIR Research Space (South Africa)

Khuluse, S

2009-04-01

Full Text Available ) determination of the distribution of the damage and (iii) preparation of products that enable prediction of future risk events. The methodology provided by extreme value theory can also be a powerful tool in risk analysis...

Preconditioned iterations to calculate extreme eigenvalues

Energy Technology Data Exchange (ETDEWEB)

Brand, C.W.; Petrova, S. [Institut fuer Angewandte Mathematik, Leoben (Austria)

1994-12-31

Common iterative algorithms to calculate a few extreme eigenvalues of a large, sparse matrix are Lanczos methods or power iterations. They converge at a rate proportional to the separation of the extreme eigenvalues from the rest of the spectrum. Appropriate preconditioning improves the separation of the eigenvalues. Davidson`s method and its generalizations exploit this fact. The authors examine a preconditioned iteration that resembles a truncated version of Davidson`s method with a different preconditioning strategy.

The Engineering for Climate Extremes Partnership

Science.gov (United States)

Holland, G. J.; Tye, M. R.

2014-12-01

Hurricane Sandy and the recent floods in Thailand have demonstrated not only how sensitive the urban environment is to the impact of severe weather, but also the associated global reach of the ramifications. These, together with other growing extreme weather impacts and the increasing interdependence of global commercial activities point towards a growing vulnerability to weather and climate extremes. The Engineering for Climate Extremes Partnership brings academia, industry and government together with the goals encouraging joint activities aimed at developing new, robust, and well-communicated responses to this increasing vulnerability. Integral to the approach is the concept of 'graceful failure' in which flexible designs are adopted that protect against failure by combining engineering or network strengths with a plan for efficient and rapid recovery if and when they fail. Such an approach enables optimal planning for both known future scenarios and their assessed uncertainty.

Mediatized Extreme Right Activism and Discourse

DEFF Research Database (Denmark)

Peters, Rikke Alberg

2015-01-01

This paper presents a case study of the German neo-fascist network The Immortals (Die Unsterblichen) who in 2011 performed a flash-mob disseminated on YouTube for the so- called ‘Become Immortal’ campaign. The street protest was designed for and adapted to the specific characteristics of online...... activism. It is a good example of how new contentious action repertoires in which online and street activism intertwine have also spread to extreme right groups. Despite its neo-fascist and extreme right content the ‘Become Immortal’ campaign serves as an illustrative case for the study of mediated...... and mediatized activism. In order to analyse of the protest form, the visual aesthetics and the discourse of ‘The Immortals’, the paper mobilises two concepts from media and communication studies: mediation and mediatization. It will be argued that that the current transformation of the extreme right: that is...

Hydroxyapatite crystal deposition disease: imaging aspects and biological behavior

International Nuclear Information System (INIS)

D'Aquino, Danilo Olavarria; Pinto, Alexandre de Lavra; Costa, Mauro Jose Brandao da; Fanelli, Vania A.; Abud, Lucas Giansante

2005-01-01

Objective: to demonstrate, using imaging methods (x-ray, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US), the phases of hydroxyapatite crystal deposition disease in joints, particularly in the shoulder, from the silent phase to the intra-osseous migration of calcifications and radiologic follow-up examinations showing complete remission after physical therapy. Material and method: we evaluated 27 joints (25 shoulders, one hip and one elbow) of patients followed-up with radiographs. Patients extremely symptomatic and refractory to treatment were referred to MRI or US. Results: total remission of calcifications was observed in 15 joints after treatment - 14 shoulders and one elbow. In two joint, migration of the calcification to bone was observed: one to the bursa subdeltoidea, one to biceps tendon, one to subcoracoid recess and one to the interior of the infra spinal muscle. In two cases MRI and CT scans showed a high inflammatory process triggered by the disease. Conclusion: hydroxyapatite crystal deposition disease affects multiple joints and can vary from asymptomatic to extremely symptomatic. Imaging methods show all phases of the disease, including the migratory phase. In general, the use of x-ray is enough for the diagnosis and follow-up. MRI and CT provide a more accurate diagnosis in the active phase of the disease. In this paper, remission was seen with physiotherapy (iontophoresis) in 55% of the cases. (author)

Extremal vectors and rectifiability | Enflo | Quaestiones Mathematicae

African Journals Online (AJOL)

Extremal vectors and rectifiability. ... The concept of extremal vectors of a linear operator with a dense range but not onto on a Hilbert space was introduced by P. Enflo in 1996 as a new approach to study invariant subspaces ... We show that in general curves that map numbers to backward minimal vectors are not rectifiable.

The effect of extremely high glucose concentrations on 21 routine chemistry and thyroid Abbott assays: interference study

OpenAIRE

?uhadar, Serap; K?seo?lu, Mehmet; ?inpolat, Yasemin; Bu?dayc?, G?ler; Usta, Murat; Semerci, Tuna

2016-01-01

Abstract Introduction: Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L. Materials and methods: Base...

Extreme project. Progress report 2006

International Nuclear Information System (INIS)

Eyrolle, F.; Masson, O.; Charmasson, S.

2007-01-01

The E.X.T.R.E.M.E. project introduced in 2005 to the S.E.S.U.R.E. / L.E.R.C.M. has for objectives to acquire data on the consequences of the extreme climatic meteorological episodes on the distribution of the artificial radioisotopes within the various compartments of the geosphere. This report presents the synthesis of the actions developed in 2006 in positioning and in co financing of the project by means of regional or national research programs (C.A.R.M.A., E.X.T.R.E.M.A., E.C.C.O.R.E.V.I.), of data acquisition, valuation and scientific collaboration. (N.C.)

Anders Breivik: Extreme Beliefs Mistaken for Psychosis.

Science.gov (United States)

Rahman, Tahir; Resnick, Phillip J; Harry, Bruce

2016-03-01

The case of Anders Breivik, who committed mass murder in Norway in 2011, stirred controversy among forensic mental health experts. His bizarrely composed compendium and references to himself as the "Knights Templar" raised concerns that he had a psychotic mental illness. Beliefs such as Mr. Breivik's that precede odd, unusual, or extremely violent behavior present a unique challenge to the forensic evaluator, who sometimes struggles to understand those beliefs. Psychotic disorder frequently is invoked to characterize odd, unusual, or extreme beliefs, with a classification that has evolved over time. However, the important concept of overvalued idea, largely ignored in American psychiatry, may better characterize these beliefs in some cases. We discuss the definitions of delusion and overvalued ideas in the context of Anders Breivik's rigidly held extreme beliefs. We also review the British definition of overvalued idea and discuss McHugh's construct, to introduce the term "extreme overvalued belief" as an aid in sharpening the forensic evaluator's conceptualization of these and similar beliefs. © 2016 American Academy of Psychiatry and the Law.

Climate impacts on extreme energy consumption of different types of buildings.

Science.gov (United States)

Li, Mingcai; Shi, Jun; Guo, Jun; Cao, Jingfu; Niu, Jide; Xiong, Mingming

2015-01-01

Exploring changes of building energy consumption and its relationships with climate can provide basis for energy-saving and carbon emission reduction. Heating and cooling energy consumption of different types of buildings during 1981-2010 in Tianjin city, was simulated by using TRNSYS software. Daily or hourly extreme energy consumption was determined by percentile methods, and the climate impact on extreme energy consumption was analyzed. The results showed that days of extreme heating consumption showed apparent decrease during the recent 30 years for residential and large venue buildings, whereas days of extreme cooling consumption increased in large venue building. No significant variations were found for the days of extreme energy consumption for commercial building, although a decreasing trend in extreme heating energy consumption. Daily extreme energy consumption for large venue building had no relationship with climate parameters, whereas extreme energy consumption for commercial and residential buildings was related to various climate parameters. Further multiple regression analysis suggested heating energy consumption for commercial building was affected by maximum temperature, dry bulb temperature, solar radiation and minimum temperature, which together can explain 71.5 % of the variation of the daily extreme heating energy consumption. The daily extreme cooling energy consumption for commercial building was only related to the wet bulb temperature (R2= 0.382). The daily extreme heating energy consumption for residential building was affected by 4 climate parameters, but the dry bulb temperature had the main impact. The impacts of climate on hourly extreme heating energy consumption has a 1-3 hour delay in all three types of buildings, but no delay was found in the impacts of climate on hourly extreme cooling energy consumption for the selected buildings.

Distant Galaxy Clusters Hosting Extreme Central Galaxies

Science.gov (United States)

McDonald, Michael

2014-09-01

The recently-discovered Phoenix cluster harbors the most star-forming central cluster galaxy of any cluster in the known Universe, by nearly a factor of 10. This extreme system appears to be fulfilling early cooling flow predictions, although the lack of similar systems makes any interpretation difficult. In an attempt to find other "Phoenix-like" clusters, we have cross-correlated archival all-sky surveys (in which Phoenix was detected) and isolated 4 similarly-extreme systems which are also coincident in position and redshift with an overdensity of red galaxies. We propose here to obtain Chandra observations of these extreme, Phoenix-like systems, in order to confirm them as relaxed, rapidly-cooling galaxy clusters.

Models and Inference for Multivariate Spatial Extremes

KAUST Repository

Vettori, Sabrina

2017-12-07

The development of flexible and interpretable statistical methods is necessary in order to provide appropriate risk assessment measures for extreme events and natural disasters. In this thesis, we address this challenge by contributing to the developing research field of Extreme-Value Theory. We initially study the performance of existing parametric and non-parametric estimators of extremal dependence for multivariate maxima. As the dimensionality increases, non-parametric estimators are more flexible than parametric methods but present some loss in efficiency that we quantify under various scenarios. We introduce a statistical tool which imposes the required shape constraints on non-parametric estimators in high dimensions, significantly improving their performance. Furthermore, by embedding the tree-based max-stable nested logistic distribution in the Bayesian framework, we develop a statistical algorithm that identifies the most likely tree structures representing the data\\'s extremal dependence using the reversible jump Monte Carlo Markov Chain method. A mixture of these trees is then used for uncertainty assessment in prediction through Bayesian model averaging. The computational complexity of full likelihood inference is significantly decreased by deriving a recursive formula for the nested logistic model likelihood. The algorithm performance is verified through simulation experiments which also compare different likelihood procedures. Finally, we extend the nested logistic representation to the spatial framework in order to jointly model multivariate variables collected across a spatial region. This situation emerges often in environmental applications but is not often considered in the current literature. Simulation experiments show that the new class of multivariate max-stable processes is able to detect both the cross and inner spatial dependence of a number of extreme variables at a relatively low computational cost, thanks to its Bayesian hierarchical

MR image of an extreme type of tophous gout arthropathy of the hand

International Nuclear Information System (INIS)

Luttke, G.; Rothdauscher, G.

1990-01-01

As the high-resolution MR imaging technique yields pictures with a high soft-tissue contrast and a good spatial resolution, and offers the possibility of multiplane imaging, it allows particularly good visualisation of the anatomy of the hand, including finest tissue compartments. The case report shows that MRI is a diagnostic technique that significantly contributes to an optimum therapy planning for patients suffering from an extreme type of tophous gout arthropathy, which is a disease less frequently met nowadays, thanks to new means of treatment and an enhanced interest in preventive health care on the part of the population. (orig.) [de

Modeling Spatial Dependence of Rainfall Extremes Across Multiple Durations

Science.gov (United States)

Le, Phuong Dong; Leonard, Michael; Westra, Seth

2018-03-01

Determining the probability of a flood event in a catchment given that another flood has occurred in a nearby catchment is useful in the design of infrastructure such as road networks that have multiple river crossings. These conditional flood probabilities can be estimated by calculating conditional probabilities of extreme rainfall and then transforming rainfall to runoff through a hydrologic model. Each catchment's hydrological response times are unlikely to be the same, so in order to estimate these conditional probabilities one must consider the dependence of extreme rainfall both across space and across critical storm durations. To represent these types of dependence, this study proposes a new approach for combining extreme rainfall across different durations within a spatial extreme value model using max-stable process theory. This is achieved in a stepwise manner. The first step defines a set of common parameters for the marginal distributions across multiple durations. The parameters are then spatially interpolated to develop a spatial field. Storm-level dependence is represented through the max-stable process for rainfall extremes across different durations. The dependence model shows a reasonable fit between the observed pairwise extremal coefficients and the theoretical pairwise extremal coefficient function across all durations. The study demonstrates how the approach can be applied to develop conditional maps of the return period and return level across different durations.

Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review

International Nuclear Information System (INIS)

Timmons, J.H.; Hartshorne, M.F.; Peters, V.J.; Cawthon, M.A.; Bauman, J.M.

1988-01-01

A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease

Bowen's Disease Associated With Two Human Papilloma Virus Types.

Science.gov (United States)

Eftekhari, Hojat; Gharaei Nejad, Kaveh; Azimi, Seyyede Zeinab; Rafiei, Rana; Mesbah, Alireza

2017-09-01

Bowen's disease (BD) is an epidermal in-situ squamous cell carcinoma (SCC). Most Human Papilloma Viruses (HPV)-positive lesions in Bowen's disease are localized to the genital region or distal extremities (periungual sites) in which HPV type-16 is frequently detected. Patient was a 64-year-old construction worker for whom we detected 2 erythematous psoriasiform reticular scaly plaques on peri-umbilical and medial knee. Biopsy established the diagnosis of Bowen's disease and polymerase chain reaction assay showed HPV-6, -18 co-infection. Patient was referred for surgical excision.

A forgotten disease reminds itself with a rare complication

Directory of Open Access Journals (Sweden)

Meetu Agrawal

2011-01-01

Full Text Available Diagnosed cases of sexually transmitted diseases (STD represent tip of the iceberg and Donovanosis in one of them. Donovanosis, in most cases is obvious clinically, but rely for its confirmation on the demonstration of donovan bodies in histological sections and cytological preparation. In an extremely rare setting, this disease may get complicated by the development of squamous cell carcinoma. We report this occurrence in an 18-year-old girl to review the currently forgotten status of donovanosis amongst the STDs and the poor outcome of the disease if left untreated.

ECMWF Extreme Forecast Index for water vapor transport: A forecast tool for atmospheric rivers and extreme precipitation

Science.gov (United States)

Lavers, David A.; Pappenberger, Florian; Richardson, David S.; Zsoter, Ervin

2016-11-01

In winter, heavy precipitation and floods along the west coasts of midlatitude continents are largely caused by intense water vapor transport (integrated vapor transport (IVT)) within the atmospheric river of extratropical cyclones. This study builds on previous findings that showed that forecasts of IVT have higher predictability than precipitation, by applying and evaluating the European Centre for Medium-Range Weather Forecasts Extreme Forecast Index (EFI) for IVT in ensemble forecasts during three winters across Europe. We show that the IVT EFI is more able (than the precipitation EFI) to capture extreme precipitation in forecast week 2 during forecasts initialized in a positive North Atlantic Oscillation (NAO) phase; conversely, the precipitation EFI is better during the negative NAO phase and at shorter leads. An IVT EFI example for storm Desmond in December 2015 highlights its potential to identify upcoming hydrometeorological extremes, which may prove useful to the user and forecasting communities.

Dracunculiasis (guinea worm disease).

Science.gov (United States)

Greenaway, Chris

2004-02-17

Dracunculiasis (guinea worm disease) is a parasitic disease that is limited to remote, rural villages in 13 sub-Saharan African countries that do not have access to safe drinking water. It is one the next diseases targeted for eradication by the World Health Organization. Guinea worm disease is transmitted by drinking water containing copepods (water fleas) that are infected with Dracunculiasis medinensis larvae. One year after human ingestion of infected water a female adult worm emerges, typically from a lower extremity, producing painful ulcers that can impair mobility for up to several weeks. This disease occurs annually when agricultural activities are at their peak. Large proportions of economically productive individuals of a village are usually affected simultaneously, resulting in decreased agricultural productivity and economic hardship. Eradication of guinea worm disease depends on prevention, as there is no effective treatment or vaccine. Since 1986, there has been a 98% reduction in guinea worm disease worldwide, achieved primarily through community-based programs. These programs have educated local populations on how to filter drinking water to remove the parasite and how to prevent those with ulcers from infecting drinking-water sources. Complete eradication will require sustained high-level political, financial and community support.

Sensitivity of Rainfall Extremes Under Warming Climate in Urban India

Science.gov (United States)

Ali, H.; Mishra, V.

2017-12-01

Extreme rainfall events in urban India halted transportation, damaged infrastructure, and affected human lives. Rainfall extremes are projected to increase under the future climate. We evaluated the relationship (scaling) between rainfall extremes at different temporal resolutions (daily, 3-hourly, and 30 minutes), daily dewpoint temperature (DPT) and daily air temperature at 850 hPa (T850) for 23 urban areas in India. Daily rainfall extremes obtained from Global Surface Summary of Day Data (GSOD) showed positive regression slopes for most of the cities with median of 14%/K for the period of 1979-2013 for DPT and T850, which is higher than Clausius-Clapeyron (C-C) rate ( 7%). Moreover, sub-daily rainfall extremes are more sensitive to both DPT and T850. For instance, 3-hourly rainfall extremes obtained from Tropical Rainfall Measurement Mission (TRMM 3B42 V7) showed regression slopes more than 16%/K aginst DPT and T850 for the period of 1998-2015. Half-hourly rainfall extremes from the Integrated Multi-satellitE Retrievals (IMERGE) of Global precipitation mission (GPM) also showed higher sensitivity against changes in DPT and T850. The super scaling of rainfall extremes against changes in DPT and T850 can be attributed to convective nature of precipitation in India. Our results show that urban India may witness non-stationary rainfall extremes, which, in turn will affect stromwater designs and frequency and magniture of urban flooding.

The waviness of the extratropical jet and daily weather extremes

Science.gov (United States)

Röthlisberger, Matthias; Martius, Olivia; Pfahl, Stephan

2016-04-01

In recent years the Northern Hemisphere mid-latitudes have experienced a large number of weather extremes with substantial socio-economic impact, such as the European and Russian heat waves in 2003 and 2010, severe winter floods in the United Kingdom in 2013/2014 and devastating winter storms such as Lothar (1999) and Xynthia (2010) in Central Europe. These have triggered an engaged debate within the scientific community on the role of human induced climate change in the occurrence of such extremes. A key element of this debate is the hypothesis that the waviness of the extratropical jet is linked to the occurrence of weather extremes, with a wavier jet stream favouring more extremes. Previous work on this topic is expanded in this study by analyzing the linkage between a regional measure of jet waviness and daily temperature, precipitation and wind gust extremes. We show that indeed such a linkage exists in many regions of the world, however this waviness-extremes linkage varies spatially in strength and sign. Locally, it is strong only where the relevant weather systems, in which the extremes occur, are affected by the jet waviness. Its sign depends on how the frequency of occurrence of the relevant weather systems is correlated with the occurrence of high and low jet waviness. These results go beyond previous studies by noting that also a decrease in waviness could be associated with an enhanced number of some weather extremes, especially wind gust and precipitation extremes over western Europe.

Gravo-Aeroelastic Scaling for Extreme-Scale Wind Turbines

Energy Technology Data Exchange (ETDEWEB)

Fingersh, Lee J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Loth, Eric [University of Virginia; Kaminski, Meghan [University of Virginia; Qin, Chao [University of Virginia; Griffith, D. Todd [Sandia National Laboratories

2017-06-09

A scaling methodology is described in the present paper for extreme-scale wind turbines (rated at 10 MW or more) that allow their sub-scale turbines to capture their key blade dynamics and aeroelastic deflections. For extreme-scale turbines, such deflections and dynamics can be substantial and are primarily driven by centrifugal, thrust and gravity forces as well as the net torque. Each of these are in turn a function of various wind conditions, including turbulence levels that cause shear, veer, and gust loads. The 13.2 MW rated SNL100-03 rotor design, having a blade length of 100-meters, is herein scaled to the CART3 wind turbine at NREL using 25% geometric scaling and blade mass and wind speed scaled by gravo-aeroelastic constraints. In order to mimic the ultralight structure on the advanced concept extreme-scale design the scaling results indicate that the gravo-aeroelastically scaled blades for the CART3 are be three times lighter and 25% longer than the current CART3 blades. A benefit of this scaling approach is that the scaled wind speeds needed for testing are reduced (in this case by a factor of two), allowing testing under extreme gust conditions to be much more easily achieved. Most importantly, this scaling approach can investigate extreme-scale concepts including dynamic behaviors and aeroelastic deflections (including flutter) at an extremely small fraction of the full-scale cost.

Analyzing phenological extreme events over the past five decades in Germany

Science.gov (United States)

Schleip, Christoph; Menzel, Annette; Estrella, Nicole; Graeser, Philipp

2010-05-01

As climate change may alter the frequency and intensity of extreme temperatures, we analysed whether warming of the last 5 decades has already changed the statistics of phenological extreme events. In this context, two extreme value statistical concepts are discussed and applied to existing phenological datasets of German Weather Service (DWD) in order to derive probabilities of occurrence for extreme early or late phenological events. We analyse four phenological groups; "begin of flowering, "leaf foliation", "fruit ripening" and "leaf colouring" as well as DWD indicator phases of the "phenological year". Additionally we put an emphasis on a between-species analysis; a comparison of differences in extreme onsets between three common northern conifers. Furthermore we conducted a within-species analysis with different phases of horse chestnut throughout a year. The first statistical approach fits data to a Gaussian model using traditional statistical techniques, and then analyses the extreme quantile. The key point of this approach is the adoption of an appropriate probability density function (PDF) to the observed data and the assessment of the PDF parameters change in time. The full analytical description in terms of the estimated PDF for defined time steps of the observation period allows probability assessments of extreme values for e.g. annual or decadal time steps. Related with this approach is the possibility of counting out the onsets which fall in our defined extreme percentiles. The estimation of the probability of extreme events on the basis of the whole data set is in contrast to analyses with the generalized extreme value distribution (GEV). The second approach deals with the extreme PDFs itself and fits the GEV distribution to annual minima of phenological series to provide useful estimates about return levels. For flowering and leaf unfolding phases exceptionally early extremes are seen since the mid 1980s and especially for the single years 1961

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

Directory of Open Access Journals (Sweden)

Seth Stake

2016-01-01

Full Text Available Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

Science.gov (United States)

Stake, Seth; du Breuil, Anne L; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Tc-99m-sestamibi scintigraphy in gaucher disease, type 1

International Nuclear Information System (INIS)

Park, Chan H.; Pai, Moon S.; Ha, Man J.; Yoon, S. N.; Kim, S.; Whang, K. H.; Kim, Hyun J.

1999-01-01

Gaucher disease is an autosomal recessive disorder characterized by lysosomal glycolipid storage in reticuloendothelial cells due to the deficiency of lysosomal enzyme, acid-glucosidase. Type 1 is one of the three subtypes of Gaucher disease and is manifested by a chronic and progressive involvement of the spleen, liver, bone marrow and other visceral organs. This study was done to see imaging feasibility of bone marrow involvement of Gaucher cells using sestamibi. Five patients with Gaucher disease, type I (M:F=4:1, age range: 9-25) underwent a simultaneous anterior and posterior whole body scan as well as spot views of the lower extremities as needed in 10-20 min following the IV administration of 0.2 mCi/kg of Tc-99m-sestamibi. Control group consisted of 10 patients with osteosarcoma, simple bone cyst, nonossifying fibroma, osteoid osteoma, exostosis and neuroblastoma ( M: F=9:1, age range: 2-20, mean : 12.1) and sestamibi images of the group were obtained as in Gaucher cases. For in vitro evaluation, Gaucher cells were isolated from the splenectomy specimen. The cells were incubated in media containing sestamibi for 10, 29, 30 min. After washing the cells twice with saline, cell labeling was checked by external counting. Control group depicted no appreciable sestamibi uptake in the lower extremities while 5 patients with Gaucher disease, type I revealed variable degrees of sestamibi uptake. It was difficult to assess vertebral activities due to hepatosplenomegaly. Ioslated Gaucher cells took up sestamibi supported by an increasing external counting in proportion to incubation time. There was sestamibi uptake in the lower extremities involved by Gaucher disease, type I, which was distinctly different from the control group. Also in vitro study revealed sestamibi uptake in Gaucher cells. On the basis of these results, we believe, it may be possible to evaluate enzyme replacement therapy in Gaucher disease, type I, utilizing sestamibi scintiscan

Tc-99m-sestamibi scintigraphy in gaucher disease, type 1

Energy Technology Data Exchange (ETDEWEB)

Park, Chan H.; Pai, Moon S.; Ha, Man J.; Yoon, S. N.; Kim, S.; Whang, K. H.; Kim, Hyun J. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

1999-07-01

Gaucher disease is an autosomal recessive disorder characterized by lysosomal glycolipid storage in reticuloendothelial cells due to the deficiency of lysosomal enzyme, acid-glucosidase. Type 1 is one of the three subtypes of Gaucher disease and is manifested by a chronic and progressive involvement of the spleen, liver, bone marrow and other visceral organs. This study was done to see imaging feasibility of bone marrow involvement of Gaucher cells using sestamibi. Five patients with Gaucher disease, type I (M:F=4:1, age range: 9-25) underwent a simultaneous anterior and posterior whole body scan as well as spot views of the lower extremities as needed in 10-20 min following the IV administration of 0.2 mCi/kg of Tc-99m-sestamibi. Control group consisted of 10 patients with osteosarcoma, simple bone cyst, nonossifying fibroma, osteoid osteoma, exostosis and neuroblastoma ( M: F=9:1, age range: 2-20, mean : 12.1) and sestamibi images of the group were obtained as in Gaucher cases. For in vitro evaluation, Gaucher cells were isolated from the splenectomy specimen. The cells were incubated in media containing sestamibi for 10, 29, 30 min. After washing the cells twice with saline, cell labeling was checked by external counting. Control group depicted no appreciable sestamibi uptake in the lower extremities while 5 patients with Gaucher disease, type I revealed variable degrees of sestamibi uptake. It was difficult to assess vertebral activities due to hepatosplenomegaly. Ioslated Gaucher cells took up sestamibi supported by an increasing external counting in proportion to incubation time. There was sestamibi uptake in the lower extremities involved by Gaucher disease, type I, which was distinctly different from the control group. Also in vitro study revealed sestamibi uptake in Gaucher cells. On the basis of these results, we believe, it may be possible to evaluate enzyme replacement therapy in Gaucher disease, type I, utilizing sestamibi scintiscan.

Climate impacts on extreme energy consumption of different types of buildings.

Directory of Open Access Journals (Sweden)

Mingcai Li

Full Text Available Exploring changes of building energy consumption and its relationships with climate can provide basis for energy-saving and carbon emission reduction. Heating and cooling energy consumption of different types of buildings during 1981-2010 in Tianjin city, was simulated by using TRNSYS software. Daily or hourly extreme energy consumption was determined by percentile methods, and the climate impact on extreme energy consumption was analyzed. The results showed that days of extreme heating consumption showed apparent decrease during the recent 30 years for residential and large venue buildings, whereas days of extreme cooling consumption increased in large venue building. No significant variations were found for the days of extreme energy consumption for commercial building, although a decreasing trend in extreme heating energy consumption. Daily extreme energy consumption for large venue building had no relationship with climate parameters, whereas extreme energy consumption for commercial and residential buildings was related to various climate parameters. Further multiple regression analysis suggested heating energy consumption for commercial building was affected by maximum temperature, dry bulb temperature, solar radiation and minimum temperature, which together can explain 71.5 % of the variation of the daily extreme heating energy consumption. The daily extreme cooling energy consumption for commercial building was only related to the wet bulb temperature (R2= 0.382. The daily extreme heating energy consumption for residential building was affected by 4 climate parameters, but the dry bulb temperature had the main impact. The impacts of climate on hourly extreme heating energy consumption has a 1-3 hour delay in all three types of buildings, but no delay was found in the impacts of climate on hourly extreme cooling energy consumption for the selected buildings.

Computational discovery of extremal microstructure families

Science.gov (United States)

Chen, Desai; Skouras, Mélina; Zhu, Bo; Matusik, Wojciech

2018-01-01

Modern fabrication techniques, such as additive manufacturing, can be used to create materials with complex custom internal structures. These engineered materials exhibit a much broader range of bulk properties than their base materials and are typically referred to as metamaterials or microstructures. Although metamaterials with extraordinary properties have many applications, designing them is very difficult and is generally done by hand. We propose a computational approach to discover families of microstructures with extremal macroscale properties automatically. Using efficient simulation and sampling techniques, we compute the space of mechanical properties covered by physically realizable microstructures. Our system then clusters microstructures with common topologies into families. Parameterized templates are eventually extracted from families to generate new microstructure designs. We demonstrate these capabilities on the computational design of mechanical metamaterials and present five auxetic microstructure families with extremal elastic material properties. Our study opens the way for the completely automated discovery of extremal microstructures across multiple domains of physics, including applications reliant on thermal, electrical, and magnetic properties. PMID:29376124

The problem of defining contemporary right-wing extremism in political theory

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Đorić Marija

2016-01-01

Full Text Available The subject matter of research in this paper is theoretical controversy related to the definition of right-wing extremism. Given the fact that extremism is a variable, amorphous and insufficiently researched phenomenon, largely conditioned by time, space, political and cultural differences, there is a great confusion in the field of political science when defining right-wing extremism. The problem of researching right-wing extremism is additionally complicated by various terms that are being used in the contemporary literature as its synonyms, such as right-wing radicalism, neo-Fascism, ultra-radicalism, etc. In order to provide the most valid theoretical determination of right-wing extremism, the author provides a detailed analysis of all the components constituting this phenomenon and examines their causality. In the political praxis, the term extremism is extensively abused, which additionally complicates its determination. Videlicet, politicians often use term 'extremist' in order to discredit their political opponents. While during the French revolution aristocracy saw the bourgeoisie as extremists, the members of the working class later stated that the bourgeoisie were extremists. The problem lies in the fact that, in politics, extremists are not only the ones who use violence as modus operandi; indeed, it is also used by political opponents who do not belong to the extreme political option. Another aggravating factor in defining right-wing extremism is that many administrative and academic definitions do not make a clear distinction between extremism and related phenomena, such as terrorism, radicalism and populism. Extremism is most often equaled with terrorism, which gives rise to another problem in defining this phenomenon. The relation between extremism and terrorism is the relation of general and specific. Namely, every act of terrorism is concurrently considered to be an act of extremism, but not vice versa, given the fact that

Structure of personality and motivation of extreme sports athletes

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Jana Mahnič

2005-09-01

Full Text Available The purpose of research was to define the eventual differences between personal and motivational structure among extreme sports athletes and non-athletes. Beside personal and motivational structure of both mentioned groups, we also examined state and trait anxiety as significant factors of success. We used a medium lengthy version of FPI inventory, Costell's questionnaire of achievement motivation and Spielberg's questionnaire STAI – X1 and STAI – X2. The pattern included 66 extreme sports athletes. We concluded that extreme sports athletes are significantly less suppressed and sincere, whereas they are more extrovert and masculine in comparison with the group of non-athletes. A trend that individuals, who reach for extreme sports, are more sociable, and less neurotic is pointed out, but it is not of significant importance. We found out that there is also a tendency that extreme sports athletes express more positive achievement motivation than non-athletes, who on the other hand express significantly higher negative achievement motivation. The analysis of anxiety differences on the other hand showed that extreme sports athletes have significantly lower state of anxiety and the anxiety itself as atrait is far less visible, but the difference did not appear as significant. The results however did not confirme previous studies' findings. Nevertheless they serve as a contribution to some earlier findings and suggest that extreme sports athletes are a special group, which differs from non-athlete population in both personal and motivational structure and relatively well suits to the profile of a top athlete. At the same time, the present research offers a possibility of shaping an extreme sports athlete's profile.

Elevated serum fibroblast growth factor 23 levels as an indicator of lower extremity atherosclerotic disease in Chinese patients with type 2 diabetes mellitus.

Science.gov (United States)

He, Xingxing; Hu, Xiang; Ma, Xiaojing; Su, Hang; Ying, Lingwen; Peng, Jiahui; Pan, Xiaoping; Bao, Yuqian; Zhou, Jian; Jia, Weiping

2017-06-15

Recently, basic and clinical studies have provided evidence supporting the relationship between circulating levels of fibroblast growth factor (FGF) 23 and the development of atherosclerosis. Given that diabetes is an established risk factor for lower extremity atherosclerotic disease (LEAD), the goal of the present study was to explore the relationship between serum FGF23 levels and LEAD, as well as the related factors, in Chinese patients with type 2 diabetes mellitus (T2DM). A total of 401 hospitalized T2DM patients (201 subjects with LEAD and 200 subjects without LEAD) were enrolled in this study. Serum FGF23 levels were determined by a sandwich enzyme-linked immunosorbent assay. Femoral intima-media thickness (F-IMT) and lower limb atherosclerotic plaque were assessed through color Doppler ultrasound. The median (interquartile range) serum FGF23 levels in the entire study population was 42.08 (35.59-49.17) pg/mL. Subjects with LEAD had significantly higher serum FGF23 levels compared with those without LEAD (44.00 [37.54-51.30] pg/mL versus 40.42 [32.61-48.23] pg/mL, P Chinese patients with T2DM, serum FGF23 levels were independently and positively correlated with the presence of LEAD.

Dosimetric characteristics of a TLD dosemeter with extremities

International Nuclear Information System (INIS)

Molina P, D.; Diaz B, E.; Lien V, R.

1999-01-01

It was designed a TLD dosemeter for the monitoring of the extremities. This one consists in a metallic ring with a circular orifice where is arranged a T L detector of LiF: Mg,Ti (Model JR1152C) 5 x 5 x 0.8 mm 3 covered by a polyethylene fine layer. In this work were studied the dosimetric properties of the dosemeter for its application in the dosimetry of extremities for photonic radiation. the results obtained allow conclude that the designed dosemeter can be used for the extremities monitoring. (Author)

Compound summer temperature and precipitation extremes over central Europe

Science.gov (United States)

Sedlmeier, Katrin; Feldmann, H.; Schädler, G.

2018-02-01

Reliable knowledge of the near-future climate change signal of extremes is important for adaptation and mitigation strategies. Especially compound extremes, like heat and drought occurring simultaneously, may have a greater impact on society than their univariate counterparts and have recently become an active field of study. In this paper, we use a 12-member ensemble of high-resolution (7 km) regional climate simulations with the regional climate model COSMO-CLM over central Europe to analyze the climate change signal and its uncertainty for compound heat and drought extremes in summer by two different measures: one describing absolute (i.e., number of exceedances of absolute thresholds like hot days), the other relative (i.e., number of exceedances of time series intrinsic thresholds) compound extreme events. Changes are assessed between a reference period (1971-2000) and a projection period (2021-2050). Our findings show an increase in the number of absolute compound events for the whole investigation area. The change signal of relative extremes is more region-dependent, but there is a strong signal change in the southern and eastern parts of Germany and the neighboring countries. Especially the Czech Republic shows strong change in absolute and relative extreme events.

Angiosarcoma of the liver and other occupational diseases in vinyl chloride workers

International Nuclear Information System (INIS)

Halama, J.; Becker-Stone, S.; Halama, J.M.

1985-01-01

Occupational diseases resulting from exposure to vinyl chloride (VC) include angiosarcoma of the liver and other neoplasms. Among workers exposed to VC we have found capillary abnormalities in the extremities, with scleroderma and Raynaud syndrome, acro-osteolysis, neurological and psychiatric diseases and chromosome abnormalities, as well as abnormal liver metabolism and haematological findings.(orig.)

Censored rainfall modelling for estimation of fine-scale extremes

Science.gov (United States)

Cross, David; Onof, Christian; Winter, Hugo; Bernardara, Pietro

2018-01-01

Reliable estimation of rainfall extremes is essential for drainage system design, flood mitigation, and risk quantification. However, traditional techniques lack physical realism and extrapolation can be highly uncertain. In this study, we improve the physical basis for short-duration extreme rainfall estimation by simulating the heavy portion of the rainfall record mechanistically using the Bartlett-Lewis rectangular pulse (BLRP) model. Mechanistic rainfall models have had a tendency to underestimate rainfall extremes at fine temporal scales. Despite this, the simple process representation of rectangular pulse models is appealing in the context of extreme rainfall estimation because it emulates the known phenomenology of rainfall generation. A censored approach to Bartlett-Lewis model calibration is proposed and performed for single-site rainfall from two gauges in the UK and Germany. Extreme rainfall estimation is performed for each gauge at the 5, 15, and 60 min resolutions, and considerations for censor selection discussed.

Statistics of Local Extremes

DEFF Research Database (Denmark)

Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

2003-01-01

. A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

[Gastroesophageal Reflux Disease Review

Science.gov (United States)

Olmos, Jorge A; Piskorz, María Marta; Vela, Marcelo F

2016-06-01

GERD is a highly prevalent disease in our country. It has a deep impact in patient´s quality of life, representing extremely high costs regarding health. The correct understanding of its pathophysiology is crucial for the rational use of diagnoses methods and the implementation of appropriate treatment adjusted to each individual case. In this review we evaluate this disorder based on the best available evidence, focusing in pathophysiological mechanisms, its epidemiology, modern diagnosis methods and current management standards.

The Extreme Right in Eastern Europe and Territorial Issues

Directory of Open Access Journals (Sweden)

Miroslav Mareš

2009-08-01

Full Text Available This article analyses and compares the different territorial conceptions of the extreme right in Eastern Europe and their political impact, with a view to explaining how important the historical legacy of the supposed territorial and border claims and injustices is for the identity of the extreme right (or their parts in contemporary Eastern Europe. It analyses the historical roots of the territorial claims of the extreme right in the area, the current situation regarding their territorial claims and disputes, and the impact of these territorial claims on domestic politics, on the politics of the extreme right at the European level and on regional security in this area.

A comparison of observed extreme water levels at the German Bight elaborated through an extreme value analysis (EVA) with extremes derived from a regionally coupled ocean-atmospheric climate model (MPI-OM)

Science.gov (United States)

Möller, Jens; Heinrich, Hartmut

2017-04-01

As a consequence of climate change atmospheric and oceanographic extremes and their potential impacts on coastal regions are of growing concern for governmental authorities responsible for the transportation infrastructure. Highest risks for shipping as well as for rail and road traffic originate from combined effects of extremes of storm surges and heavy rainfall which sometimes lead to insufficient dewatering of inland waterways. The German Ministry of Transport and digital Infrastructure therefore has tasked its Network of Experts to investigate the possible evolutions of extreme threats for low lands and especially for Kiel Canal, which is an important shortcut for shipping between the North and Baltic Seas. In this study we present results of a comparison of an Extreme Value Analysis (EVA) carried out on gauge observations and values derived from a coupled Regional Ocean-Atmosphere Climate Model (MPI-OM). High water levels at the coasts of the North and Baltic Seas are one of the most important hazards which increase the risk of flooding of the low-lying land and prevents such areas from an adequate dewatering. In this study changes in the intensity (magnitude of the extremes) and duration of extreme water levels (above a selected threshold) are investigated for several gauge stations with data partly reaching back to 1843. Different methods are used for the extreme value statistics, (1) a stationary general Pareto distribution (GPD) model as well as (2) an instationary statistical model for better reproduction of the impact of climate change. Most gauge stations show an increase of the mean water level of about 1-2 mm/year, with a stronger increase of the highest water levels and a decrease (or lower increase) of the lowest water levels. Also, the duration of possible dewatering time intervals for the Kiel-Canal was analysed. The results for the historical gauge station observations are compared to the statistics of modelled water levels from the coupled

Medical and psychosocial implications of adolescent extreme obesity - acceptance and effects of structured care, short: Youth with Extreme Obesity Study (YES).

Science.gov (United States)

Wabitsch, Martin; Moss, Anja; Reinehr, Thomas; Wiegand, Susanna; Kiess, Wieland; Scherag, André; Holl, Reinhard; Holle, Rolf; Hebebrand, Johannes

2013-08-29

Prevalence rates of overweight and obesity have increased in German children and adolescents in the last three decades. Adolescents with extreme obesity represent a distinct risk group. On the basis of data obtained by the German Child and Youth Survey (KiGGS) and the German district military offices we estimate that the group of extremely obese adolescents (BMI ≥ 35 kg/m2) currently encompasses approximately 200.000 adolescents aged 14 to 21 yrs. Conventional approaches focusing on weight reduction have largely proven futile for them. In addition, only a small percentage of adolescents with extreme obesity seek actively treatment for obesity while contributing disproportionately strong to health care costs. Because of somatic and psychiatric co-morbidities and social problems adolescents with extreme obesity require special attention within the medical care system. We have initiated the project "Medical and psychosocial implications of adolescents with extreme obesity--acceptance and effects of structured care, short: 'Youths with Extreme Obesity Study (YES)'", which aims at improving the medical care and social support structures for youths with extreme obesity in Germany. We focus on identification of these subjects (baseline examination) and their acceptance of diagnostic and subsequent treatment procedures. In a randomized controlled trial (RCT) we will investigate the effectiveness of a low key group intervention not focusing on weight loss but aimed at the provision of obesity related information, alleviation of social isolation, school and vocational integration and improvement of self-esteem in comparison to a control group treated in a conventional way with focus on weight loss. Interested individuals who fulfill current recommended criteria for weight loss surgery will be provided with a structured preparation and follow-up programs. All subjects will be monitored within a long-term observational study to elucidate medical and psychosocial outcomes

Base Oil-Extreme Pressure Additive Synergy in Lubricants

Science.gov (United States)

Extreme pressure (EP) additives are those containing reactive elements such as sulfur, phosphorus, and chlorine. In lubrication processes that occur under extremely severe conditions (e.g., high pressure and/or slow speed), these elements undergo chemical reactions generating new materials (tribofi...

SIZE AND SHAPE FACTOR EXTREMES OF SPHEROIDS

Directory of Open Access Journals (Sweden)

Daniel Hlubinka

2011-05-01

Full Text Available In the paper we consider random prolate (oblate spheroids and their random profiles. The limiting distribution of the extremal characteristics of the spheroids is related to the limiting distribution of the corresponding extremal characteristics of the profiles. The difference between the analysis of the prolate and oblate spheroids is discussed. We propose the possible application of the theoretical results.

Nailfold capillaroscopy in Buerger’s disease: A useful tool?

OpenAIRE

Guidelli, Giacomo Maria; Bardelli, Marco; Fioravanti, Antonella; Selvi, Enrico

2014-01-01

Thromboangiitis obliterans (TAO, or Buerger’s disease) is a rare inflammatory vasculitis that commonly involves small and medium-sized arteries of the extremities of tobacco smokers between the ages of 25 and 50 years. Although the diagnosis is based on the clinical picture and angiographic findings, we studied the microvascular involvement by nailfold capillaroscopy. We evaluated by nailfold capillaroscopy 2 patients with Buerger’s disease, at baseline and after 6 months of tobacco discontin...

Moving in extreme environments:what’s extreme and who decides?

OpenAIRE

Cotter, James David; Tipton, Michael J

2014-01-01

Humans work, rest and play in immensely varied extreme environments. The term ‘extreme’ typically refers to insufficiency or excess of one or more stressors, such as thermal energy or gravity. Individuals’ behavioural and physiological capacity to endure and enjoy such environments varies immensely. Adverse effects of acute exposure to these environments are readily identifiable (e.g. heat stroke or bone fracture), whereas adverse effects of chronic exposure (e.g. stress fractures or osteopor...

Detecting change-points in extremes

KAUST Repository

Dupuis, D. J.

2015-01-01

Even though most work on change-point estimation focuses on changes in the mean, changes in the variance or in the tail distribution can lead to more extreme events. In this paper, we develop a new method of detecting and estimating the change-points in the tail of multiple time series data. In addition, we adapt existing tail change-point detection methods to our specific problem and conduct a thorough comparison of different methods in terms of performance on the estimation of change-points and computational time. We also examine three locations on the U.S. northeast coast and demonstrate that the methods are useful for identifying changes in seasonally extreme warm temperatures.

Extremes in nature

CERN Document Server

Salvadori, Gianfausto; Kottegoda, Nathabandu T

2007-01-01

This book is about the theoretical and practical aspects of the statistics of Extreme Events in Nature. Most importantly, this is the first text in which Copulas are introduced and used in Geophysics. Several topics are fully original, and show how standard models and calculations can be improved by exploiting the opportunities offered by Copulas. In addition, new quantities useful for design and risk assessment are introduced.

Extreme climate in China. Facts, simulation and projection

Energy Technology Data Exchange (ETDEWEB)

Wang, Hui-Jun; Sun, Jian-Qi; Chen, Huo-Po; Zhu, Ya-Li; Zhang, Ying; Jiang, Da-Bang; Lang, Xian-Mei; Fan, Ke; Yu, En-Tao [Chinese Academy of Sciences, Beijing (China). Inst. of Atmospheric Physics; Yang, Song [NOAA Climate Prediction Center, Camp Springs, MD (United States)

2012-06-15

In this paper, studies on extreme climate in China including extreme temperature and precipitation, dust weather activity, tropical cyclone activity, intense snowfall and cold surge activity, floods, and droughts are reviewed based on the peer-reviewed publications in recent decades. The review is focused first on the climatological features, variability, and trends in the past half century and then on simulations and projections based on global and regional climate models. As the annual mean surface air temperature (SAT) increased throughout China, heat wave intensity and frequency overall increased in the past half century, with a large rate after the 1980s. The daily or yearly minimum SAT increased more significantly than the mean or maximum SAT. The long-term change in precipitation is predominantly characterized by the so-called southern flood and northern drought pattern in eastern China and by the overall increase over Northwest China. The interdecadal variation of monsoon, represented by the monsoon weakening in the end of 1970s, is largely responsible for this change in mean precipitation. Precipitation-related extreme events (e.g., heavy rainfall and intense snowfall) have become more frequent and intense generally over China in the recent years, with large spatial features. Dust weather activity, however, has become less frequent over northern China in the recent years, as result of weakened cold surge activity, reinforced precipitation, and improved vegetation condition. State-of-the-art climate models are capable of reproducing some features of the mean climate and extreme climate events. However, discrepancies among models in simulating and projecting the mean and extreme climate are also demonstrated by many recent studies. Regional models with higher resolutions often perform better than global models. To predict and project climate variations and extremes, many new approaches and schemes based on dynamical models, statistical methods, or their

Extraosseous manifestation of Gaucher's disease type I: MR and histological appearance

International Nuclear Information System (INIS)

Poll, L.W.; Koch, J.A.; Moedder, U.

2000-01-01

Gaucher's disease type I is the most prevalent lysosomal storage disorder caused by an autosomal-recessive inherited deficiency of glucocerebrosidase activity with secondary accumulation of glucocerebrosides within the lysosomes of macrophages. The storage disorder produces a multisystem disease characterized by progressive visceral enlargement and gradual replacement of bone marrow with lipid-laden macrophages. Skeletal disease is a major source of disability in Gaucher's disease. Extraosseous extension of Gaucher cells is an extremely rare manifestation of skeletal Gaucher's disease. This is a report on the MRI and histopathological findings of an extraosseous Gaucher-cell extension into the midface in a patient with Gaucher's disease. (orig.)

Design of manufacturable 3D extremal elastic microstructure

DEFF Research Database (Denmark)

Andreassen, Erik; Lazarov, Boyan Stefanov; Sigmund, Ole

2014-01-01

We present a method to design manufacturable extremal elastic materials. Extremal materials can possess interesting properties such as a negative Poisson's ratio. The effective properties of the obtained microstructures are shown to be close to the theoretical limit given by mathematical bounds...

JIGSAW PUZZLE IMPROVE FINE MOTOR ABILITIES OF UPPER EXTREMITIES IN POST-STROKE ISCHEMIC CLIENTS

Directory of Open Access Journals (Sweden)

Kusnanto Kusnanto

2017-06-01

Full Text Available Introduction: Ischemic stroke is a disease caused by focal cerebral ischemia, where is a decline in blood flow that needed for neuronal metabolism, leading to neurologic deficit include motor deficit such as fine motor skills impairment. Therapy of fine motor skills disorders is to improve motor function, prevent contractures and complications. These study aimed to identify the effect of playing Jigsaw Puzzle on muscle strength, extensive motion, and upper extremity fine motor skills in patients with ischemic stroke at Dr. Moewardi Hospital, Surakarta. Methods: Experimental Quasi pre-posttest one group control. The number of samples were 34 respondents selected using purposive sampling technique. The samples were divided into intervention and control groups. The intervention group was 17 respondents who were given standard treatment hospital and played Jigsaw Puzzle 2 times a day for six days. Control group is one respondent given by hospital standard therapy without given additional Jigsaw Puzzle game. Evaluation of these research is done on the first and seventh day for those groups. Result: The results showed that muscle strength, the range of joint motion and fine motor skills of upper extremities increased (p = 0.001 significantly after being given the Jigsaw Puzzle games. These means playing Jigsaw Puzzle increase muscle strength, the range of joint motion and upper extremity fine motor skill of ischemic stroke patients. Discussion and conclusion: Jigsaw puzzle game administration as additional rehabilitation therapy in upper extremity fine motor to minimize the occurrence of contractures and motor disorders in patients with ischemic stroke. Jigsaw puzzle game therapy capable of creating repetitive motion as a key of neurological rehabilitation in Ischemic Stroke. This study recommends using jigsaw puzzle game as one of intervention in the nursing care of Ischemic Stroke patients.

Extremity perfusion for sarcoma

NARCIS (Netherlands)

Hoekstra, Harald Joan

2008-01-01

For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

Typologies of extreme longevity myths.

Science.gov (United States)

Young, Robert D; Desjardins, Bertrand; McLaughlin, Kirsten; Poulain, Michel; Perls, Thomas T

2010-01-01

Purpose. Political, national, religious, and other motivations have led the media and even scientists to errantly accept extreme longevity claims prima facie. We describe various causes of false claims of extraordinary longevity. Design and Methods. American Social Security Death Index files for the period 1980-2009 were queried for individuals with birth and death dates yielding ages 110+ years of age. Frequency was compared to a list of age-validated supercentenarians maintained by the Gerontology Research Group who died during the same time period. Age claims of 110+ years and the age validation experiences of the authors facilitated a list of typologies of false age claims. Results. Invalid age claim rates increase with age from 65% at age 110-111 to 98% by age 115 to 100% for 120+ years. Eleven typologies of false claims were: Religious Authority Myth, Village Elder Myth, Fountain of Youth Myth (substance), Shangri-La Myth (geographic), Nationalist Pride, Spiritual Practice, Familial Longevity, Individual and/or Family Notoriety, Military Service, Administrative Entry Error, and Pension-Social Entitlement Fraud. Conclusions. Understanding various causes of false extreme age claims is important for placing current, past, and future extreme longevity claims in context and for providing a necessary level of skepticism.

Moderate and extreme maternal obesity.

LENUS (Irish Health Repository)

Abdelmaboud, M O

2012-05-01

The aim of this study was to investigate the prevalence of moderate and extreme obesity among an Irish obstetric population over a 10-year period, and to evaluate the obstetric features of such pregnancies. Of 31,869 women delivered during the years 2000-2009, there were 306 women in the study group, including 173 in the moderate or Class 2 obese category (BMI 35-39.9) and 133 in the extreme or Class 3 obese category (BMI > or = 40).The prevalence of obese women with BMI > or = 35 was 9.6 per 1000 (0.96%), with an upward trend observed from 2.1 per 1000 in the year 2000, to 11.8 per 1000 in the year 2009 (P = 0.001). There was an increase in emergency caesarean section (EMCS) risk for primigravida versus multigravid women, within both obese categories (P < 0.001). However, there was no significant difference in EMCS rates observed between Class 2 and Class 3 obese women, when matched for parity. The prevalence of moderate and extreme obesity reported in this population is high, and appears to be increasing. The increased rates of abdominal delivery, and the levels of associated morbidity observed, have serious implications for such women embarking on pregnancy.

Typologies of Extreme Longevity Myths

Directory of Open Access Journals (Sweden)

Robert D. Young

2010-01-01

Full Text Available Purpose. Political, national, religious, and other motivations have led the media and even scientists to errantly accept extreme longevity claims prima facie. We describe various causes of false claims of extraordinary longevity. Design and Methods. American Social Security Death Index files for the period 1980–2009 were queried for individuals with birth and death dates yielding ages 110+ years of age. Frequency was compared to a list of age-validated supercentenarians maintained by the Gerontology Research Group who died during the same time period. Age claims of 110+ years and the age validation experiences of the authors facilitated a list of typologies of false age claims. Results. Invalid age claim rates increase with age from 65% at age 110-111 to 98% by age 115 to 100% for 120+ years. Eleven typologies of false claims were: Religious Authority Myth, Village Elder Myth, Fountain of Youth Myth (substance, Shangri-La Myth (geographic, Nationalist Pride, Spiritual Practice, Familial Longevity, Individual and/or Family Notoriety, Military Service, Administrative Entry Error, and Pension-Social Entitlement Fraud. Conclusions. Understanding various causes of false extreme age claims is important for placing current, past, and future extreme longevity claims in context and for providing a necessary level of skepticism.

Australia's Unprecedented Future Temperature Extremes Under Paris Limits to Warming

Science.gov (United States)

Lewis, Sophie C.; King, Andrew D.; Mitchell, Daniel M.

2017-10-01

Record-breaking temperatures can detrimentally impact ecosystems, infrastructure, and human health. Previous studies show that climate change has influenced some observed extremes, which are expected to become more frequent under enhanced future warming. Understanding the magnitude, as a well as frequency, of such future extremes is critical for limiting detrimental impacts. We focus on temperature changes in Australian regions, including over a major coral reef-building area, and assess the potential magnitude of future extreme temperatures under Paris Agreement global warming targets (1.5°C and 2°C). Under these limits to global mean warming, we determine a set of projected high-magnitude unprecedented Australian temperature extremes. These include extremes unexpected based on observational temperatures, including current record-breaking events. For example, while the difference in global-average warming during the hottest Australian summer and the 2°C Paris target is 1.1°C, extremes of 2.4°C above the observed summer record are simulated. This example represents a more than doubling of the magnitude of extremes, compared with global mean change, and such temperatures are unexpected based on the observed record alone. Projected extremes do not necessarily scale linearly with mean global warming, and this effect demonstrates the significant potential benefits of limiting warming to 1.5°C, compared to 2°C or warmer.

Early neurodevelopmental outcomes of extremely preterm infants.

Science.gov (United States)

Rogers, Elizabeth E; Hintz, Susan R

2016-12-01

Infants born at extreme preterm gestation are at risk for both death and disability. Although rates of survival have improved for this population, and some evidence suggests a trend toward decreased neuromotor impairment over the past decades, a significant improvement in overall early neurodevelopmental outcome has not yet been realized. This review will examine the rates and types of neurodevelopmental impairment seen after extremely preterm birth, including neurosensory, motor, cognitive, and behavioral outcomes. We focus on early outcomes in the first 18-36 months of life, as the majority of large neonatal studies examining neurodevelopmental outcomes stop at this age. However, this early age is clearly just a first glimpse into lifetime outcomes; the neurodevelopmental effects of extreme prematurity may last through school age, adolescence, and beyond. Importantly, prematurity appears to be an independent risk factor for adverse development, but this population demonstrates considerable variability in the types and severity of impairments. Understanding both the nature and prevalence of neurodevelopmental impairment among extremely preterm infants is important because it can lead to targeted interventions that in turn may lead to improved outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Software challenges in extreme scale systems

International Nuclear Information System (INIS)

Sarkar, Vivek; Harrod, William; Snavely, Allan E

2009-01-01

Computer systems anticipated in the 2015 - 2020 timeframe are referred to as Extreme Scale because they will be built using massive multi-core processors with 100's of cores per chip. The largest capability Extreme Scale system is expected to deliver Exascale performance of the order of 10 18 operations per second. These systems pose new critical challenges for software in the areas of concurrency, energy efficiency and resiliency. In this paper, we discuss the implications of the concurrency and energy efficiency challenges on future software for Extreme Scale Systems. From an application viewpoint, the concurrency and energy challenges boil down to the ability to express and manage parallelism and locality by exploring a range of strong scaling and new-era weak scaling techniques. For expressing parallelism and locality, the key challenges are the ability to expose all of the intrinsic parallelism and locality in a programming model, while ensuring that this expression of parallelism and locality is portable across a range of systems. For managing parallelism and locality, the OS-related challenges include parallel scalability, spatial partitioning of OS and application functionality, direct hardware access for inter-processor communication, and asynchronous rather than interrupt-driven events, which are accompanied by runtime system challenges for scheduling, synchronization, memory management, communication, performance monitoring, and power management. We conclude by discussing the importance of software-hardware co-design in addressing the fundamental challenges for application enablement on Extreme Scale systems.

Patient and implant survival following joint replacement because of metastatic bone disease

DEFF Research Database (Denmark)

Sørensen, Michala S; Gregersen, Kristine G; Grum-Schwensen, Tomas

2013-01-01

Patients suffering from a pathological fracture or painful bony lesion because of metastatic bone disease often benefit from a total joint replacement. However, these are large operations in patients who are often weak. We examined the patient survival and complication rates after total joint...... replacement as the treatment for bone metastasis or hematological diseases of the extremities....

A Generalized Framework for Non-Stationary Extreme Value Analysis

Science.gov (United States)

Ragno, E.; Cheng, L.; Sadegh, M.; AghaKouchak, A.

2017-12-01

Empirical trends in climate variables including precipitation, temperature, snow-water equivalent at regional to continental scales are evidence of changes in climate over time. The evolving climate conditions and human activity-related factors such as urbanization and population growth can exert further changes in weather and climate extremes. As a result, the scientific community faces an increasing demand for updated appraisal of the time-varying climate extremes. The purpose of this study is to offer a robust and flexible statistical tool for non-stationary extreme value analysis which can better characterize the severity and likelihood of extreme climatic variables. This is critical to ensure a more resilient environment in a changing climate. Following the positive feedback on the first version of Non-Stationary Extreme Value Analysis (NEVA) Toolbox by Cheng at al. 2014, we present an improved version, i.e. NEVA2.0. The upgraded version herein builds upon a newly-developed hybrid evolution Markov Chain Monte Carlo (MCMC) approach for numerical parameters estimation and uncertainty assessment. This addition leads to a more robust uncertainty estimates of return levels, return periods, and risks of climatic extremes under both stationary and non-stationary assumptions. Moreover, NEVA2.0 is flexible in incorporating any user-specified covariate other than the default time-covariate (e.g., CO2 emissions, large scale climatic oscillation patterns). The new feature will allow users to examine non-stationarity of extremes induced by physical conditions that underlie the extreme events (e.g. antecedent soil moisture deficit, large-scale climatic teleconnections, urbanization). In addition, the new version offers an option to generate stationary and/or non-stationary rainfall Intensity - Duration - Frequency (IDF) curves that are widely used for risk assessment and infrastructure design. Finally, a Graphical User Interface (GUI) of the package is provided, making NEVA

Motor function and respiratory capacity in patients with late-onset pompe disease

DEFF Research Database (Denmark)

Illes, Zsolt; Mike, Andrea; Trauninger, Anita

2014-01-01

Introduction: The relationship between skeletal muscle strength and respiratory dysfunction in Pompe disease has not been examined by quantitative methods. We investigated correlations among lower extremity proximal muscle strength, respiratory function, and motor performance. Methods: Concentric...... strength of the knee extensor and flexor muscles were measured with a dynamometer, and pulmonary function was evaluated using spirometry in 7 adult patients. The six-minute walk test and the four-step stair-climb test were used for assessing aerobic endurance and anaerobic power, respectively. Results......: Anaerobic motor performance correlated with strength of both thigh muscles. Respiratory function did not correlate with either muscle strength or motor function performance. Conclusions: Respiratory and lower extremity proximal muscles could be differentially affected by the disease in individual patients...

Counting States of Near-Extremal Black Holes

International Nuclear Information System (INIS)

Horowitz, G.T.; Strominger, A.

1996-01-01

A six-dimensional black string is considered and its Bekenstein-Hawking entropy computed. It is shown that to leading order above extremality this entropy precisely counts the number of string states with the given energy and charges. This identification implies that Hawking decay of the near-extremal black string can be analyzed in string perturbation theory and is perturbatively unitary. copyright 1996 The American Physical Society

Tukey max-stable processes for spatial extremes

KAUST Repository

Xu, Ganggang

2016-09-21

We propose a new type of max-stable process that we call the Tukey max-stable process for spatial extremes. It brings additional flexibility to modeling dependence structures among spatial extremes. The statistical properties of the Tukey max-stable process are demonstrated theoretically and numerically. Simulation studies and an application to Swiss rainfall data indicate the effectiveness of the proposed process. © 2016 Elsevier B.V.

Extreme-value dependence: An application to exchange rate markets

Science.gov (United States)

Fernandez, Viviana

2007-04-01

Extreme value theory (EVT) focuses on modeling the tail behavior of a loss distribution using only extreme values rather than the whole data set. For a sample of 10 countries with dirty/free float regimes, we investigate whether paired currencies exhibit a pattern of asymptotic dependence. That is, whether an extremely large appreciation or depreciation in the nominal exchange rate of one country might transmit to another. In general, after controlling for volatility clustering and inertia in returns, we do not find evidence of extreme-value dependence between paired exchange rates. However, for asymptotic-independent paired returns, we find that tail dependency of exchange rates is stronger under large appreciations than under large depreciations.

Microstructured extremely thin absorber solar cells

DEFF Research Database (Denmark)

Biancardo, Matteo; Krebs, Frederik C

2007-01-01

In this paper we present the realization of extremely thin absorber (ETA) solar cells employing conductive glass substrates functionalized with TiO2 microstructures produced by embossing. Nanocrystalline or compact TiO2 films on Indium doped tin oxide (ITO) glass substrates were embossed by press......In this paper we present the realization of extremely thin absorber (ETA) solar cells employing conductive glass substrates functionalized with TiO2 microstructures produced by embossing. Nanocrystalline or compact TiO2 films on Indium doped tin oxide (ITO) glass substrates were embossed...

A scheme for designing extreme multistable discrete dynamical ...

Indian Academy of Sciences (India)

A scheme for designing extreme multistable discrete dynamical systems ... Abstract. In this paper, we propose a scheme for designing discrete extreme multistable systems coupling two identical dynamical systems. Existence ... Department of Applied Mathematics, University of Calcutta, 92 APC Road, Kolkata 700 009, India ...

Insertion sequences enrichment in extreme Red sea brine pool vent

KAUST Repository

Elbehery, Ali H. A.

2016-12-03

Mobile genetic elements are major agents of genome diversification and evolution. Limited studies addressed their characteristics, including abundance, and role in extreme habitats. One of the rare natural habitats exposed to multiple-extreme conditions, including high temperature, salinity and concentration of heavy metals, are the Red Sea brine pools. We assessed the abundance and distribution of different mobile genetic elements in four Red Sea brine pools including the world’s largest known multiple-extreme deep-sea environment, the Red Sea Atlantis II Deep. We report a gradient in the abundance of mobile genetic elements, dramatically increasing in the harshest environment of the pool. Additionally, we identified a strong association between the abundance of insertion sequences and extreme conditions, being highest in the harshest and deepest layer of the Red Sea Atlantis II Deep. Our comparative analyses of mobile genetic elements in secluded, extreme and relatively non-extreme environments, suggest that insertion sequences predominantly contribute to polyextremophiles genome plasticity.

Modeling annual extreme temperature using generalized extreme value distribution: A case study in Malaysia

Science.gov (United States)

Hasan, Husna; Salam, Norfatin; Kassim, Suraiya

2013-04-01

Extreme temperature of several stations in Malaysia is modeled by fitting the annual maximum to the Generalized Extreme Value (GEV) distribution. The Augmented Dickey Fuller (ADF) and Phillips Perron (PP) tests are used to detect stochastic trends among the stations. The Mann-Kendall (MK) test suggests a non-stationary model. Three models are considered for stations with trend and the Likelihood Ratio test is used to determine the best-fitting model. The results show that Subang and Bayan Lepas stations favour a model which is linear for the location parameters while Kota Kinabalu and Sibu stations are suitable with a model in the logarithm of the scale parameters. The return level is the level of events (maximum temperature) which is expected to be exceeded once, on average, in a given number of years, is obtained.

The Contribution of Extreme Precipitation to the Total Precipitation in China

Institute of Scientific and Technical Information of China (English)

SUN Jian-Qi

2012-01-01

Using daily precipitation data from weather stations in China, the variations in the contribution of extreme precipitation to the total precipitation are analyzed. It is found that extreme precipitation accounts for approximately one third of the total precipitation based on the overall mean for China. Over the past half century, extreme precipitation has played a dominant role in the year-to-year variability of the total precipitation. On the decadal time scale, the extreme precipitation makes different contributions to the wetting and drying regions of China. The wetting trends of particular regions are mainly attributed to increases in extreme precipitation; in contrast, the drying trends of other regions are mainly due to decreases in non-extreme precipitation.

Temperature extremes: Effect on plant growth and development

Directory of Open Access Journals (Sweden)

Jerry L. Hatfield

2015-12-01

Full Text Available Temperature is a primary factor affecting the rate of plant development. Warmer temperatures expected with climate change and the potential for more extreme temperature events will impact plant productivity. Pollination is one of the most sensitive phenological stages to temperature extremes across all species and during this developmental stage temperature extremes would greatly affect production. Few adaptation strategies are available to cope with temperature extremes at this developmental stage other than to select for plants which shed pollen during the cooler periods of the day or are indeterminate so flowering occurs over a longer period of the growing season. In controlled environment studies, warm temperatures increased the rate of phenological development; however, there was no effect on leaf area or vegetative biomass compared to normal temperatures. The major impact of warmer temperatures was during the reproductive stage of development and in all cases grain yield in maize was significantly reduced by as much as 80−90% from a normal temperature regime. Temperature effects are increased by water deficits and excess soil water demonstrating that understanding the interaction of temperature and water will be needed to develop more effective adaptation strategies to offset the impacts of greater temperature extreme events associated with a changing climate.

Operational early warning platform for extreme meteorological events

Science.gov (United States)

Mühr, Bernhard; Kunz, Michael

2015-04-01

Operational early warning platform for extreme meteorological events Most natural disasters are related to extreme weather events (e.g. typhoons); weather conditions, however, are also highly relevant for humanitarian and disaster relief operations during and after other natural disaster like earthquakes. The internet service "Wettergefahren-Frühwarnung" (WF) provides various information on extreme weather events, especially when these events are associated with a high potential for large damage. The main focus of the platform is on Central Europe, but major events are also monitored worldwide on a daily routine. WF provides high-resolution forecast maps for many weather parameters which allow detailed and reliable predictions about weather conditions during the next days in the affected areas. The WF service became operational in February 2004 and is part of the Center for Disaster Management and Risk Reduction Technology (CEDIM) since 2007. At the end of 2011, CEDIM embarked a new type of interdisciplinary disaster research termed as forensic disaster analysis (FDA) in near real time. In case of an imminent extreme weather event WF plays an important role in CEDIM's FDA group. It provides early and precise information which are always available and updated several times during a day and gives advice and assists with articles and reports on extreme events.

Non-extremal D-instantons

NARCIS (Netherlands)

Bergshoeff, E; Collinucci, A; Gran, U; Roest, D; Vandoren, S

2004-01-01

We construct the most general non-extremal deformation of the D-instanton solution with maximal rotational symmetry. The general non-supersymmetric solution carries electric charges of the SL(2,R) symmetry, which correspond to each of the three conjugacy classes of SL (2, R). Our calculations

Non-extremal D-instantons

NARCIS (Netherlands)

Bergshoeff, E.; Collinucci, A.; Gran, U.; Roest, D.; Vandoren, S.

2004-01-01

We construct the most general non-extremal deformation of the D-instanton solution with maximal rotational symmetry. The general non-supersymmetric solution carries electric charges of the SL(2,R) symmetry, which correspond to each of the three conjugacy classes of SL(2,R). Our calculations

Multifractal Conceptualisation of Hydro-Meteorological Extremes

Science.gov (United States)

Tchiguirinskaia, I.; Schertzer, D.; Lovejoy, S.

2009-04-01

Hydrology and more generally sciences involved in water resources management, technological or operational developments face a fundamental difficulty: the extreme variability of hydro-meteorological fields. It clearly appears today that this variability is a function of the observation scale and yield hydro-meteorological hazards. Throughout the world, the development of multifractal theory offers new techniques for handling such non-classical variability over wide ranges of time and space scales. The resulting stochastic simulations with a very limited number of parameters well reproduce the long range dependencies and the clustering of rainfall extremes often yielding fat tailed (i.e., an algebraic type) probability distributions. The goal of this work was to investigate the ability of using very short or incomplete data records for reliable statistical predictions of the extremes. In particular we discuss how to evaluate the uncertainty in the empirical or semi-analytical multifractal outcomes. We consider three main aspects of the evaluation, such as the scaling adequacy, the multifractal parameter estimation error and the quantile estimation error. We first use the multiplicative cascade model to generate long series of multifractal data. The simulated samples had to cover the range of the universal multifractal parameters widely available in the scientific literature for the rainfall and river discharges. Using these long multifractal series and their sub-samples, we defined a metric for parameter estimation error. Then using the sets of estimated parameters, we obtained the quantile values for a range of excedance probabilities from 5% to 0.01%. Plotting the error bars on a quantile plot enable an approximation of confidence intervals that would be particularly important for the predictions of multifractal extremes. We finally illustrate the efficiency of such concept on its application to a large database (more than 16000 selected stations over USA and

Lymphoscintigraphy in the diagnosis of extremity lymphedema

International Nuclear Information System (INIS)

Yang Meifang; Lu Gang; Li Fang; Tian Jian

1994-01-01

Lymphoscintigraphy, using 99m Tc labeled antimony sulfur colloid and 99m Tc labeled dextran, was performed on 25 patients with swelling of upper or lower extremities for diagnosis of lymphedema. Five different lymphoscintigraphic patterns were identified, that is normal (4 cases), collaterals (2 cases), mixed (13 cases), dermal backflow (4 cases) and no backflow pattern (2 cases). Eight patients underwent operations for lympho-venous anastomoses on the involved extremity. The results indicate that lymphoscintigraphy has many advantages, such as simplicity and non-invasiveness, safety and reliability, being able to differentiate properties of extremity edema, to provide the information of morphologic changes and dynamically display lymphatic drainage and obstructive extent in the lymphatic system. The procedure is valuable for determination of the treatment modalities and the selection of patient for lymphatic microsurgery

Bone disease in primary hyperparathyroidism

Science.gov (United States)

Bandeira, Francisco; Cusano, Natalie E.; Silva, Barbara C.; Cassibba, Sara; Almeida, Clarissa Beatriz; Machado, Vanessa Caroline Costa; Bilezikian, John P.

2015-01-01

Bone disease in severe primary hyperparathyroidism (PHPT) is described classically as osteitis fibrosa cystica (OFC). Bone pain, skeletal deformities and pathological fractures are features of OFC. Bone mineral density is usually extremely low in OFC, but it is reversible after surgical cure. The signs and symptoms of severe bone disease include bone pain, pathologic fractures, proximal muscle weakness with hyperreflexia. Bone involvement is typically characterized as salt-and-pepper appearance in the skull, bone erosions and bone resorption of the phalanges, brown tumors and cysts. In the radiography, diffuse demineralization is observed, along with pathological fractures, particularly in the long bones of the extremities. In severe, symptomatic PHPT, marked elevation of the serum calcium and PTH concentrations are seen and renal involvement is manifested by nephrolithiasis and nephrocalcinosis. A new technology, recently approved for clinical use in the United States and Europe, is likely to become more widely available because it is an adaptation of the lumbar spine DXA image. Trabecular bone score (TBS) is a gray-level textural analysis that provides an indirect index of trabecular microarchitecture. Newer technologies, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), have provided further understanding of the microstructural skeletal features in PHPT. PMID:25166047

Detection of trends in precipitation extremes in Zhejiang, east China

NARCIS (Netherlands)

Tian, Ye; Xu, YuePing; Booij, Martijn J.; Lin, Shengji; Zhang, Qingqing; Lou, Zhanghua

2012-01-01

Extreme weather exerts a huge impact on human beings and it is of vital importance to study the regular pattern of meteorological and hydrological factors. In this paper, a selection of seven extreme indices is used to analyze the trend of precipitation extremes of 18 meteorological stations located