WorldWideScience

Sample records for psig preflash outlet

  1. The PSIG procedure to Persistent Scatterer Interferometry (PSI) using X-band and C-band Sentinel-1 data

    Science.gov (United States)

    Cuevas-González, María.; Devanthéry, Núria; Crosetto, Michele; Monserrat, Oriol; Crippa, Bruno

    2015-10-01

    A new approach to Persistent Scatterer Interferometry (PSI) data processing and analysis implemented in the PSI chain of the Geomatics (PSIG) Division of CTTC is used in this work. The flexibility of the PSIG procedure allowed evaluating two different processing chains of the PSIG procedure. A full PSIG procedure was implemented in the TerraSAR-X dataset while a reduced PSIG procedure was applied to the nine Sentinel-1 images available at the time of processing. The performance of the PSIG procedure is illustrated using X-band and C-band Sentinel-1 data and several examples of deformation maps covering different types of deformation phenomena are shown.

  2. Double outlet right ventricle

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007328.htm Double outlet right ventricle To use the sharing features on this page, please enable JavaScript. Double outlet right ventricle (DORV) is a heart disease that is ...

  3. Double Outlet Right Ventricle

    Science.gov (United States)

    ... Right Ventricle Menu Topics Topics FAQs Double Outlet Right Ventricle Double outlet right ventricle (DORV) is a rare form of congenital heart disease. Article Info En español Double outlet right ventricle (DORV) is a rare form of congenital ...

  4. Thoracic outlet anatomy (image)

    Science.gov (United States)

    ... spinal vertebra to the rib. There may be pain in the neck and shoulders, and numbess in the last 3 fingers and inner forearm. Thoracic outlet syndrome is usually treated with physical therapy which helps ...

  5. The properties of the positively charged loop region in PSI-G are essential for its "spontaneous" insertion into thylakoids and rapid assembly into the photosystem I complex

    National Research Council Canada - National Science Library

    Zygadlo, Agnieszka; Robinson, Colin; Scheller, Henrik Vibe; Mant, Alexandra; Jensen, Poul Erik

    2006-01-01

    The PSI-G subunit of photosystem I (PSI) is an 11-kDa membrane protein that plays an important role in electron transport between plastocyanin and PSI and is involved in the stability of the PSI complex...

  6. Core Outlet Temperature Study

    Energy Technology Data Exchange (ETDEWEB)

    Moisseytsev, A. [Argonne National Laboratory (ANL), Argonne, IL (United States); Hoffman, E. [Argonne National Laboratory (ANL), Argonne, IL (United States); Majumdar, S. [Argonne National Laboratory (ANL), Argonne, IL (United States)

    2008-07-28

    It is a known fact that the power conversion plant efficiency increases with elevation of the heat addition temperature. The higher efficiency means better utilization of the available resources such that higher output in terms of electricity production can be achieved for the same size and power of the reactor core or, alternatively, a lower power core could be used to produce the same electrical output. Since any nuclear power plant, such as the Advanced Burner Reactor, is ultimately built to produce electricity, a higher electrical output is always desirable. However, the benefits of the higher efficiency and electricity production usually come at a price. Both the benefits and the disadvantages of higher reactor outlet temperatures are analyzed in this work.

  7. Relative Roles of the fla/che PA, PD-3, and PsigD Promoters in Regulating Motility and sigD Expression in Bacillus subtilis

    Science.gov (United States)

    West, Joyce T.; Estacio, William; Márquez-Magaña, Leticia

    2000-01-01

    Three promoters have been identified as having potentially important regulatory roles in governing expression of the fla/che operon and of sigD, a gene that lies near the 3′ end of the operon. Two of these promoters, fla/che PA and PD-3, lie upstream of the >26-kb fla/che operon. The third promoter, PsigD, lies within the operon, immediately upstream of sigD. fla/che PA, transcribed by EςA, lies ≥24 kb upstream of sigD and appears to be largely responsible for sigD expression. PD-3, transcribed by EςD, has been proposed to participate in an autoregulatory positive feedback loop. PsigD, a minor ςA-dependent promoter, has been implicated as essential for normal expression of the fla/che operon. We tested the proposed functions of these promoters in experiments that utilized strains that bear chromosomal deletions of fla/che PA, PD-3, or PsigD. Our analysis of these strains indicates that fla/che PA is absolutely essential for motility, that PD-3 does not function in positive feedback regulation of sigD expression, and that PsigD is not essential for normal fla/che expression. Further, our results suggest that an additional promoter(s) contributes to sigD expression. PMID:10940026

  8. Flowrate testing of the bag filter LANCS-BOP 6CPVC-1.5-2SPVC (LANCS Industries) at 1 psig

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Murray E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Currie, Karissa Lyn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Berg, Charlotte Katherine [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-09-13

    The air flowrate through a flexible HEPA grade filter (Part LANCS-BOP 6CPVC-1.5-2SPVC www.lancsindustries.com) was measured at 48 ALPM for a differential pressure drop of 1.0 psig (28 inWC, 7.0 kPa). These filters are rated by the manufacturer to have a flowrate of 3 ALPM at a differential pressure drop of 1 inWC (0.25 kPa). The Los Alamos National Laboratory Aerosol Engineering Facility used one of their test rigs (originally developed to measure the pressure drop in capsule HEPA filters) to measure the airflow through the LANCS bag filter.

  9. Hydrologic Outlets of the Greenland Ice Sheet

    Data.gov (United States)

    National Aeronautics and Space Administration — The Hydrologic Outlets of the Greenland Ice Sheet data set contains GIS point shapefiles that include 891 observed and potential hydrologic outlets of the Greenland...

  10. Intelligent electrical outlet for collective load control

    Science.gov (United States)

    Lentine, Anthony L.; Ford, Justin R.; Spires, Shannon V.; Goldsmith, Steven Y.

    2015-10-27

    Various technologies described herein pertain to an electrical outlet that autonomously manages loads in a microgrid. The electrical outlet can provide autonomous load control in response to variations in electrical power generation supply in the microgrid. The electrical outlet includes a receptacle, a sensor operably coupled to the receptacle, and an actuator configured to selectively actuate the receptacle. The sensor measures electrical parameters at the receptacle. Further, a processor autonomously controls the actuator based at least in part on the electrical parameters measured at the receptacle, electrical parameters from one or more disparate electrical outlets in the microgrid, and a supply of generated electric power in the microgrid at a given time.

  11. Gastric outlet obstruction in Northwestern Ethiopia

    African Journals Online (AJOL)

    2. Gastric outlet obstruction in Northwestern Ethiopia. Rerhanu Kotisso MD. Associale Professor of Surgey. 1:;iculry of Medicine, Addis Ababa University. Key Words: Gastric outlet obstruction, peptic ulcer, tuberculosis, gastric cancer. This was a three-year prospective study to assess the magnitude and spectrum of gastric.

  12. MRI of thoracic outlet syndrome in children

    Energy Technology Data Exchange (ETDEWEB)

    Chavhan, Govind B.; Batmanabane, Vaishnavi [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto, ON (Canada); Muthusami, Prakash [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Division of Image Guided Therapy, Department of Diagnostic Imaging, Toronto, ON (Canada); Towbin, Alexander J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology and Medical Imaging, Cincinnati, OH (United States); Borschel, Gregory H. [The Hospital for Sick Children and University of Toronto, Division of Plastic Surgery, Department of Pediatric Surgery, Toronto, ON (Canada)

    2017-09-15

    Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging. Imaging is performed to confirm the diagnosis, exclude mimics and classify thoracic outlet syndrome into neurogenic, arterial, venous or mixed causes. MRI and MR angiography are useful in this process. A complete MRI examination for suspected thoracic outlet syndrome should include the assessment of anatomy and any abnormalities using routine sequences, vessel assessment with the arms in adduction by MR angiography and assessment of dynamic compression of vessels with abduction of the arms. The purpose of this paper is to describe the anatomy of the thoracic outlet, causes of thoracic outlet syndrome, the MR imaging techniques used in its diagnosis and the principles of image interpretation. (orig.)

  13. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy

    2012-01-01

    We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...

  14. Gastric outlet obstruction in Northwestern Ethiopia

    African Journals Online (AJOL)

    pyloroplasty was performed. TABLE V Postoperative complication of GOO patients. ** Malignant obstruction. Discussion. Gastric outlet obstruction (GOO) is a frequent cause of surgical admissions to the Gondar Teaching. Hospital, comprising 2.6% of all surgical admissions and 14.6% of the general surgical problems12.

  15. Double-outlet right ventricle revisited.

    Science.gov (United States)

    Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

    2017-08-01

    Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

  16. Hydrologic Outlets of the Greenland Ice Sheet, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Hydrologic Outlets of the Greenland Ice Sheet data set contains GIS point shapefiles that include 891 observed and potential hydrologic outlets of the Greenland...

  17. EFFECTS OF HACHIMIJIOHGAN ON BLADDER OUTLET OBSTRUCTION

    OpenAIRE

    北川, 竜一; 加納, 勝利; 西浦, 弘; 小川, 由英; 高橋, 茂喜

    1980-01-01

    The effects of Hachimijiohgan (herb) on bladder outlet obstruction were evaluated subjectively and objectively in 41 patients. These cases included 25 of prostate hypertrophy, 12 of bladder neck contracture, 2 of neurogenic bladder, 1 of irritable bladder and 1 of chronic cystitis. Administration ofHachimijiohgan resulted in some subjective and objective improvement in mild prostatic obstruction. There was no significant improvement in uroBowmetry. These findings suggest Hachimijiohgan may im...

  18. Giant bladder diverticulum : A rare cause of bladder outlet ...

    African Journals Online (AJOL)

    Giant bladder diverticula are rare causes of bladder outlet obstruction in children and have rarely been reported. In this paper, we present three children with giant bladder diverticula who presented with bladder outlet obstruction within a year. Micturating cystourethrogram is important for investigating bladder outlet ...

  19. Audit of tobacco retail outlets in Hangzhou, China.

    Science.gov (United States)

    Gong, Ting; Lv, Jun; Liu, Qingmin; Ren, Yanjun; Li, Liming; Kawachi, Ichiro

    2013-07-01

    To determine the prevalence of tobacco advertisements and warning messages at points of sale as well as to examine the density of tobacco retail outlets in neighbourhoods and around schools in Hangzhou, China. Tobacco retail outlets (n=1639) in all food and tobacco specialty stores were observed objectively by trained students. Tobacco advertisements and warning messages were assessed with an audit, and stores' addresses were recorded with Global Positioning System coordinates. The distances (1) between all pairs of tobacco retail outlets (2) between each tobacco retail outlet and 15 middle schools were calculated to assess the density of tobacco retail outlets in neighbourhoods and around schools. Among the 1639 tobacco retail outlets, retail outlets, the nearest distances to other tobacco retail outlets were retail outlets within a 100 m radius. Tobacco advertisement in retail outlets is prevalent and the density of tobacco retail outlets is high in Hangzhou, China. Signs indicating 'no sales to minors' and tobacco warning signs are almost non-existent. These findings point to an urgent need for the enforcement of regulations on display of 'no sales to minors' and a new density standard for tobacco retail outlets based on protecting the public's health.

  20. Alcohol Outlet Density and Intimate Partner Violence in a Nonmetropolitan College Town: Accounting for Neighborhood Characteristics and Alcohol Outlet Types.

    Science.gov (United States)

    Snowden, Aleksandra J

    2016-01-01

    There is a growing evidence of an ecological association between alcohol outlet density and intimate partner violence. It is reasonable to assume, however, that not all types of alcohol outlets contribute equally to criminal behavior, and to date, most ecological studies have been of large urban cities. Using Bloomington, Indiana, block groups as units of analysis and controlling for several structural characteristics associated with violence rates, I estimated spatially lagged regression models to determine if the variation in alcohol outlet density, including total outlets and disaggregating by on- and off-premise outlets, is related to intimate partner violence density. Results suggested that total alcohol outlet density and off-premise alcohol outlet density were significantly associated with intimate partner violence density. On-premise alcohol outlet density was not significantly associated with intimate partner violence density. These results not only extend the geographic scope of this relationship beyond large metropolitan areas but also have important policy implications.

  1. Conservative management of thoracic outlet syndrome.

    Science.gov (United States)

    Novak, C B

    1996-04-01

    Conservative management of thoracic outlet syndrome requires accurate evaluation of the peripheral nervous system, posture, and the cervico-scapular muscles. Patients should be instructed in postural correction in sitting, standing and sleeping, stretching exercises (ie, upper trapezius, levator scapulae, suboccipitals, scalenes, sternocleidomastoid and pectoral muscles), and strengthening exercises of the lower scapular stabilizers beginning in gravity-assisted positions to regain normal movement patterns in the cervico-scapular region. Patient education, compliance to an exercise program, and behavioral modification at home and work are critical to successful conservative management.

  2. Epidemiology and pathogenesis of thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Wojcik Gustaw

    2015-03-01

    Full Text Available The superior thoracic aperture is a place particularly vulnerable to the occurrence of tissue conflict and the development of a number of neurovascular changes carrying a risk of upper limb dysfunction. The triggering factor in this case is the pressure on the nerve vascular elements brought about by too large muscles of the chest and neck, clavicle fracture and dislocation of the upper ribs, anomalies in the form of ribs, in the neck, or by apex of the lung tumors. Each anatomical anomaly may be a cause of a number of lesions and lead to the development of the disease. Due to the nature of the oppressed structures, there are two basic groups: neurogenic and vascular. The most common variant giving clinical symptoms is neurogenic thoracic outlet syndrome. In this, the compression ratio, the brachial plexus, and for this reason, the vascular surface of the upper limb dysfunction is often overlooked. However, the vascular variant, and especially arterial sub-variant, is very dangerous because it can give complications even in the form of aneurysms, and even upper limb ischemia. The aim of the study is to present the most common changes in the thoracic outlet causing functional disorders of the upper limb.

  3. Modelling air―water flows in bottom outlets of dams

    OpenAIRE

    Liu, Ting

    2014-01-01

    If air is entrained in a bottom outlet of a dam in an uncontrolled way, the resulting air pockets may cause problems such as blowback, blowout and loss of discharge capacity. In order to provide guidance for bottom outlet design and operation, this study examines how governing parameters affect air entrainment, air-pocket transport and de-aeration and the surrounding flow structure in pipe flows. Both experimental and numerical approaches are used. Air can be entrained into the bottom outlet ...

  4. ADJUSTED F FACTOR FOR MULTIPLE-OUTLET PIPES.

    OpenAIRE

    Scaloppi, Edmar José [UNESP

    1988-01-01

    An adjusted F factor to compute pressure head loss in pipes having multiple, equally spaced outlets is derived for any given distance from the first outlet to the beginning of the pipe. The proposed factor is dependent on the number of outlets and is expressed as a function of the J. E. Christiansen's F factor. It may be useful to irrigation engineers to estimate friction in sprinkle and trickle irrigation laterals and manifolds, as well as gated pipes.

  5. Impedance plethysmographic observations in thoracic outlet syndrome.

    Directory of Open Access Journals (Sweden)

    Nerurkar S

    1990-07-01

    Full Text Available Forty patients with symptoms of neuro-vascular compression in the upper extremities were subjected to impedance plethysmographic study using Parulkar′s method. Two patients recorded decreased blood flow (BFI in supine position and were diagnosed as having partial occlusion at subclavian level. Sixteen of the patients recorded decreased BFI on 90 degrees abduction and hyper-abduction. Twelve of these patients had radiological evidence of anomalous cervicle ribs. In remaining four patients extrinsic impression on the subclavian artery due to fibrous deposits was confirmed by arteriography. Remaining 22 patients recorded normal impedance plethysmograms. Impedance plethysmography thus provided a non-invasive modality for confirmation of vascular compression in thoracic outlet syndrome.

  6. Corrosion of CANDU outlet feeder pipes

    Energy Technology Data Exchange (ETDEWEB)

    Burrill, K.A.; Cheluget, E.L

    1999-02-01

    Recent inspections have indicated that carbon steel outlet feeder pipes in some CANDU reactors are experiencing wall loss near the exit from the reactor core. This phenomenon is not observed in inlet feeder pipes. Examination of a sample of pipe removed from a CANDU 6 reactor has indicated that the mechanism causing the wall loss is flow-accelerated corrosion (FAC), at rates higher than expected, but two orders of magnitude lower than those typically observed in secondary circuits of nuclear and conventional power plants. Although the CANDU reactor outlet feeder operating temperatures and the use of LiOH at a high pH should have ensured low corrosion rates, use of SA 106 Grade B carbon steel with a low chromium content resulted in some susceptibility to FAC. The main parameter influencing the rate of wall loss is the coolant velocity, with the bend angle playing a secondary role. A solubility-based mathematical model describing the effects of water chemistry and coolant hydrodynamics on the rate of FAC has been developed and has been recently improved by the empirical incorporation of the effect of electrochemical potential on the solubility of magnetite. Experiment and theory have indicated that the corrosion rates are lower at lower pH values within the permissible operating range. Experiments are being conducted to obtain more information on the effects of water chemistry and material composition on FAC. Current results support the predicted effects of pH and carbon steel chromium content on the FAC rate. Remedial measures implemented include operation of existing reactors at the lower end of the specified pH range and the specification of a minimum of 0.20 wt% Cr in the carbon steel of feeder pipes of future CANDU reactors. (author)

  7. Tobacco Retail Outlets and Vulnerable Populations in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Michael O. Chaiton

    2013-12-01

    Full Text Available Interest has been increasing in regulating the location and number of tobacco vendors as part of a comprehensive tobacco control program. The objective of this paper is to examine the distribution of tobacco outlets in a large jurisdiction, to assess: (1 whether tobacco outlets are more likely to be located in vulnerable areas; and (2 what proportion of tobacco outlets are located close to schools. Retail locations across the Province of Ontario from Ministry of Health Promotion data were linked to 2006 Census data at the neighbourhood level. There was one tobacco retail outlet for every 1,000 people over age 15 in Ontario. Density of outlets varied by public health unit, and was associated with the number of smokers. Tobacco outlets were more likely to be located in areas that had high neighbourhood deprivation, in both rural and urban areas. Outlets were less likely to be located in areas with high immigrant populations in urban areas, with the reverse being true for rural areas. Overall, 65% of tobacco retailers were located within 500 m of a school. The sale of tobacco products is ubiquitous, however, neighbourhoods with lower socio-economic status are more likely to have easier availability of tobacco products and most retailers are located within walking distance of a school. The results suggest the importance of policies to regulate the location of tobacco retail outlets.

  8. Gastrojejunostomy for gastric outlet obstruction in patients with ...

    African Journals Online (AJOL)

    Objective. To investigate the utility of gastrojejunostomy for the palliation of gastric outlet obstruction in irresectable or incurable gastric carcinoma. Methods. This is a retrospective review of 67 patients who underwent a gastrojejunostomy for gastric outlet obstruction caused by gastric carcinoma between 1 January 1996 ...

  9. Effect of bag failure on baghouse outlet loading

    Energy Technology Data Exchange (ETDEWEB)

    Theodore, L.; Reynolds, J.

    1979-08-01

    Bag failure is one of the more serious problems encountered in filter baghouse operation. Equations describing changes in outlet loading resulting from the sudden rupture of one or more bags are developed. Calculated results from the equations are given in a chart that can be used to quickly obtain a numerical value for a revised outlet loading. (1 graph)

  10. Benign Strictures of the Esophagus and Gastric Outlet: Interventional Management

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Shin, Ji Hoon; Song, Ho Young [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2010-10-15

    Benign strictures of the esophagus and gastric outlet are difficult to manage conservatively and they usually require intervention to relieve dysphagia or to treat the stricture-related complications. In this article, authors review the non-surgical options that are used to treat benign strictures of the esophagus and gastric outlet, including balloon dilation, temporary stent placement, intralesional steroid injection and incisional therapy

  11. Gastric outlet obstruction in Northwestern Ethiopia | Kotisso | East ...

    African Journals Online (AJOL)

    ... drugs against peptic ulcer disease available. Moreover, in our set up, tuberculosis should always be borne in mind differential diagnosis to the other causes of gastric outlet obstruction such as complicated peptic ulcer disease and malignancy. Keywords: Gastric outlet obstruction, peptic ulcer, tuberculosis, gastric cancer ...

  12. [Treatment of the thoracic outlet vascular syndrome].

    Science.gov (United States)

    Davidović, L B; Lotina, S I; Vojnović, B R; Kostić, D M; Colić, M M; Stanić, M I; Djorić, P D

    1998-01-01

    The title "Thoracic Outlet Syndrome" (TOS) was introduced by Peet in 1956 [1]. In 1958 Charles Rob defined TOS as a "set of symptoms that may exist due to compression on the brachial plexus and on subclavian vessels in the region of the thoracic outlet" [2]. Compression due to cervical rib was first described by Galenus and Veaslius in the 2nd century A.D. The first unsuccessful resection of the cervical rib in patients with TOS was performed by Coote in 1861 [4]. In 1905 Murphy first made a successful resection of the cervical rib in patients with TOS and subclavian artery aneurysm [5]. He also removed the normal first rib in patients with TOS using the supraclavicular approach for the first time [6]. In 1920 Law described ligaments and other structures originating in soft tissue associated with TOS [8], while Adson and Coffey in 1927 emphasized the role of the scalene anticus muscle in TOS [3]. Ochsner, Gage and DeBakey in 1935 named it the "scalenus anticus syndrome", and made the first successful resection of the anterior scalene muscle [9]. In 1966 David Ross introduced the transaxillary resection of the first rib to relieve TOS [11]. The aim of the paper is to describe the treatment of patients with vascular TOS. Over a six-year-period (1990-1997) 12 patients with vascular TOS were evaluated at our Centre. Seven (58%) were female and 5 (42%) male patients, average age 33.1 years. Eleven of them had congenital TOS, and one acquired TOS after trauma at neck-shoulder region. Seven patients had arterial and 5 venous TOS. Two patients with arterial TOS had ischaemia of the upper extremity due to embolism of the brachial artery. In one of them axillary artery was completely thrombosed, and in the other postenotic dilatation of the subclavian artery was present. The other 5 patients with arterial TOS demonstrated only hand pain and radial puls during hyperabduction of the arm. One of our patients with venous TOS had also symptoms and signs of hand oedema during

  13. Alcohol Outlets and Violent Crime in Washington D.C.

    Directory of Open Access Journals (Sweden)

    Pan, William K

    2010-08-01

    Full Text Available Objective: Alcohol is more likely than any other drug to be involved in substance-related violence. In 2000 violence-related and self-directed injuries accounted for an estimated $37 billion and $33 billion in productivity losses and medical treatment, respectively. A review of emergency department data revealed violence and clinically identified trauma-related injuries have the strongest correlation among alcohol-dependent injuries. At the environmental level there is a relationship between alcohol outlet density and violent crime. A limited number of studies have examined the relationship between alcohol outlet type and the components of violent crime. The aim of this study is to examine the relationship between the aggregate components of violent crime and alcohol outlet density by type of outlet.Methods: For this study we used Washington, D.C. census tract data from the 2000 census to examine neighborhood characteristics. Alcohol outlet, violent crime, and population-level data for Washington, D.C. were drawn from various official yet publicly available sources. We developed an analytic database to examine the relationship between alcohol outlet category and four types of violent crime. After estimating spatial correlation and determining spatial dependence, we used a negative binomial regression analysis to assess the alcohol availability-violent crime association, while controlling for structural correlates of violence.Results: Independent of alternative structural correlates of violent crime, including the prevalence of weapons and illicit drugs, community-level alcohol outlet density is significantly associated with assaultive violence. Outlets were significantly related to robbery, assault, and sexual offenses. In addition, the relationship among on-premise and off-premise outlets varied across violent crime categories.Conclusion: In Washington, D.C., alcohol outlet density is significantly associated with the violent crimes. The

  14. The Geography of Fast Food Outlets: A Review

    Science.gov (United States)

    Fraser, Lorna K.; Edwards, Kimberly L.; Cade, Janet; Clarke, Graham P.

    2010-01-01

    The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity. PMID:20623025

  15. The geography of Fast Food outlets: a review.

    Science.gov (United States)

    Fraser, Lorna K; Edwards, Kimberly L; Cade, Janet; Clarke, Graham P

    2010-05-01

    The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

  16. The Geography of Fast Food Outlets: A Review

    Directory of Open Access Journals (Sweden)

    Lorna K. Fraser

    2010-05-01

    Full Text Available The availability of food high in fat, salt and sugar through Fast Food (FF or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

  17. MRI findings in thoracic outlet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)

    2012-11-15

    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  18. Routine bladder biopsies in men with bladder outlet obstruction?

    NARCIS (Netherlands)

    Horn, T.; Kortmann, B.B.M.; Holm, N.R.; Smedts, F.; Nordling, J.; Kiemeney, L.A.L.M.; Rosette, J.J.M.H.C. de la

    2004-01-01

    OBJECTIVES: To establish whether routine evaluation of light microscopic changes in bladder biopsies in men with graded bladder outlet obstruction correlates with urodynamic parameters and to evaluate the performance of two pathologists in bladder biopsy interpretation. METHODS: In 63 consecutive

  19. Geoengineering Outlet Glaciers and Ice Streams

    Science.gov (United States)

    Wolovick, Michael

    2017-04-01

    Mass loss from Greenland and Antarctica is highly sensitive to the presence of warm ocean water that drives melting of ice shelves and marine terminated glaciers. This warm water resides offshore at depth and accesses the grounding line through deep but narrow troughs and fjords. Here, we investigate the possibility of blocking warm water transport through these choke points with an artificial sill. Using a simple width-averaged model of ice stream flow coupled to a buoyant-plume model of submarine melt, we find that grounding line retreat and sea level rise can be delayed or reversed for hundreds of years if warm water is prevented from accessing outlet glaciers and ice-shelf cavities. Glaciers with a floating shelf exhibit a strong response to the presence of the artificial sill regardless of our choice of calving law, while tidewater glaciers require a strong linkage between submarine melt and iceberg calving for the artificial sill to have an effect. As a result of this difference and as a result of differing degrees of overdeepening in the basal topography, Antarctica and Greenland present very different societal cost-benefit analyses. Intervention in Greenland would be low-cost and low-reward: the volume of the artificial sill is comparable to existing large public works projects such as the Dubai Islands or the Suez Canal, but the magnitude of averted sea-level rise is small, the success of the intervention depends on the choice of calving law, and the glaciers return to their non-geoengineered trajectories within one to two centuries. Intervention in Antarctica, on the other hand, would be high-cost and high-reward: the volume of the artificial sill is one to two orders of magnitude greater, but the averted sea level rise is much larger, the intervention is successful regardless of the choice of calving law, and the ice streams remain far from their non-geoengineered trajectories throughout the 1000 year duration of our model runs. In both cases, an

  20. Outlet types and the Canadian Consumer Price Index

    OpenAIRE

    Alan G. WHITE

    2000-01-01

    Recent phenomenal growth in popularity of large warehouse/discount stores has important implications for price measurement. Consumer substitution to such outlets could produce a bias in consumer price indexes (CPIs), which may be exacerbated by unrepresentative sampling and discount outlets" apparent slower rates of price increases. It is shown that in 1990-96 unit value indexes rose at a lower rate than the corresponding Canadian CPI subaggregate indexes for other household equipment, non-pr...

  1. TARGET MARKETS FOR RETAIL OUTLETS OF LANDSCAPE PLANTS

    OpenAIRE

    Turner, Steven C.; Dorfman, Jeffrey H.; Fletcher, Stanley M.

    1990-01-01

    Merchandisers of landscape plants can increase the effectiveness of their marketing strategies by identifying target markets. Using a full information maximum likelihood tobit procedure on a system of three equations, target markets for different types of retail outlets in Georgia were identified. The results lend support and empirical evidence to the premise that different retail outlet types have different target markets and thus should develop different market strategies. The estimated tar...

  2. Evaluation of alcohol outlet density and its relation with violence

    Directory of Open Access Journals (Sweden)

    Ronaldo Laranjeira

    2002-08-01

    Full Text Available OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban São Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km; and the proportion of all properties that sold alcohol (1 in 12. CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.

  3. Alcohol outlet density and violence: A geographically weighted regression approach.

    Science.gov (United States)

    Cameron, Michael P; Cochrane, William; Gordon, Craig; Livingston, Michael

    2016-05-01

    We investigate the relationship between outlet density (of different types) and violence (as measured by police activity) across the North Island of New Zealand, specifically looking at whether the relationships vary spatially. We use New Zealand data at the census area unit (approximately suburb) level, on police-attended violent incidents and outlet density (by type of outlet), controlling for population density and local social deprivation. We employed geographically weighted regression to obtain both global average and locally specific estimates of the relationships between alcohol outlet density and violence. We find that bar and night club density, and licensed club density (e.g. sports clubs) have statistically significant and positive relationships with violence, with an additional bar or night club is associated with nearly 5.3 additional violent events per year, and an additional licensed club associated with 0.8 additional violent events per year. These relationships do not show significant spatial variation. In contrast, the effects of off-licence density and restaurant/café density do exhibit significant spatial variation. However, the non-varying effects of bar and night club density are larger than the locally specific effects of other outlet types. The relationships between outlet density and violence vary significantly across space for off-licences and restaurants/cafés. These results suggest that in order to minimise alcohol-related harms, such as violence, locally specific policy interventions are likely to be necessary. [Cameron MP, Cochrane W, Gordon C, Livingston M. Alcohol outlet density and violence: A geographically weighted regression approach. Drug Alcohol Rev 2016;35:280-288]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  4. Improving data accuracy of commercial food outlet databases.

    Science.gov (United States)

    Ohri-Vachaspati, Punam; Martinez, Diane; Yedidia, Michael J; Petlick, Nirvana

    2011-01-01

    PURPOSE. Assessing food environments often requires using commercially available data. Disparate methods used for classifying food outlets in these databases call for creating a classification approach using common definitions. A systematic strategy for reclassifying food stores and restaurants, as they appear in commercial databases, into categories that differentiate the availability of healthy options is described here. DESIGN AND SETTING. Commercially available data on food outlets including names, addresses, North American Industry Classification System codes, and associated characteristics was obtained for five New Jersey communities. ANALYSIS. A reclassification methodology was developed using criteria and definitions from the literature to categorize food outlets based on availability of healthy options. Information in the database was supplemented by systematic Internet and key word searches, and from phone calls to food outlets. RESULTS. The methodology resulted in 622 supermarket/grocery stores, 183 convenience stores, and 148 specialty stores in the original data to be reclassified into 58 supermarkets, 30 grocery stores, 692 convenience stores, and 115 specialty stores. Outlets from the original list of 1485 full-service restaurants and 506 limited-service restaurants were reclassified as 563 full-service restaurants and 1247 limited-service restaurants. Reclassification resulted in less than one-seventh the number of supermarkets and grocery stores, more than three times the number of convenience stores, and twice as many limited-service restaurants-a much less healthy profile than the one generated by using exclusively the commercial databases. CONCLUSION. An explicit and replicable strategy is proposed for reclassifying food outlets in commercial databases into categories that differentiate on the basis of healthy food availability. The intent is to contribute towards building a consensus among researchers on definitions used in public health

  5. Evaluation of alcohol outlet density and its relation with violence

    Directory of Open Access Journals (Sweden)

    Laranjeira Ronaldo

    2002-01-01

    Full Text Available OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban São Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km; and the proportion of all properties that sold alcohol (1 in 12. CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.

  6. Effect of bag failure on baghouse outlet loading

    Energy Technology Data Exchange (ETDEWEB)

    Theodore, L.; Reynolds, J.

    1979-08-01

    One of the most important considerations in baghouse operation is the effect of bag failure on outlet loading. This information would be of use to equipment manufacturers, users, and regulatory officials. Unfortunately, little information is available in the literature on this aspect of baghouse performance. Equations describing changes in outlet loading resulting from the sudden rupture of one or more bags are developed from first principles. Calculated result from these equations are presented in the form of a chart which can very quickly and simply be used to obtain a numerical value for a revised outlet loading resulting from bag failure(s) for a variety of system conditions. Due to an assumption made in the derivation, the new outlet loading thus obtained represents the maximum increase (worst case conditions) to be expected from the rupture of one or more bags. The following variables are included in the analysis: inlet loading, outlet loading (prior to bag failure), number of bag failures, bag diameter, system pressure drop; and gas temperature.

  7. Hydrological Modeling of the Jezero Crater Outlet-Forming Flood

    Science.gov (United States)

    Fassett, Caleb I.; Goudge, Timothy A.

    2017-01-01

    Jezero crater is a site of prime scientific interest because it was a lake early in Mars history. Preserved clay- and carbonate-bearing sedimentary fans on Jezero's western and northwestern margin (Fig. 2) are accessible to future exploration. Geologic context [1] and stratigraphic analysis of the western fan strongly support the interpretation that these fans were deposited as deltas into the lake. This has helped establish Jezero as one of the final candidate landing sites for Mars 2020. The high level of certainty that Jezero was a lake results from the existence of its outlet valley, which required filling of the crater to form [e.g., 1,4]. Here, we specifically focus on how this outlet valley was carved by the dam breach flood that eroded the eastern crater rim. We have completed preliminary modeling in both 1D and 2D of the outlet's formation.

  8. Melting beneath Greenland outlet glaciers and ice streams

    Science.gov (United States)

    Alexander, David; Perrette, Mahé; Beckmann, Johanna

    2015-04-01

    Basal melting of fast-flowing Greenland outlet glaciers and ice streams due to frictional heating at the ice-bed interface contributes significantly to total glacier mass balance and subglacial meltwater flux, yet modelling this basal melt process in Greenland has received minimal research attention. A one-dimensional dynamic ice-flow model is calibrated to the present day longitudinal profiles of 10 major Greenland outlet glaciers and ice streams (including the Jakobshavn Isbrae, Petermann Glacier and Helheim Glacier) and is validated against published ice flow and surface elevation measurements. Along each longitudinal profile, basal melt is calculated as a function of ice flow velocity and basal shear stress. The basal shear stress is dependent on the effective pressure (difference between ice overburden pressure and water pressure), basal roughness and a sliding parametrization. Model output indicates that where outlet glaciers and ice streams terminate into the ocean with either a small floating ice tongue or no floating tongue whatsoever, the proportion of basal melt to total melt (surface, basal and submarine melt) is 5-10% (e.g. Jakobshavn Isbrae; Daugaard-Jensen Glacier). This proportion is, however, negligible where larger ice tongues lose mass mostly by submarine melt (~1%; e.g. Nioghalvfjerdsfjorden Glacier). Modelled basal melt is highest immediately upvalley of the grounding line, with contributions typically up to 20-40% of the total melt for slippery beds and up to 30-70% for resistant beds. Additionally, modelled grounding line and calving front migration inland for all outlet glaciers and ice streams of hundreds of metres to several kilometres occurs. Including basal melt due to frictional heating in outlet glacier and ice stream models is important for more accurately modelling mass balance and subglacial meltwater flux, and therefore, more accurately modelling outlet glacier and ice stream dynamics and responses to future climate change.

  9. Effects of thermal insulation on electrical connections and outlet boxes

    Science.gov (United States)

    Beausoliel, R. W.; Clifton, J. R.; Meese, W. J.

    1981-04-01

    When residential walls are retrofitted with foamed-in urea formaldehyde or blown-in cellulose thermal insulations, the insulation may enter electrical outlet and switch boxes. The effects of these thermal insulations on the durability of electrical components were studied. These studies were carried out at 44, 75, and 96 percent relative humidities with test periods between one and twelve months. Laboratory test methods were developed and tests performed to determine the electrical and corrosive effects of urea formaldehyde and cellulose thermal insulation contained in electrical outlet and switch boxes.

  10. Using marine sediment archives to reconstruct past outlet glacier variability

    DEFF Research Database (Denmark)

    Andresen, Camilla Snowman; Straneo, Fiamma; Ribergaard, Mads

    2013-01-01

    Ice-rafted debris in fjord sediment cores provides information about outlet glacier activity beyond the instrumental time period. It tells us that the Helheim Glacier, Greenland’s third most productive glacier, responds rapidly to short-term (3 to 10 years) climate changes.......Ice-rafted debris in fjord sediment cores provides information about outlet glacier activity beyond the instrumental time period. It tells us that the Helheim Glacier, Greenland’s third most productive glacier, responds rapidly to short-term (3 to 10 years) climate changes....

  11. Perineal sound recording for diagnosis of bladder outlet obstruction.

    NARCIS (Netherlands)

    Idzenga, T.; Pel, J.J.; Mastrigt, R. van

    2009-01-01

    OBJECTIVES: Elderly men are prone to developing lower urinary tract symptoms (LUTS) possibly caused by bladder outlet obstruction (BOO). The most frequently used method to diagnose this condition is an invasive and time-consuming pressure-flow study. We are developing a novel non-invasive method to

  12. Double Outlet Right Ventricle with Anatomical Associations of ...

    African Journals Online (AJOL)

    Background: Complex congenital cardiac abnormalities involving double outlet right ventricle (DORV) are uncommon diseases. They contribute to mortality and morbidity among children in Nigeria and the exact etiology is unknown. However, infective, genetic and environmental factors among others are commonly ...

  13. Publication Outlets for School Psychology Faculty: 2010 to 2015

    Science.gov (United States)

    Hulac, David; Johnson, Natalie D.; Ushijima, Shiho C.; Schneider, Maryia M.

    2016-01-01

    Many school psychology faculty are required to publish for purposes of retention and promotion. It is useful to have an understanding of the different outlets for scholarly publications. In the present study, we investigated the peer-reviewed journals in which school psychology faculty were published between 2010 and 2015, the number of articles…

  14. Assessment of retention basin volume and outlet capacity in urban ...

    Indian Academy of Sciences (India)

    The quality of river water or other surface waters is detrimentally affected by the contaminants carried by the rainfall runoff in urban areas. The control of pollution moved by rainfall runoff is achieved by installing outlets and small retention basins in stormwater collection systems, thereby allowing only a certain amount of ...

  15. Gastric Outlet Obstruction from Duodenal Lipoma in an Adult ...

    African Journals Online (AJOL)

    PN Wichendu, A Dodiyi-Manuel ... remains the most common benign cause of gastric outlet obstruction (GOO), duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in countries where access to endoscopy and modern imaging techniques poses a challenge.

  16. 7 CFR 993.108 - Non-human consumption outlet.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing... consumption outlet means any livestock feeder or manufacturer of inedible syrup, industrial alcohol, animal feed, or other product for non-human use, who has established, to the satisfaction of the committee...

  17. Predictive factors of bladder outlet obstruction following the tension ...

    African Journals Online (AJOL)

    H. Elghamrawi

    Abstract. Objectives: To identify patients at risk for postoperative outlet obstruction after the tension-free vaginal tape obturator (TVTO) procedure in order to allow for better counseling and possible treatment alternatives. Subjects and methods: This prospective study was carried out on 85 women who underwent the TVTO.

  18. Evaluation of Synthetic Outlet Runoff Assessment Models | Adib ...

    African Journals Online (AJOL)

    Quantitative understanding and prediction of the processes of runoff generation and its transmission to the outlet represent one of the most basic and challenging areas of hydrology. Traditional techniques for design flood estimation use historical rainfall-runoff data for unit hydrograph (UH) derivation. Such techniques have ...

  19. 49 CFR 179.220-18 - Bottom outlets.

    Science.gov (United States)

    2010-10-01

    ... Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.220-18 Bottom outlets. (a) The... or stem projection below the “V” groove or its equivalent. The valve and seat must be readily...

  20. Electrical Power Quality--What's behind the Outlet?

    Science.gov (United States)

    Baird, William H.; Secrest, Jeffrey; Padgett, Clifford

    2017-01-01

    Although we may consider the power outlets in our homes to be nearly ideal voltage sources, a variety of influences in and around the home can cause departures from the nominal 60 Hz, 110-120 V root-mean-square (rms) of the North American grid. Even without instrumentation, we can see that a large motor starting from rest can be sufficient to…

  1. Using marine sediment archives to reconstruct past outlet glacier variability

    DEFF Research Database (Denmark)

    Andresen, Camilla Snowman; Straneo, Fiamma; Ribergaard, Mads

    2013-01-01

    Ice-rafted debris in fjord sediment cores provides information about outlet glacier activity beyond the instrumental time period. It tells us that the Helheim Glacier, Greenland’s third most productive glacier, responds rapidly to short-term (3 to 10 years) climate changes....

  2. “Clavicular duplication causing thoracic outlet obstruction”: Unique ...

    African Journals Online (AJOL)

    A 22‑year‑old female student reported with features of neurogenic thoracic outlet syndrome mainly involving C8‑T1 components of the brachial plexus, seemingly originating from involvement in costo‑clavicular space. Radiograph of the shoulder revealed clavicular duplication. Neuro‑physiological studies corroborated the ...

  3. Gastrojejunostomy for gastric outlet obstruction in patients with ...

    African Journals Online (AJOL)

    The management of irresectable gastric carcinoma with gas- tric outlet obstruction is controversial. Some authors ques- tion the role of gastrojejunostomy, raising concerns about impaired gastric motility1 and bleeding from the tumour,2,3 as well as suggesting that palliation is poor and survival short.4,5. Some even go as ...

  4. Pancreatic Pseudocyst Causing Gastric Outlet Obstruction In A 35 ...

    African Journals Online (AJOL)

    Pancreatic pseudocyst is an uncommon clinical entity in our environment and for it to cause gastric-outlet obstruction is even a rarer event in our practice. The overall incidence is unknown but the frequency may be more than is reported. It is commonly associated with alcohol related pancreatitis, trauma or cholelithiasis.

  5. Perineal sound recording for diagnosis of bladder outlet obstruction

    NARCIS (Netherlands)

    T. Idzenga (Tim); J.J.M. Pel (Johan); R. van Mastrigt (Ron)

    2009-01-01

    textabstractObjectives: Elderly men are prone to developing lower urinary tract symptoms (LUTS) possibly caused by bladder outlet obstruction (BOO). The most frequently used method to diagnose this condition is an invasive and time-consuming pressure-flow study. We are developing a novel

  6. Giant hepatic hemangioma presenting as gastric outlet obstruction.

    Science.gov (United States)

    Aydin, Cemalettin; Akbulut, Sami; Kutluturk, Koray; Kahraman, Aysegul; Kayaalp, Cuneyt; Yilmaz, Sezai

    2013-01-01

    Hemangioma, a most frequently encountered primary benign tumor of the liver, is generally determined incidentally during the course of radiologic tests for other reasons. Most lesions are less than 3 cm and a significant proportion of patients are asymptomatic, although the size and location of the lesion in some patients may be associated with the onset of symptoms. Pressure on the stomach and duodenum of giant hemagiomas developing in the left lobe of the liver, in particular, may result in the development of abdominal pain, nausea, vomiting, and feeling bloated, which are characteristic of a gastric outlet obstruction. A 42-year-old man presented with findings of gastric outlet obstruction and weight loss as a result of a giant hepatic hemangioma.

  7. Modeling of Flow in Nuclear Reactor Fuel Cell Outlet

    Directory of Open Access Journals (Sweden)

    František URBAN

    2010-12-01

    Full Text Available Safe and effective load of nuclear reactor fuel cells demands qualitative and quantitative analysis of relations between coolant temperature in fuel cell outlet temperature measured by thermocouple and middle temperature of coolant in thermocouple plane position. In laboratory at Insitute of thermal power engineering of the Slovak University of Technology in Bratislava was installed an experimental physical fuel cell model of VVER 440 nuclear power plant with V 213 nuclear reactors. Objective of measurements on physical model was temperature and velocity profiles analysis in the fuel cell outlet. In this paper the measured temperature and velocity profiles are compared with the results of CFD simulation of fuel cell physical model coolant flow.

  8. Boundary conditions for free surface inlet and outlet problems

    KAUST Repository

    Taroni, M.

    2012-08-10

    We investigate and compare the boundary conditions that are to be applied to free-surface problems involving inlet and outlets of Newtonian fluid, typically found in coating processes. The flux of fluid is a priori known at an inlet, but unknown at an outlet, where it is governed by the local behaviour near the film-forming meniscus. In the limit of vanishing capillary number Ca it is well known that the flux scales with Ca 2/3, but this classical result is non-uniform as the contact angle approaches π. By examining this limit we find a solution that is uniformly valid for all contact angles. Furthermore, by considering the far-field behaviour of the free surface we show that there exists a critical capillary number above which the problem at an inlet becomes over-determined. The implications of this result for the modelling of coating flows are discussed. © 2012 Cambridge University Press.

  9. Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

    Directory of Open Access Journals (Sweden)

    Abdulrahman Al-Hussaini

    2014-01-01

    Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

  10. A GIS Application to Explore Postal Retail Outlet Locations

    OpenAIRE

    Nikola Trubint

    2012-01-01

    The use of GIS in solving a wide variety of problems in postal operations is expanding. This approach provides the development and usage of new methods in spatial data analysis, as support in achieving a better quality of the decision-making process. The use of location analysis model based on GIS software is implemented in solving the Belgrade postal retail outlet problem. One of the most important experiences of model implementation is that the local environmental conditions have a signific...

  11. Infantile myofibromatosis: a most unusual cause of gastric outlet obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Rohrer, Kellie; Murphy, Robyn; Thresher, Caroline; Jacir, Nabil; Bergman, Kerry [Morristown Memorial Hospital, Department of Radiology, Morristown, NJ (United States)

    2005-08-01

    Non-bilious vomiting in the newborn is common. Etiologies include both surgical and medical conditions. Gastroesophageal reflux, soy or milk protein allergy, and prostaglandin-induced foveolar hyperplasia are among the medical causes. Surgical entities include gastric antral webs, pre-ampullary duodenal and pyloric atresia, and hypertrophic pyloric stenosis. We report the unique case of an 8-day-old girl who presented with gastric outlet obstruction secondary to infantile myofibromatosis. (orig.)

  12. EFFECT OF GENERIC PROMOTION OF FLOWERS ON THE USE OF RETAIL FLOWER OUTLETS

    OpenAIRE

    Rimal, Arbindra; Ward, Ronald W.

    1998-01-01

    AIDs demand models are used to test if the generic promotion of fresh-cut flowers influenced the market shares for florists, supermarkets, and other retail outlets. Were the generic efforts outlet neutral? Generic promotions of fresh-cut flowers is shown to be outlet neutral while the brand advertising increased florists' market share.

  13. A Geospatial Statistical Analysis of the Density of Lottery Outlets within Ethnically Concentrated Neighborhoods

    Science.gov (United States)

    Wiggins, Lyna; Nower, Lia; Mayers, Raymond Sanchez; Peterson, N. Andrew

    2010-01-01

    This study examines the density of lottery outlets within ethnically concentrated neighborhoods in Middlesex County, New Jersey, using geospatial statistical analyses. No prior studies have empirically examined the relationship between lottery outlet density and population demographics. Results indicate that lottery outlets were not randomly…

  14. Expiry of medicines in supply outlets in Uganda.

    Science.gov (United States)

    Nakyanzi, Josephine Katabaazi; Kitutu, Freddy Eric; Oria, Hussein; Kamba, Pakoyo Fadhiru

    2010-02-01

    The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-structured questionnaires. The study area has 19 public medicine outlets (three non-profit wholesalers, 16 hospital stores/pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies, equivalent to about 70% of the country's pharmaceutical businesses. Our findings indicate that medicines prone to expiry include those used for vertical programmes, donated medicines and those with a slow turnover. Awareness about the threat of expiry of medicines to the delivery of health services has increased. We have adapted training modules to emphasize management of medicine expiry for pharmacy students, pharmacists and other persons handling medicines. Our work has also generated more research interest on medicine expiry in Uganda. Even essential medicines expire in the supply chain in Uganda. Sound coordination is needed between public medicine wholesalers and their clients to harmonize procurement and consumption as well as with vertical programmes to prevent duplicate procurement. Additionally, national medicine regulatory authorities should enforce existing international guidelines to prevent dumping of donated medicine. Medicine selection and quantification should be matched with consumer tastes and prescribing habits. Lean supply and stock rotation should be considered.

  15. Availability of limited service food outlets surrounding schools in British Columbia.

    Science.gov (United States)

    Black, Jennifer L; Day, Meghan

    2012-06-05

    The purpose of this study was to provide a descriptive profile of the availability of limited service food outlets surrounding public schools in British Columbia, Canada. Data from the 2010 Canadian Business Data Files were used to identify limited service food outlets including fast food outlets, beverage and snack food stores, delis and convenience stores. The number of food outlets within 800 metres of 1,392 public schools and the distance from schools to the nearest food outlets were assessed. Multivariate regression models examined the associations between food outlet availability and school-level characteristics. In 2010, over half of the public schools in BC (54%) were located within a 10-12 minute walk from at least one limited service food outlet. The median closest distance to a food outlet was just over 1 km (1016 m). Schools comprised of students living in densely populated urban neighbourhoods and neighbourhoods characterized by lower socio-economic status were more likely to have access to limited service food outlets within walking distance. After adjusting for school-level median family income and population density, larger schools had higher odds of exposure to food vendors compared to schools with fewer students. The availability of and proximity to limited service food outlets vary widely across schools in British Columbia and school-level characteristics are significantly associated with food outlet availability. Additional research is needed to understand how food environment exposures inside and surrounding schools impact students' attitudes, food choices and dietary quality.

  16. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

    Directory of Open Access Journals (Sweden)

    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  17. Technologies for Upgrading Light Water Reactor Outlet Temperature

    Energy Technology Data Exchange (ETDEWEB)

    Daniel S. Wendt; Piyush Sabharwall; Vivek Utgikar

    2013-07-01

    Nuclear energy could potentially be utilized in hybrid energy systems to produce synthetic fuels and feedstocks from indigenous carbon sources such as coal and biomass. First generation nuclear hybrid energy system (NHES) technology will most likely be based on conventional light water reactors (LWRs). However, these LWRs provide thermal energy at temperatures of approximately 300°C, while the desired temperatures for many chemical processes are much higher. In order to realize the benefits of nuclear hybrid energy systems with the current LWR reactor fleets, selection and development of a complimentary temperature upgrading technology is necessary. This paper provides an initial assessment of technologies that may be well suited toward LWR outlet temperature upgrading for powering elevated temperature industrial and chemical processes during periods of off-peak power demand. Chemical heat transformers (CHTs) are a technology with the potential to meet LWR temperature upgrading requirements for NHESs. CHTs utilize chemical heat of reaction to change the temperature at which selected heat sources supply or consume thermal energy. CHTs could directly utilize LWR heat output without intermediate mechanical or electrical power conversion operations and the associated thermodynamic losses. CHT thermal characteristics are determined by selection of the chemical working pair and operating conditions. This paper discusses the chemical working pairs applicable to LWR outlet temperature upgrading and the CHT operating conditions required for providing process heat in NHES applications.

  18. Surgical treatment of thoracic outlet syndrome; by supraclavicular approach

    Directory of Open Access Journals (Sweden)

    Osman Abd Ellah Mohamed

    2012-01-01

    Full Text Available Background: Thoracic outlet syndrome comprises a wide spectrum of disorders with different compressive pathologies attributed to the neurovascular bundle passing from the root of the neck to supply the upper extremity. New concepts and advances in diagnosis and treatment are emerging. This study evaluates effectiveness and safety of the supraclavicular approach in management of neurovascular compression at the thoracic outlet. Materials and Methods: Twenty patients (15 females and 5 males with mean age of 20 years (ranging from 18 to 40 years underwent anterior neurovascular decompression procedures because of symptoms of lower plexus compression (C8 - T1. Preoperative plain radiography, MRI and nerve conduction velocity studies confirmed the clinical diagnosis. Nine patients had neck pain, all had sensory deficit and eight had motor deficit. Results: After 35 months of follow-up, 17 patients showed excellent results, two cases had good results and one case had fair results according to the visual analog scale, and nerve conduction velocities. Conclusions: We recommend nerve conduction velocity studies beside clinical assessment for diagnosis and follow-up, and supraclavicular approach in neurogenic decompression which is relatively safe and effective.

  19. Gastric outlet obstruction: Report of an exceptional case

    Directory of Open Access Journals (Sweden)

    Moutoshi Saha

    2017-01-01

    Full Text Available Although gastric outlet obstruction is a common condition, etiology could not be determined in a few cases by means of clinical features, radiological, and endoscopic examination, resulting in substantial diagnostic dilemma. A case is being described where a 30-year-old male presented with anorexia, dyspepsia, vomiting, low-grade fever, and weight loss for 2 months. Results of routine laboratory tests were within normal limit except elevated erythrocyte sedimentation rate. Abdominal computed tomography scan demonstrated a gastric outlet obstruction by an antral mass with mild enhancement of the area. Upper gastrointestinal endoscopy depicted an ulcerated and friable mass with an irregular shape and surface at pylorus resulting in pyloric obstruction. Endoscopic biopsy revealed only chronic gastritis with regenerative changes of epithelium. As the patient was not relieved of obstruction by conservative management, Billroth Type II gastrectomy was done. Histopathological examination of the resected specimen revealed caseating granulomas with acid-fast bacilli. Finally, the patient was diagnosed as primary gastric tuberculosis after exclusion affection of other organs and antituberculous medications was initiated. A good response to antitubercular treatment was noted after 5 months. Stomach being an uncommon site of tuberculosis and as it can occur in patients with no risk factors or characteristic symptoms, diagnosis of such rare condition remains a diagnostic enigma.

  20. Methodological Approaches to Locating Outlets of the Franchise Retail Network

    Directory of Open Access Journals (Sweden)

    Grygorenko Tetyana M.

    2016-08-01

    Full Text Available Methodical approaches to selecting strategic areas of managing the future location of franchise retail network outlets are presented. The main stages in the assessment of strategic areas of managing the future location of franchise retail network outlets have been determined and the evaluation criteria have been suggested. Since such selection requires consideration of a variety of indicators and directions of the assessment, the author proposes a scale of evaluation, which allows generalizing and organizing the research data and calculations of the previous stages of the analysis. The most important criteria and sequence of the selection of the potential franchisees for the franchise retail network have been identified, the technique for their evaluation has been proposed. The use of the suggested methodological approaches will allow the franchiser making sound decisions on the selection of potential target markets, minimizing expenditures of time and efforts on the selection of franchisees and hence optimizing the process of development of the franchise retail network, which will contribute to the formation of its structure.

  1. A longitudinal analysis of cigarette prices in military retail outlets.

    Science.gov (United States)

    Haddock, Christopher Keith; Hyder, Melissa L; Poston, Walker S C; Jahnke, Sara A; Williams, Larry N; Lando, Harry

    2014-04-01

    We conducted a longitudinal assessment of tobacco pricing in military retail outlets, including trends within each service branch. We determined the price of a single pack of Marlboro Red cigarettes at military retail stores located in the continental United States, Alaska, and Hawaii and at their nearest Walmarts in spring 2011 and 2013 (n = 128 for pairs available at both assessments). The average difference between cigarettes sold in military retail outlets and Walmarts decreased from 24.5% in 2011 to 12.5% in 2013. The decrease was partially attributable to significant price decreases at Walmarts. The largest increases in cigarette prices occurred on naval installations. Potential savings at stores on several installations remained substantial in 2013; the largest approached $6 per pack. Stores on 17 military installations decreased cigarette prices during the study period. Tobacco can be purchased in military retail stores at substantial savings over civilian stores. If tobacco pricing is to cease to be an incentive for use among personnel, a revised military tobacco pricing policy is needed.

  2. Spatial accessibility to physical activity facilities and to food outlets and overweight in French youth.

    Science.gov (United States)

    Casey, R; Chaix, B; Weber, C; Schweitzer, B; Charreire, H; Salze, P; Badariotti, D; Banos, A; Oppert, J-M; Simon, C

    2012-07-01

    Some characteristics of the built environment have been associated with obesity in youth. Our aim was to determine whether individual and environmental socio-economic characteristics modulate the relation between youth overweight and spatial accessibility to physical activity (PA) facilities and to food outlets. Cross-sectional study. 3293 students, aged 12 ± 0.6 years, randomly selected from eastern France middle schools. Using geographical information systems (GIS), spatial accessibility to PA facilities (urban and nature) was assessed using the distance to PA facilities at the municipality level; spatial accessibility to food outlets (general food outlets, bakeries and fast-food outlets) was calculated at individual level using the student home address and the food outlets addresses. Relations of weight status with spatial accessibility to PA facilities and to food outlets were analysed using mixed logistic models, testing potential direct and interaction effects of individual and environmental socio-economic characteristics. Individual socio-economic status modulated the relation between spatial accessibility to PA facilities and to general food outlets and overweight. The likelihood of being overweight was higher when spatial accessibility to urban PA facilities and to general food outlets was low, but in children of blue-collar-workers only. The odds ratio (OR) (95% confidence interval) for being overweight of blue-collar-workers children compared with non-blue-collar-workers children was 1.76 (1.25-2.49) when spatial accessibility to urban PA facilities was low. This OR was 1.86 (1.20-2.86) when spatial accessibility to general food outlets was low. There was no significant relationship of overweight with either nature PA facilities or other food outlets (bakeries and fast-food outlets). These results indicate that disparities in spatial accessibility to PA facilities and to general food outlets may amplify the risk of overweight in socio

  3. Suicide and alcohol: do outlets play a role?

    Science.gov (United States)

    Johnson, Fred W; Gruenewald, Paul J; Remer, Lillian G

    2009-12-01

    The purpose of this study was to determine whether the number of alcohol outlets in local and adjacent areas, in particular bars, was related over time to completed suicide and suicide attempts. There is evidence both from studies of individuals and time series aggregate studies, mostly at the national level, of substantial alcohol involvement in suicide, but no small-area, longitudinal studies have been carried out. The present study is the first that is both longitudinal and based on a large number of small spatial units, California zip codes, a level of resolution permitting analysis of the relationship between local alcohol access and suicide rates over time. Longitudinal data were obtained from 581 consistently defined zip code areas over 6 years (1995-2000) using data from the California Index Locations Database, a geographic information system that contains both population and place information with spatial attributes for the entire state. Measures obtained from each zip code included population characteristics (e.g., median age) and place characteristics (e.g., numbers of retail and alcohol outlets) which were related in separate analyses to (i) suicide mortality and (ii) the number of hospitalizations for injuries caused by suicide attempts. The effect of place characteristics in zip code areas adjacent to each of the 581 local zip codes (spatial lags) was also assessed. Analysis methods were random effects models corrected for spatial autocorrelation. Completed suicide rates were higher in zip code areas with greater local and lagged bar densities; and higher in areas with greater local but not lagged off-premise outlet densities. Whereas completed suicide rates were lower among blacks and Hispanics, completed suicide rates were higher among low income, older whites living in less densely populated areas, that is, rural areas. Rates of suicide attempts were higher in zip code areas with greater local but not lagged bar densities, and higher among low

  4. Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

    LENUS (Irish Health Repository)

    Glynn, Ronan W

    2012-02-01

    To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.

  5. Effects of Outlets on Cracking Risk and Integral Stability of Super-High Arch Dams

    Directory of Open Access Journals (Sweden)

    Peng Lin

    2014-01-01

    Full Text Available In this paper, case study on outlet cracking is first conducted for the Goupitan and Xiaowan arch dams. A nonlinear FEM method is then implemented to study effects of the outlets on integral stability of the Xiluodu arch dam under two loading conditions, i.e., normal loading and overloading conditions. On the basis of the case study and the numerical modelling, the outlet cracking mechanism, risk, and corresponding reinforcement measures are discussed. Furthermore, the numerical simulation reveals that (1 under the normal loading conditions, the optimal distribution of the outlets will contribute to the tensile stress release in the local zone of the dam stream surface and decrease the outlet cracking risk during the operation period. (2 Under the overloading conditions, the cracks initiate around the outlets, then propagate along the horizontal direction, and finally coalesce with those in adjacent outlets, where the yield zone of the dam has a shape of butterfly. Throughout this study, a dam outlet cracking risk control and reinforcement principle is proposed to optimize the outlet design, select the appropriate concrete material, strengthen the temperature control during construction period, design reasonable impounding scheme, and repair the cracks according to their classification.

  6. Effects of outlets on cracking risk and integral stability of super-high arch dams.

    Science.gov (United States)

    Lin, Peng; Liu, Hongyuan; Li, Qingbin; Hu, Hang

    2014-01-01

    In this paper, case study on outlet cracking is first conducted for the Goupitan and Xiaowan arch dams. A nonlinear FEM method is then implemented to study effects of the outlets on integral stability of the Xiluodu arch dam under two loading conditions, i.e., normal loading and overloading conditions. On the basis of the case study and the numerical modelling, the outlet cracking mechanism, risk, and corresponding reinforcement measures are discussed. Furthermore, the numerical simulation reveals that (1) under the normal loading conditions, the optimal distribution of the outlets will contribute to the tensile stress release in the local zone of the dam stream surface and decrease the outlet cracking risk during the operation period. (2) Under the overloading conditions, the cracks initiate around the outlets, then propagate along the horizontal direction, and finally coalesce with those in adjacent outlets, where the yield zone of the dam has a shape of butterfly. Throughout this study, a dam outlet cracking risk control and reinforcement principle is proposed to optimize the outlet design, select the appropriate concrete material, strengthen the temperature control during construction period, design reasonable impounding scheme, and repair the cracks according to their classification.

  7. North Atlantic warming and the retreat of Greenland's outlet glaciers.

    Science.gov (United States)

    Straneo, Fiammetta; Heimbach, Patrick

    2013-12-05

    Mass loss from the Greenland ice sheet quadrupled over the past two decades, contributing a quarter of the observed global sea-level rise. Increased submarine melting is thought to have triggered the retreat of Greenland's outlet glaciers, which is partly responsible for the ice loss. However, the chain of events and physical processes remain elusive. Recent evidence suggests that an anomalous inflow of subtropical waters driven by atmospheric changes, multidecadal natural ocean variability and a long-term increase in the North Atlantic's upper ocean heat content since the 1950s all contributed to a warming of the subpolar North Atlantic. This led, in conjunction with increased runoff, to enhanced submarine glacier melting. Future climate projections raise the potential for continued increases in warming and ice-mass loss, with implications for sea level and climate.

  8. A GIS Application to Explore Postal Retail Outlet Locations

    Directory of Open Access Journals (Sweden)

    Nikola Trubint

    2012-03-01

    Full Text Available The use of GIS in solving a wide variety of problems in postal operations is expanding. This approach provides the development and usage of new methods in spatial data analysis, as support in achieving a better quality of the decision-making process. The use of location analysis model based on GIS software is implemented in solving the Belgrade postal retail outlet problem. One of the most important experiences of model implementation is that the local environmental conditions have a significant impact on strategic as well as operational approach. A portion of the material included in the paper has resulted from the Serbian PTT and CPC (Canada Post Corporation joint project Location Analysis.

  9. Public health implications of animals in retail food outlets.

    Science.gov (United States)

    Dyjack, David T; Ho, Jessica; Lynes, Rahel; Lynes, Rachel; Bliss, Jesse C

    2013-12-01

    Growing societal interest to permit animals into retail food outlets presents both risks and benefits to the dining public and consumers. This article summarizes a literature review that evaluated the associated potential public health issues related to this subject. Using the EBSCOhost research protocol and Google search engines between March 2010 and June 2011, the authors have compiled and synthesized scientific research articles, empirical scientific literature, and publicly available news media. While pets are known carriers of bacteria and parasites, among others, the relative risk associated with specific pet-human interactions in the dining public has yet to be established in a clear and consistent manner. Much of the available health-risk-factor evidence reflects pets in domestic conditions and interaction with farm animals. Special consideration is recommended for vulnerable populations such as children, asthmatics, the elderly, pregnant women, and the immunocompromised.

  10. Access to alcohol outlets, alcohol consumption and mental health.

    Directory of Open Access Journals (Sweden)

    Gavin Pereira

    Full Text Available The objective of this study was to investigate residential exposure to alcohol outlets in relation to alcohol consumption and mental health morbidity (anxiety, stress, and depression. This was a cross-sectional study of 6,837 adults obtained from a population representative sample for the period 2006-2009 in Perth, Western Australia. The number of alcohol outlets was ascertained for a 1600 m service area surrounding the residential address. Zero-inflated negative binomial and logistic regression were used to assess associations with total alcohol consumption, harmful alcohol consumption (7-10 drinks containing 10 g of alcohol for men, 5-6 drinks for women and medically diagnosed and hospital contacts (for anxiety, stress, and depression, respectively. The rate ratio for the number of days of harmful consumption of alcohol per month and the number of standard drinks of alcohol consumed per drinking day was 1.06 (95% CI: 1.02, 1.11 and 1.01 (95% CI: 1.00, 1.03 for each additional liquor store within a 1600 m service area, respectively. The odds ratio of hospital contact for anxiety, stress, or depression was 1.56 (95% CI: 0.98, 2.49 for those with a liquor store within the service area compared to those without. We observed strong evidence for a small association between residential exposure to liquor stores and harmful consumption of alcohol, and some support for a moderate-sized effect on hospital contacts for anxiety, stress, and depression.

  11. Thoracic outlet syndrome after the Nuss procedure for pectus excavatum: Is it a rare complication?

    Science.gov (United States)

    Nagasao, Tomohisa; Morotomi, Tadaaki; Kuriyama, Motone; Kogure, Tetsukuni; Kudo, Hirro; Hamamoto, Yusuke; Tamai, Motoki

    2017-10-01

    The present study aims to elucidate the frequency of thoracic outlet syndrome after the Nuss procedure for pectus excavatum and the conditions in which thoracic outlet syndrome is likely to develop. A retrospective study including 85 pectus excavatum patients (58 males and 27 females) was conducted. Thoracic outlet syndrome was defined as a condition in which the patient has numbness, lassitude, or pain of the upper limbs at rest or during motion of the upper limbs. The frequency of the thus-defined thoracic outlet syndrome was evaluated in 85 patients. Age, sex, Haller indices, and the positions of the correction bars were compared between the patients who developed thoracic outlet syndrome and those who did not. Preadolescent patients (18 out of 85) did not develop postoperative thoracic outlet syndrome. In total, 15.2% of adult male patients (7 out of 46) and 33% of adult female patients (7 out of 21) developed postoperative thoracic outlet syndrome. For both male and female groups, Haller indices were significantly greater for patients who had postoperative thoracic outlet syndrome than for those who did not. Correction bars were generally placed at higher intercostal spaces in patients who developed postoperative thoracic outlet syndrome than in those who did not. A considerable percentage of adult patients develop thoracic outlet syndrome after the Nuss procedure for pectus excavatum. Maturity of the thoracic wall, femininity, severity of the deformity (represented by greater Haller indices), and placement of correction bars at superior intercostal spaces are risk factors for postoperative thoracic outlet syndrome. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Neighbourhood fast food outlets and obesity in children and adults: the CLAN Study.

    Science.gov (United States)

    Crawford, David A; Timperio, Anna F; Salmon, Jo A; Baur, Louise; Giles-Corti, Billie; Roberts, Rebecca J; Jackson, Michelle L; Andrianopoulos, Nick; Ball, Kylie

    2008-01-01

    We examined associations between density of and proximity to fast food outlets and body weight in a sample of children (137 aged 8-9 years and 243 aged 13-15 years) and their parents (322 fathers and 362 mothers). Children's measured and parents' self-reported heights and weights were used to calculate body mass index (BMI). Locations of major fast food outlets were geocoded. Bivariate linear regression analyses examined associations between the presence of any fast food outlet within a 2 km buffer around participants' homes, fast food outlet density within the 2 km buffer, and distance to the nearest outlet and BMI. Each independent variable was also entered into separate bivariate logistic regression analyses to predict the odds of being overweight or obese. Among older children, those with at least one outlet within 2 km had lower BMI z-scores. The further that fathers lived from an outlet, the higher their BMI. Among 13-15-year-old girls and their fathers, the likelihood of overweight/obesity was reduced by 80% and 50%, respectively, if they had at least one fast food outlet within 2 km of their home. Among older girls, the likelihood of being overweight/obese was reduced by 14% with each additional outlet within 2 km. Fathers' odds of being overweight/obese increased by 13% for each additional kilometre to the nearest outlet. While consumption of fast food has been shown to be associated with obesity, this study provides little support for the concept that exposure to fast food outlets in the local neighbourhood increases risk of obesity.

  13. Out-of-home food outlets and area deprivation: case study in Glasgow, UK

    Directory of Open Access Journals (Sweden)

    Cummins Steven

    2005-10-01

    Full Text Available Abstract Background There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. Methods We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways, and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. Results The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2 and lowest in the second most deprived quintile (Q4. Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32–0.84 in Q1, 0.50 (CI 0.31 – 0.80 in Q4 and 0.61 (CI 0.38 – 0.98 in Q5. Outlets were located in the City Centre, West End, and along arterial roads. Conclusion In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

  14. Evaluation of microbial contents of table eggs at retail outlets in ...

    African Journals Online (AJOL)

    This study was carried out to evaluate the microbial contents of chicken eggs, sold at retail outlets in Sokoto metropolis. A total of 160 eggs were collected from 16 randomly selected retail outlets, in Sokoto metropolis, for microbial evaluation. Samples were cultured and isolated using nutrient and McConkey agar for ...

  15. Evaluation of microbial contents of table eggs at retail outlets in ...

    African Journals Online (AJOL)

    ADEYEYE

    2015-02-23

    Feb 23, 2015 ... *Correspondence: Tel.: +2348035950593, E-mail: mdsal70@yahoo.com. Abstract. This study was carried out to evaluate the microbial contents of chicken eggs, sold at retail outlets in Sokoto metropolis. A total of 160 eggs were collected from 16 randomly selected retail outlets, in Sokoto metropolis, for.

  16. 24 CFR 3280.813 - Outdoor outlets, fixtures, air-conditioning equipment, etc.

    Science.gov (United States)

    2010-04-01

    ... Electrical Systems § 3280.813 Outdoor outlets, fixtures, air-conditioning equipment, etc. (a) Outdoor.../or air conditioning equipment located outside the manufactured home, shall have permanently affixed, adjacent to the outlet, a metal tag which reads: This Connection Is for Air Conditioning Equipment Rated at...

  17. The association between the geography of fast food outlets and childhood obesity rates in Leeds, UK.

    Science.gov (United States)

    Fraser, Lorna K; Edwards, Kimberley L

    2010-11-01

    To analyse the association between childhood overweight and obesity and the density and proximity of fast food outlets in relation to the child's residential postcode. This was an observational study using individual level height/weight data and geographic information systems methodology. Leeds in West Yorkshire, UK. This area consists of 476 lower super-output areas. Children aged 3-14 years who lived within the Leeds metropolitan boundaries (n=33,594). The number of fast food outlets per area and the distance to the nearest fast food outlet from the child's home address. The weight status of the child: overweight, obese or neither. 27.1% of the children were overweight or obese with 12.6% classified as obese. There is a significant positive correlation (pfast food outlets and higher deprivation. A higher density of fast food outlets was significantly associated (p=0.02) with the child being obese (or overweight/obese) in the generalised estimating equation model which also included sex, age and deprivation. No significant association between distance to the nearest fast food outlet and overweight or obese status was found. There is a positive relationship between the density of fast food outlets per area and the obesity status of children in Leeds. There is also a significant association between fast food outlet density and areas of higher deprivation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Validation of presence of supermarkets and fast-food outlets in Copenhagen

    DEFF Research Database (Denmark)

    Svastisalee, Chalida M; Holstein, Bjørn E; Due, Pernille

    2012-01-01

    We examined the quality of food outlet addresses provided by secondary sources and determined whether they could be physically located in the field.......We examined the quality of food outlet addresses provided by secondary sources and determined whether they could be physically located in the field....

  19. Impurity profiling of trinitrotoluene using vacuum-​outlet gas chromatography-​mass spectrometry

    NARCIS (Netherlands)

    Brust, H.; Willemse, S.; Zeng, T.; van Asten, A.; Koeberg, M.; van der Heijden, A.; Bolck, A.; Schoenmakers, P.

    2014-01-01

    In this work, a reliable and robust vacuum-​outlet gas chromatog.-​mass spectrometry (GC-​MS) method is introduced for the identification and quantification of impurities in trinitrotoluene (TNT)​. Vacuum-​outlet GC-​MS allows for short anal. times; the anal. of impurities in TNT was performed in 4

  20. Impurity profiling of trinitrotoluene using vacuum-outlet gas chromatography-mass spectrometry

    NARCIS (Netherlands)

    Brust, H.; Willemse, S.; Zeng, T.; Asten, A. van; Koeberg, M.; Heijden, A.E.D.M. van der; Bolck, A.; Schoenmakers, P.

    2014-01-01

    In this work, a reliable and robust vacuum-outlet gas chromatography-mass spectrometry (GC-MS) method is introduced for the identification and quantification of impurities in trinitrotoluene (TNT). Vacuum-outlet GC-MS allows for short analysis times the analysis of impurities in TNT was performed in

  1. Alcohol outlet density and alcohol consumption in Los Angeles county and southern Louisiana

    Directory of Open Access Journals (Sweden)

    Matthias Schonlau

    2008-11-01

    Full Text Available The objective of this study was to assess the relationship between alcohol availability, as measured by the density of off-premise alcohol outlets, and alcohol consumption in Los Angeles county and southern Louisiana, USA. Consumption information was collected through a telephone survey of 2,881 households in Los Angeles county and pre-Katrina southern Louisiana, nested within 220 census tracts. Respondents’ addresses were geo-coded and both neighbourhood (census tracts and buffers of varying sizes and individual (network distance to the closest alcohol outlet estimates of off-sale alcohol outlet density were computed. Alcohol outlet density was not associated with the percentage of people who were drinkers in either site. Alcohol outlet density was associated with the quantity of consumption among drinkers in Louisiana but not in Los Angeles. Outlet density within a one-mile buffer of the respondent’s home was more strongly associated with alcohol consumption than outlet density in the respondent’s census tract. The conclusion is that the relationship between neighbourhood alcohol outlet density and alcohol consumption is complex and may vary due to differences in neighbourhood design and travel patterns.

  2. Survey of Publication Outlets in Early Childhood Education: Descriptive Data, Review Processes, and Advice to Authors

    Science.gov (United States)

    Amodei, Michelle L.; Jalongo, Mary Renck; Myers, Jacqueline; Onchwari, Jacqueline; Gargiulo, Richard M.

    2013-01-01

    Publishing outlets in the field of early childhood vary widely in terms of emphasis on theory, practice, and research as they relate to the care and education of the very young; these outlets also have different readerships (i.e., primarily for teachers, the teachers of their teachers, or the fellow scholars/researchers). Included in the mixture…

  3. Shopper loyalty to whom? Chain versus outlet loyalty in the context of store acquisitions

    NARCIS (Netherlands)

    van Lin, A.I.J.G.; Gijsbrechts, E.

    When patronizing stores, consumers may exhibit loyalty not only to a retail chain but also to a specific outlet. This distinction is important in a dynamic retail environment: if a store changes ownership, chain loyalty makes customers inclined to seek out another outlet of the former chain, whereas

  4. Shopper Loyalty to Whom? Chain Versus Outlet Loyalty in the Context of Store Acquisitions

    NARCIS (Netherlands)

    van Lin, Arjen; Gijsbrechts, E.

    2014-01-01

    When patronizing stores, consumers may exhibit loyalty not only to a retail chain but also to a specific outlet. This distinction is important in a dynamic retail environment: if a store changes ownership, chain loyalty makes customers inclined to seek out another outlet of the former chain, whereas

  5. Bilateral functional thoracic outlet syndrome in a collegiate football player.

    Science.gov (United States)

    Robey, Jason H; Boyle, Kyndall L

    2009-11-01

    Thoracic Outlet Syndrome (TOS) involves compression of the brachial plexus, subclavius artery and vein. Many studies discuss efficacy of surgery and few discuss conservative treatment. It is unknown what specific forms of conservative treatment are best. Describe conservative management for TOS using unique exercises. A collegiate football player reported numbness/tingling down his right arm after a right brachial plexus stretch injury. Seven months later, he was diagnosed with recurrent cervical traction neuropraxia. Two months later, he reported bilateral symptoms and was diagnosed with functional TOS. The athlete began shoulder strengthening (deltoid, middle trapezius, rhomboids, pectoralis major, latissimus dorsi, biceps, upper trapezius and rotator cuff) and stretching (pectoralis, scalene and upper trapezius) which failed to resolve his symptoms after four weeks. Surgical resection of bilateral first ribs and quitting football was recommended by four physicians. Unique therapeutic exercises developed by the Postural Restoration Institute™ were used to optimize respiration/posture via muscle activation and inhibition. After six weeks, the athlete was asymptomatic and returned to football but still experienced paresthesia with contact. Additional exercises were prescribed and remaining symptoms were abolished. The Northwick Park Neck Pain Questionnaire was 55.5% at initial and 0% at four weeks and discharge. Athlete did not demonstrate relief of symptoms from shoulder stretching and strengthening. Intervention designed to optimize respiration/posture by repositioning the pelvis/trunk via specific muscle inhibition and activation resulted in abolishing the athlete's symptoms. Management that aims to optimize respiration via muscle inhibition, activation, and repositioning warrants further research.

  6. Salvage surgery for bladder outlet obstruction after prostatectomy or cystectomy.

    Science.gov (United States)

    Westney, Ouida L

    2008-11-01

    Obstruction of the outlet secondary to a recurrent bladder neck contracture postprostatectomy or cystectomy presents a reconstructive challenge combined with the goal of restoring normal lower urinary tract function. The majority of bladder neck contractures are responsive to urethral dilation or cold knife direct visual internal urethrotomy. Urethral stents and anastomotic urethroplasty have been used with increasing frequency to regain urethral continuity. In the postcystectomy patient, obstruction due to stricture must be differentiated from dysfunctional voiding - unfavorable pouch voiding mechanics, insufficient pouch pressure generation or failure of external sphincter relaxation. Aggressive electrocautery resection with urethral stent placement and anastomotic urethroplasty are viable options for achieving patency after bladder neck obstruction. For those desirous of achieving a continent endpoint, artificial urinary sphincter should be planned as a second stage procedure after stabilization of the bladder neck. Creation of a catheterizable limb remains an option for the unreconstructable urethra. If augmentation cystoplasty is necessary due to storage pressure abnormalities, an appendicovesicostomy or reconfigured ileum segment is a reasonable method to achieve continence. The incidence of recurrent obstruction due to tissue in-growth or stricture is similar between urethral stent placement and anastomotic urethroplasty, respectively. The high incontinence rate after either initial treatment should be expected and factored into the overall treatment plan.

  7. Understanding private retail drug outlet dispenser knowledge and practices in tuberculosis care in Tanzania.

    Science.gov (United States)

    Rutta, E; Tarimo, A; Delmotte, E; James, I; Mwakisu, S; Kasembe, D; Konduri, N; Silumbe, R; Kakanda, K; Valimba, R

    2014-09-01

    Private sector accredited drug dispensing outlets in Morogoro and pharmacies in Dar es Salaam, Tanzania. To assess 1) the level of knowledge about tuberculosis (TB) among dispensers in Tanzania's retail pharmaceutical sector; 2) practices related to identification of patients with suspected TB; 3) the availability of educational materials and training; and 4) the availability of first- and second-line anti-tuberculosis treatment in retail drug outlets. A cross-sectional descriptive study involving the administration of a structured questionnaire among drug dispensers in 122 pharmacies and 173 accredited drug dispensing outlets. Private retail drug outlets are convenient; most are open at least 12 h per day, 7 days/week. Although 95% of dispensers identified persistent cough as a symptom of TB, only 1% had received TB-related training in the previous 3 years; 8% of outlets stocked first-line anti-tuberculosis medicines, which are legally prohibited from being sold at retail outlets. The majority of respondents reported seeing clients with TB-like symptoms, and of these 95% reported frequently referring clients to nearby health facilities. Private retail pharmaceutical outlets can potentially contribute to TB case detection and treatment; however, a coordinated effort is needed to train dispensers and implement appropriate referral procedures.

  8. Local tobacco policy and tobacco outlet density: associations with youth smoking.

    Science.gov (United States)

    Lipperman-Kreda, Sharon; Grube, Joel W; Friend, Karen B

    2012-06-01

    This study investigates the associations between local tobacco policy, tobacco outlet density, and youth smoking. A primary focus is on whether local tobacco policy moderates the relation between outlet density and youth smoking. In all, 1,491 youth (51.9% male, mean age = 14.7 years, standard deviation = 1.05) in 50 midsized California cities were surveyed through a computer-assisted telephone interview. Measures of local clean air policy and youth access policy were created based on a review of tobacco policies in these cities. Outlet density was calculated as the number of retail tobacco outlets per 10,000 persons, and city characteristics were obtained from 2000 U.S. Census data. Using multilevel regression analyses and controlling for city characteristics, tobacco outlet density was positively associated with youth smoking. No significant main effects were found for the two tobacco policy types on any of the smoking outcomes after controlling for interactions and covariates. However, statistically significant interactions were found between local clean air policy and tobacco outlet density for ever smoked and past 12-month cigarette smoking. Comparisons of simple slopes indicated that the positive associations between tobacco outlet density and youth smoking behaviors were stronger at the lowest level of local clean air policy compared with the moderate and high levels. Our results suggest that tobacco outlet density is related to youth smoking. In addition, local clean air policy may act as a moderator of relationship between tobacco outlet density and youth smoking, such that density is less important at moderate and high levels of this tobacco policy. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Methods for implementing a medicine outlet survey: lessons from the anti-malarial market.

    Science.gov (United States)

    O'Connell, Kathryn A; Poyer, Stephen; Solomon, Tsione; Munroe, Erik; Patouillard, Edith; Njogu, Julius; Evance, Illah; Hanson, Kara; Shewchuk, Tanya; Goodman, Catherine

    2013-02-05

    In recent years an increasing number of public investments and policy changes have been made to improve the availability, affordability and quality of medicines available to consumers in developing countries, including anti-malarials. It is important to monitor the extent to which these interventions are successful in achieving their aims using quantitative data on the supply side of the market. There are a number of challenges related to studying supply, including outlet sampling, gaining provider cooperation and collecting accurate data on medicines. This paper provides guidance on key steps to address these issues when conducting a medicine outlet survey in a developing country context. While the basic principles of good survey design and implementation are important for all surveys, there are a set of specific issues that should be considered when conducting a medicine outlet survey. This paper draws on the authors' experience of designing and implementing outlet surveys, including the lessons learnt from ACTwatch outlet surveys on anti-malarial retail supply, and other key studies in the field. Key lessons and points of debate are distilled around the following areas: selecting a sample of outlets; techniques for collecting and analysing data on medicine availability, price and sales volumes; and methods for ensuring high quality data in general. The authors first consider the inclusion criteria for outlets, contrasting comprehensive versus more focused approaches. Methods for developing a reliable sampling frame of outlets are then presented, including use of existing lists, key informants and an outlet census. Specific issues in the collection of data on medicine prices and sales volumes are discussed; and approaches for generating comparable price and sales volume data across products using the adult equivalent treatment dose (AETD) are explored. The paper concludes with advice on practical considerations, including questionnaire design, field worker

  10. Boundary layer models for calving marine outlet glaciers

    Science.gov (United States)

    Schoof, Christian; Davis, Andrew D.; Popa, Tiberiu V.

    2017-10-01

    We consider the flow of marine-terminating outlet glaciers that are laterally confined in a channel of prescribed width. In that case, the drag exerted by the channel side walls on a floating ice shelf can reduce extensional stress at the grounding line. If ice flux through the grounding line increases with both ice thickness and extensional stress, then a longer shelf can reduce ice flux by decreasing extensional stress. Consequently, calving has an effect on flux through the grounding line by regulating the length of the shelf. In the absence of a shelf, it plays a similar role by controlling the above-flotation height of the calving cliff. Using two calving laws, one due to Nick et al. (2010) based on a model for crevasse propagation due to hydrofracture and the other simply asserting that calving occurs where the glacier ice becomes afloat, we pose and analyse a flowline model for a marine-terminating glacier by two methods: direct numerical solution and matched asymptotic expansions. The latter leads to a boundary layer formulation that predicts flux through the grounding line as a function of depth to bedrock, channel width, basal drag coefficient, and a calving parameter. By contrast with unbuttressed marine ice sheets, we find that flux can decrease with increasing depth to bedrock at the grounding line, reversing the usual stability criterion for steady grounding line location. Stable steady states can then have grounding lines located on retrograde slopes. We show how this anomalous behaviour relates to the strength of lateral versus basal drag on the grounded portion of the glacier and to the specifics of the calving law used.

  11. Boundary layer models for calving marine outlet glaciers

    Directory of Open Access Journals (Sweden)

    C. Schoof

    2017-10-01

    Full Text Available We consider the flow of marine-terminating outlet glaciers that are laterally confined in a channel of prescribed width. In that case, the drag exerted by the channel side walls on a floating ice shelf can reduce extensional stress at the grounding line. If ice flux through the grounding line increases with both ice thickness and extensional stress, then a longer shelf can reduce ice flux by decreasing extensional stress. Consequently, calving has an effect on flux through the grounding line by regulating the length of the shelf. In the absence of a shelf, it plays a similar role by controlling the above-flotation height of the calving cliff. Using two calving laws, one due to Nick et al. (2010 based on a model for crevasse propagation due to hydrofracture and the other simply asserting that calving occurs where the glacier ice becomes afloat, we pose and analyse a flowline model for a marine-terminating glacier by two methods: direct numerical solution and matched asymptotic expansions. The latter leads to a boundary layer formulation that predicts flux through the grounding line as a function of depth to bedrock, channel width, basal drag coefficient, and a calving parameter. By contrast with unbuttressed marine ice sheets, we find that flux can decrease with increasing depth to bedrock at the grounding line, reversing the usual stability criterion for steady grounding line location. Stable steady states can then have grounding lines located on retrograde slopes. We show how this anomalous behaviour relates to the strength of lateral versus basal drag on the grounded portion of the glacier and to the specifics of the calving law used.

  12. Benefits of mesenchymal stem cells after partial bladder outlet obstruction.

    Science.gov (United States)

    Al-Saikan, Bader; Ding, Jie; Tredget, Edward; Metcalfe, Peter

    2016-01-01

    Partial bladder outlet obstruction (pBOO) results in significant morbidity and mortality in the pediatric and adult populations. Mesenchymal stem cells (MSC) have been widely studied in many organ systems for the treatment and prevention of fibrotic and inflammatory conditions. Therefore, we hypothesize that systemic administration of MSC will demonstrate short-term biochemical, histological, and urodynamic benefits in an animal model for pBOO. After University ethics approval, 5 × 106 green fluorescent protein GFP-labeled MSC were intravenously injected concurrently with pBOO in adult Sprague-Dawley rats. Five groups (n=3/group) were analyzed: a) unobstructed controls; b) pBOO for seven days with intravenous MSC (7d+MSC); c) pBOO for seven days without intravenous MSC (7d-MSC); d) pBOO for 14 days with intravenous MSC (14d+MSC), e) pBOO for 14 days without MSC (14d-MSC). Urodynamics were performed at the end of the experimental period and bladders were weighed. Immunohistochemistry was performed for GFP detection and reverse transcription polymerase chain reaction (RT-PCR) to detect mRNA of: TGF-B, HIF-1a, RhoA, GRP-78, lumican, and decorin. All animals remained healthy. GFP was detected in all treatment groups. MSC treatment resulted in a significant decrease in bladder capacity (0.91 cc vs. 2.15 cc, p=0.04). Treatment also resulted in significant decreases in mRNA levels of: TGF-B, HIF-1a, Rho-A, and GRP-78. Systemic treatment with MSC was well tolerated and resulted in MSC accumulation after pBOO. Despite our low numbers, we were able to successfully demonstrate short-term urodynamic improvements and widespread, significant decreases in inflammatory mediators. We believe that this decreased inflammatory cascade will help prevent long-term detrusor deterioration.

  13. Perineal sound recording for diagnosis of bladder outlet obstruction

    Directory of Open Access Journals (Sweden)

    Tim Idzenga

    2009-01-01

    Full Text Available Objectives: Elderly men are prone to developing lower urinary tract symptoms (LUTS possibly caused by bladder outlet obstruction (BOO. The most frequently used method to diagnose this condition is an invasive and time-consuming pressure-flow study. We are developing a novel non-invasive method to diagnose BOO in men with LUTS based on perineal sound recording. Methods: A biophysical model urethra was made from polyvinyl alcohol (PVA cryogel with viscoelastic properties comparable to those of the male pig urethra. To this model different degrees of obstruction were applied and sound was recorded at different positions downstream of the obstruction. In a study in 16 healthy male volunteers the variability and repeatability of perineal sound recording was tested. Results: In the model three parameters, derived from the frequency spectrum of the recorded sound (i.e., weighted average frequency, standard deviation and skewness are uniquely related to the degree of obstruction (linear regression, P< 0.001. The variability of perineal sound recording in healthy male volunteers was found to be smaller within volunteers than between volunteers (Kruskal-Wallis, P< 0.001 and the repeatability was comparable to that of the maximum flow rate. Conclusions: We conclude that perineal sound recordings are significantly different between volunteers. In combination with the unique relations found in the model-experiments these results increase the probability that perineal sound recording can be used as a simple and cheap non-invasive method to diagnose BOO. Clinical testing of this method is therefore strongly indicated.

  14. Arterial Thoracic Outlet Syndrome Treated Successfully with Totally Endoscopic First Rib Resection.

    Science.gov (United States)

    Mitsos, Sofoklis; Patrini, Davide; Velo, Sara; Antonopoulos, Achilleas; Hayward, Martin; George, Robert S; Lawrence, David; Panagiotopoulos, Nikolaos

    2017-01-01

    Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection.

  15. The “School Foodshed”: schools and fast-food outlets in a London borough

    OpenAIRE

    Caraher, M.; Lloyd, S; Madelin, T.

    2014-01-01

    Purpose – The purpose of this paper is to explore the location of fast-food outlets around secondary schools and the influence of fast-food availability on the food choices of school children in an inner-London borough. \\ud \\ud Design/methodology/approach – A number of methods including: mapping of outlets relative to schools; sampling food; gathering data on secondary school food policies; observing food behaviour in fast food outlets and focus groups with young people. Findings were fed bac...

  16. Spontaneous Gastric Perforation in a Neonate Presenting as Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Saeid Aslanabadi

    2013-07-01

    Full Text Available Gastric perforation in neonates is a rare but frequently fatal condition which is associated with massive pneumoperitoneum in radiography. Here, we report a case of neonatal spontaneous gastric perforation presenting as gastric outlet obstruction rather than pneumoperitoneum. Physical examination and imaging modalities were indicative of abdominal distension and gastric outlet obstruction. With diagnosis of gastric perforation at laparotomy, subtotal gastric resection was performed and a feeding jejunostomy was placed. The present report highlights that gastric perforation should be of clinical suspicion in neonates with abdominal distension and unusual imaging findings rather than pneumoperitoneum. Keywords: Spontaneous gastric perforation; gastric outlet obstruction; pneumoperitoneum

  17. Numerical Investigation of the Hydrodynamic Conditions in A Multi-Strand Cc Tundish with Closed Outlets

    Directory of Open Access Journals (Sweden)

    Merder T.

    2014-10-01

    Full Text Available In industrial conditions there are situations when the CC machine works under emergency. It can be result of mechanical or electrical causes, breakout of billet or problem with supplying new parts of liquid steel to the CC machine. As a consequence one or two outlets of the tundish should be closed. However, closing one of the outlets influences the hydrodynamic and thermal conditions occurring in the tundish. Thus, the important information is which of the outlets should be closed to conduct further continuous casting process correctly.

  18. Giant bladder diverticulum: A rare cause of bladder outlet obstruction in children

    Directory of Open Access Journals (Sweden)

    William Appeadu-Mensah

    2012-01-01

    Full Text Available Giant bladder diverticula are rare causes of bladder outlet obstruction in children and have rarely been reported. [1] In this paper, we present three children with giant bladder diverticula who presented with bladder outlet obstruction within a year. Micturating cystourethrogram is important for investigating bladder outlet obstruction in children and was used to confirm the diagnosis in all the patients. The relationship between the diverticula and ureters varied, with the ureters running either through the wall of the diverticulum and opening directly into the bladder, or opening into the diverticulum. In one patient, there was a recurrence, which was excised successfully. Excision is important to reduce the risk of recurrence.

  19. A Comparative Analysis of the Distributions of KFC and McDonald’s Outlets in China

    National Research Council Canada - National Science Library

    Yikang Rui; Huang Huang; Min Lu; Bao Wang; Jiechen Wang

    2016-01-01

    .... To study the regional spread of KFC and McDonald’s outlets in Chinese cities, the correlation of their distributions and degree of market expansion were explored and compared to analyze both the local and the global spatial autocorrelations...

  20. Is proximity to alcohol outlets associated with alcohol consumption and alcohol-related harm in Denmark?

    DEFF Research Database (Denmark)

    Kedir, Abdu; Berg-Beckhoff, Gabriele; Stock, Christiane

    2018-01-01

    Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug...... and Alcohol Survey (n=5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption...... and alcohol consumption (volume of drinking and risky single occasion drinking). Conclusions: This study found some support for an association between closer distances between place of residence and alcohol outlets and alcohol related harm for women. Future studies in the Nordic region should continue...

  1. Employee Anonymous Online Dissent: Dynamics and Ethical Challenges for Employees, Targeted Organisations, Online Outlets and Audiences

    DEFF Research Database (Denmark)

    Ravazzani, Silvia; Mazzei, Alessandra

    2018-01-01

    This article aims to enhance understanding of employee anonymous online dissent (EAOD), a controversial phenomenon in contemporary digital environments. We conceptualise and scrutinise EAOD as a communicative and interactional process among four key actors: dissenting employees, online outlet...

  2. Estimates of sport fishing effort, catch, and harvest at Ugashik Narrows and Outlet

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Creel surveys were conducted at Ugashik Narrows during the summers of 1987 and 1988, and at Ugashik Outlet during the summer of 1988. Coho salmon Onvorhynchus...

  3. Usefulness of 3D Reconstructed Computed Tomography Imaging for Double Outlet Right Ventricle

    Directory of Open Access Journals (Sweden)

    Shyh-Jye Chen

    2008-05-01

    Conclusion: 3D constructed CT imaging is a good modality for differentiating VSD type in DORV. It allowed us to directly evaluate the inside of cardiac chambers for the right ventricular outlet, great arterial root, and determine the VSD relationships.

  4. The relationship between liquor outlet density and injury and violence in New Mexico.

    Science.gov (United States)

    Escobedo, Luis G; Ortiz, Melchor

    2002-09-01

    This study used an ecologic design based on data from 1990 to 1994 gathered from forensic, vital statistic, census, law enforcement and liquor licensing agencies to assess the relationship between liquor outlet density and alcohol-related health outcomes in New Mexico. Linear regression models show that suicide, alcohol-related crash, and alcohol-related crash fatality (adjusted for age, sex, and minority status) are significantly associated with liquor outlet density. Data also show that, compared with the first tertile, suicide and alcohol-related crash rates increase about 50% and the alcohol-related crash fatality rate two-fold with the third tertile of liquor outlet density. Greater availability of liquor outlets is associated with higher rates of suicide, alcohol-related crash, and alcohol-related crash fatality.

  5. Heat transfer from the evaporator outlet to the charge of thermostatic expansion valves

    DEFF Research Database (Denmark)

    Langmaack, Lasse Nicolai; Knudsen, Hans-Jørgen Høgaard

    2006-01-01

    The bulb of a thermostatic expansion valve (TXV) is basically a temperature-pressure converter. It senses the temperature at the outlet of the evaporator, and the substance in the bulb (charge) generates the corresponding saturation pressure inside the bulb. The bulb is mounted on the evaporator...... outlet with a special mounting strap. The heat transfer is quite complex because it takes place both directly through the contact points between bulb and pipe and indirectly through the mounting strap The TXV has to react to temperature changes at the evaporator outlet. Therefore, the dynamic behavior...... of the valve (and thereby the whole refrigeration system) depends greatly on the heat transfer between the evaporator outlet tube and the charge in the bulb. In this paper a model for the overall heat transfer between the pipe and the charge is presented. Geometrical data and material properties have been kept...

  6. Density of tobacco retail outlets near schools and smoking behaviour among secondary school students

    National Research Council Canada - National Science Library

    Scully, Maree; McCarthy, Molly; Zacher, Meghan; Warne, Charles; Wakefield, Melanie; White, Victoria

    2013-01-01

    .... Associations between students' self‐reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio...

  7. PIV measurement at the blowdown pipe outlet. [Particle Image Velocimetry

    Energy Technology Data Exchange (ETDEWEB)

    Puustinen, M.; Laine, J.; Raesaenen, A.; Pyy, L.; Telkkae, J. [Lappeenranta Univ. of Technology, Lappeenranta (Finland)

    2013-04-15

    This report summarizes the findings of the PIV measurement tests carried out in January - February 2013 with the scaled down PPOOLEX test facility at LUT. The main objective of the tests was to find out the operational limits of the PIV system regarding suitable test conditions and correct values of different adjustable PIV parameters. An additional objective was to gather CFD grade data for verification/validation of numerical models. Both water and steam injection tests were carried out. PIV measurements with cold water injection succeeded well. Raw images were of high quality, averaging over the whole measurement period could be done and flow fields close to the blowdown pipe outlet could be determined. In the warm water injection cases the obtained averaged velocity field images were harder to interpret, especially if the blowdown pipe was also filled with warm water in the beginning of the measurement period. The absolute values of the velocity vectors seemed to be smaller than in the cold water injection cases. With very small steam flow rates the steam/water interface was inside the blowdown pipe and quite stable in nature. The raw images were of good quality but due to some fluctuation in the velocity field averaging of the velocity images over the whole measured period couldn't be done. Condensation of steam in the vicinity of the pipe exit probably caused these fluctuations. A constant outflow was usually followed by a constant inflow towards the pipe exit. Vector field images corresponding to a certain phase of the test could be extracted and averaged but this would require a very careful analysis so that the images could be correctly categorized. With higher steam flow rates rapid condensation of large steam bubbles created small gas bubbles which were in front of the measurement area of the PIV system. They disturbed the measurements by reflecting laser light like seeding particles and therefore the raw images were of poor quality and they couldn

  8. Alcohol outlets near schools in a midsize Romanian city. Prevalence and chararteristics

    OpenAIRE

    van Hoof, Joris Jasper; Reijlink, Lian M.J.; van Dalen, Wim E.

    2010-01-01

    Objective: alcohol availability is one of the strongest predictors of adolescent alcohol use, and subsequent harm. Alcohol outlets near schools are an important indicator of three types of availability related to adolescent alcohol use; physical (number), economic (price), and legal (compliance with age limits). Method: two teams with trained students (16 and 17 years old) visited all 37 schools in a 200,000 inhabitant Romanian city (Pitesti). On the spot all alcohol outlets were visited and ...

  9. The concept of double inlet-double outlet right ventricle: a distinct congenital heart disease

    OpenAIRE

    Spadotto, V; Frescura, C; Ho, SY; Thiene, G

    2016-01-01

    The aim of this study was to estimate the incidence and to analyze the anatomy of double inlet-double outlet right ventricle complex and its associated cardiac anomalies in our autopsy series. Among the 1640 hearts with congenital heart disease of our Anatomical Collection, we reviewed the specimens with double inlet-double outlet right ventricle, according to the sequential-segmental analysis, identifying associated cardiac anomalies and examining lung histology to assess the presence of pul...

  10. Contamination of faecal coliforms in ice cubes sampled from food outlets in Kubang Kerian, Kelantan.

    Science.gov (United States)

    Noor Izani, N J; Zulaikha, A R; Mohamad Noor, M R; Amri, M A; Mahat, N A

    2012-03-01

    The use of ice cubes in beverages is common among patrons of food outlets in Malaysia although its safety for human consumption remains unclear. Hence, this study was designed to determine the presence of faecal coliforms and several useful water physicochemical parameters viz. free residual chlorine concentration, turbidity and pH in ice cubes from 30 randomly selected food outlets in Kubang Kerian, Kelantan. Faecal coliforms were found in ice cubes in 16 (53%) food outlets ranging between 1 CFU/100mL to >50 CFU/ 100mL, while in the remaining 14 (47%) food outlets, in samples of tap water as well as in commercially bottled drinking water, faecal coliforms were not detected. The highest faecal coliform counts of >50 CFU/100mL were observed in 3 (10%) food outlets followed by 11-50 CFU/100mL and 1-10 CFU/100mL in 7 (23%) and 6 (20%) food outlets, respectively. All samples recorded low free residual chlorine concentration (coliforms was not detected in 47% of the samples, tap water and commercially bottled drinking water, it was concluded that (1) contamination by faecal coliforms may occur due to improper handling of ice cubes at the food outlets or (2) they may not be the water sources used for making ice cubes. Since low free residual chlorine concentrations were observed (coliforms in ice cubes also could not be ruled out. Therefore, a periodical, yet comprehensive check on the food outlets, including that of ice cube is crucial in ensuring better food and water for human consumption.

  11. Consumer Benefits from Increased Competition in Shopping Outlets: Measuring the Effect of Wal-Mart

    OpenAIRE

    Jerry Hausman; Ephraim Leibtag

    2006-01-01

    Consumers often benefit from increased competition in differentiated product settings. In previous research Hausman (1997a, 1997b, 1999, 2002) has estimated the increased consumer welfare from the introduction of new brand, e.g. Apple Cinnamon Cheerios, and new products, e.g. mobile telephones. In this paper we consider consumer benefits from increased competition in a differentiated product setting: the spread of nontraditional retail outlets. Non-traditional outlets, including supercenters,...

  12. WHY DO CONSUMERS CROSS-SHOP BETWEEN DIFFERENT TYPES OF FOOD RETAIL OUTLETS?

    OpenAIRE

    Morganosky, Michelle A.; Cude, Brenda J.

    2001-01-01

    This research analyzed consumer cross-shopping between supermarkets and nontraditional food retail outlets and examined reasons for cross-shopping. Focus groups were conducted in two major metropolitan markets and one medium-size market. Participants indicated they add nontraditional retail formats to the existing mix of stores at which they shop. Despite the increased number of types of food retail outlets they patronized, focus group participants said they didn't feel they spent more time g...

  13. Density of tobacco retail outlets near schools and smoking behaviour among secondary school students.

    Science.gov (United States)

    Scully, Maree; McCarthy, Molly; Zacher, Meghan; Warne, Charles; Wakefield, Melanie; White, Victoria

    2013-12-01

    To investigate whether the density of tobacco retail outlets near schools in Victoria, Australia, is associated with adolescent smoking behaviour. Cross-sectional survey data of 2,044 secondary school students aged 12-17 years was combined with tobacco outlet audit data. Associations between students' self-reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio-demographic and school-related variables included as covariates. Increased tobacco retail outlet density was associated with a significant increase in the number of cigarettes smoked in the previous seven days among students who smoked in the past month (IRR=1.13; 95% CI 1.02-1.26), but not the odds of smoking in the past month in the larger sample (OR=1.06; 95% CI 0.90-1.24), after controlling for local mean price of cigarettes and socio-demographic and school-related variables. This study suggests there is a positive association between tobacco retail outlet density and cigarette consumption among adolescent smokers, but not smoking prevalence, in the Australian context. There is value in considering policy measures that restrict the supply of tobacco retail outlets in school neighbourhoods as a means of reducing youth cigarette consumption.

  14. The geography of violence, alcohol outlets, and drug arrests in Boston.

    Science.gov (United States)

    Lipton, Robert; Yang, Xiaowen; Braga, Anthony A; Goldstick, Jason; Newton, Manya; Rura, Melissa

    2013-04-01

    We examined the relationship between alcohol outlets, drug markets (approximated by arrests for possession and trafficking), and violence in Boston, Massachusetts, in 2006. We analyzed geographic and environmental versus individual factors related to violence and identified areas high in violent crime. We used data from the Boston Police Department, US Census, and Massachusetts State Alcohol Beverage Control Commission. Spatial modeling was employed at the block group level, and violent crime, alcohol outlets, and drug markets were mapped. Relative to other block groups, block groups in the highest decile of violent crime (n = 55) were found to be poorer (e.g., lower incomes, higher percentages of vacant homes), and they had greater numbers of alcohol outlets and higher drug arrest rates. Alcohol outlets and drug possession and trafficking arrests were predictive of violent crime. Also, spatial effects resulting from neighboring block groups were related to violent crime. Both alcohol outlet density and type were associated with violent crime in a differentiated and complex way. With drug possession and trafficking arrests as a proxy for drug markets, spatial relationships between alcohol outlets and violence were found in addition to typical sociodemographic predictors.

  15. The association of alcohol outlet density with illegal underage adolescent purchasing of alcohol.

    Science.gov (United States)

    Rowland, Bosco; Toumbourou, John W; Livingston, Michael

    2015-02-01

    Although previous studies have suggested that greater community densities of alcohol sales outlets are associated with greater alcohol use and problems, the mechanisms are unclear. The present study examined whether density was associated with increased purchasing of alcohol by adolescents younger than the legal purchase age of 18 in Australia. The number of alcohol outlets per 10,000 population was identified within geographic regions in Victoria, Australia. A state-representative student survey (N = 10,143) identified adolescent reports of purchasing alcohol, and multilevel modeling was then used to predict the effects for different densities of outlet types (packaged, club, on-premise, general, and overall). Each extra sales outlet per 10,000 population was associated with a significant increase in the risk of underage adolescent purchasing. The strongest effect was for club density (odds ratio = 1.22) and packaged (takeaway) outlet density (odds ratio = 1.12). Males, older children, smokers, and those with substance-using friends were more likely to purchase alcohol. One mechanism by which alcohol sales outlet density may influence population rates of alcohol use and related problems is through increasing the illegal underage purchasing of alcohol. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Development of a solenoid actuated planar valveless micropump with single and multiple inlet-outlet arrangements

    Science.gov (United States)

    Kumar, N.; George, D.; Sajeesh, P.; Manivannan, P. V.; Sen, A. K.

    2016-07-01

    We report a planar solenoid actuated valveless micropump with multiple inlet-outlet configurations. The self-priming characteristics of the multiple inlet-multiple outlet micropump are studied. The filling dynamics of the micropump chamber during start-up and the effects of fluid viscosity, voltage and frequency on the dynamics are investigated. Numerical simulations for multiple inlet-multiple outlet micropumps are carried out using fluid structure algorithm. With DI water and at 5.0 Vp-p, 20 Hz frequency, the two inlet-two outlet micropump provides a maximum flow rate of 336 μl min-1 and maximum back pressure of 441 Pa. Performance characteristics of the two inlet-two outlet micropump are studied for aqueous fluids of different viscosity. Transport of biological cell lines and diluted blood samples are demonstrated; the flow rate-frequency characteristics are studied. Viability of cells during pumping with multiple inlet multiple outlet configuration is also studied in this work, which shows 100% of cells are viable. Application of the proposed micropump for simultaneous pumping, mixing and distribution of fluids is demonstrated. The proposed integrated, standalone and portable micropump is suitable for drug delivery, lab-on-chip and micro-total-analysis applications.

  17. Association Between Alcohol Use Among College Students and Alcohol Outlet Proximity and Densities.

    Science.gov (United States)

    Tanumihardjo, Jacob; Shoff, Suzanne M; Koenings, Mallory; Zhang, Zhumin; Lai, HuiChuan J

    2015-08-01

    Alcohol consumption is common on college campuses and is associated with negative consequences. Factors associated with availability of alcohol are not completely understood. To describe how proximity and density of alcohol outlets are associated with any drinking and binge drinking in students at the University of Wisconsin-Madison. Participants were full-time students enrolled in the Young Adults Eating and Active for Health, a multisite, randomized intervention that assessed a variety of health behaviors. Geographic information systems were used to calculate proximity and enumerate alcohol outlet densities. Participants were categorized as "drinkers" or "nondrinkers" based on self-reported alcohol consumption. Binge drinking was categorized as "non-binge drinker," "frequent binge drinker," and "excessive binge drinker." Analysis included regression, t tests, and chi-square tests. RESULTS. Among the 166 participants, 126 (76%) were drinkers. Among drinkers, 80 (63%) were either frequent or excessive binge drinkers. Drinkers lived closer to an alcohol outlet than non-drinkers (0.18 +/- 0.15 vs. 0.61 +/- 1.59 miles, respectively, P=0.005). Within a 1-mile walking radius, there were 47% more establishments for drinkers (153 +/- 47 compared to 104 +/- 55 outlets for nondrinkers, Palcohol outlets and had significantly more outlets available at a distance of up to 1 mile. Municipal and college administrators could consider limiting alcohol license distributions in municipalities with high alcohol consumption.

  18. The impact of the tobacco retail outlet environment on adult cessation and differences by neighborhood poverty.

    Science.gov (United States)

    Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Pearson, Jennifer L; Xiao, Haijun; Vallone, Donna; Kirchner, Thomas R

    2015-01-01

    This study examined the impact of tobacco retail outlets on cessation outcomes over time among non-treatment-seeking smokers and assessed differences by neighborhood poverty and individual factors. Observational longitudinal cohort study using geospatial data. We used generalized estimating equations to examine cessation outcomes in relation to the proximity and density of tobacco retail outlets near the home. Eight large Designated Media Areas across the United States. A total of 2377 baseline smokers followed over three waves from 2008 to 2010. Outlet addresses were identified through North American Industry Classification System codes and proximity and density measures were constructed for each participant at each wave. Outcomes included past 30-day abstinence and pro-cessation attitudes. Smokers in high poverty census tracts living between 500 m and 1.9 km from an outlet were over two times more likely to be abstinent than those living fewer than 500 m from an outlet (P poverty areas. In low poverty areas, density within 500 m was associated with greater pro-cessation attitudes (OR = 0.06; CI = 0.01, 0.12). Gender, education and heaviness of smoking did not moderate the impact of outlet proximity and density on cessation outcomes. In the United States, density of tobacco outlets within 500 m of the home residence appears to be negatively associated with smoking abstinence and pro-cessation attitudes only in poor areas. © 2014 Society for the Study of Addiction.

  19. The Moderating Role of Gender in the Relationship Between Tobacco Outlet Exposure and Tobacco Use Among African American Young Adults.

    Science.gov (United States)

    Brown, Qiana; Milam, Adam J; Bowie, Janice V; Ialongo, Nicholas S; Gaskin, Darrell J; Furr-Holden, Debra

    2016-04-01

    Tobacco outlet exposure is a correlate of tobacco use with potential differences by gender that warrant attention. The aim of this study is to explore the moderating role of gender in the relationship between tobacco outlet exposure and past month tobacco use among African American young adults 21 to 24 years old. This cross-sectional study (n = 283) used geospatial methods to determine the number of tobacco outlets within walking distance (i.e., a quarter mile) of participants' homes and distance to the nearest outlet. Logistic regression models were used to test interactions between gender and tobacco outlet exposure (i.e., density and proximity). Tobacco outlets were classified based on whether or not they were licensed to sell tobacco only (TO outlets) or tobacco and alcohol (TA outlets). Neither density nor proximity was associated with past month tobacco use in the pooled models. However, gender modified the relationship between TO outlet density and tobacco use, and this relationship was significant only among women (OR = 1.02; p gender differences in the relationship between tobacco outlet density and tobacco use.

  20. Midterm and long-term follow-up in competitive athletes undergoing thoracic outlet decompression for neurogenic thoracic outlet syndrome.

    Science.gov (United States)

    Shutze, William; Richardson, Brad; Shutze, Ryan; Tran, Kimberly; Dao, Allen; Ogola, Gerald O; Young, Allan; Pearl, Greg

    2017-12-01

    Neurogenic thoracic outlet syndrome (NTOS) results from compression of the brachial plexus by the clavicle, first rib, and scalene muscles and may develop secondary to repetitive motion of the upper extremity. Athletes routinely perform repetitive motions, and sports requiring significant arm and shoulder use may put the participant at increased risk for NTOS. Competitive athletes who develop NTOS may require first rib resection and scalenectomy (FRRS) for symptomatic relief. However, the effectiveness of FRRS has not previously been studied in this vulnerable population. This is a cross-sectional study of competitive athletes with NTOS who received FRRS by the senior author between 2009 and 2014. Eligible patients were contacted by phone and invited to complete a nine-item survey assessing the long-term effects of FRRS on pain medication use, postoperative physical therapy duration, patient satisfaction, symptom relief, activities of daily living, athletic performance, time to return of athletic performance, and need for other operations. Multivariate analyses of the following risk factors were performed: age, pectoralis minor release, preoperative narcotic use, athletic shutdown, and involvement in a throwing sport. There were 232 competitive athletes who met the inclusion criteria, and 67 of these (age, 14-48 years; 35 male; 99% white) responded to the survey. The average time between surgery and survey completion was 3.9 years (range, 2.2-7.0 years). The most frequent sports conducted by this group were baseball and softball (n = 44 [66%]), volleyball (n = 7 [10%]), and cheerleading and gymnastics (n = 5 [7%]), ranging from high-school to professional levels. The survey results revealed that 96% were improved in pain medication use, 75% would undergo FRRS on the contralateral side if needed, 82% had resolution of symptoms, and 94% were able to perform activities of daily living without limitation; 70% returned to the same or better level of athletic

  1. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I determine the outlet THC.../outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and add-on control... section to determine either the outlet THC emissions or add-on control device emission destruction or...

  2. Numerical Study of Outlet Boundary Conditions for Unsteady Turbulent Internal Flows Using the NCC

    Science.gov (United States)

    Liu, Nan-Suey; Shih, Tsan-Hsing

    2009-01-01

    This paper presents the results of studies on the outlet boundary conditions for turbulent internal flow simulations. Several outlet boundary conditions have been investigated by applying the National Combustion Code (NCC) to the configuration of a LM6000 single injector flame tube. First of all, very large eddy simulations (VLES) have been performed using the partially resolved numerical simulation (PRNS) approach, in which both the nonlinear and linear dynamic subscale models were employed. Secondly, unsteady Reynolds averaged Navier- Stokes (URANS) simulations have also been performed for the same configuration to investigate the effects of different outlet boundary conditions in the context of URANS. Thirdly, the possible role of the initial condition is inspected by using three different initial flow fields for both the PRNS/VLES simulation and the URANS simulation. The same grid is used for all the simulations and the number of mesh element is about 0.5 million. The main purpose of this study is to examine the long-time behavior of the solution as determined by the imposed outlet boundary conditions. For a particular simulation to be considered as successful under the given initial and boundary conditions, the solution must be sustainable in a physically meaningful manner over a sufficiently long period of time. The commonly used outlet boundary condition for steady Reynolds averaged Navier-Stokes (RANS) simulation is a fixed pressure at the outlet with all the other dependent variables being extrapolated from the interior. The results of the present study suggest that this is also workable for the URANS simulation of the LM6000 injector flame tube. However, it does not work for the PRNS/VLES simulation due to the unphysical reflections of the pressure disturbances at the outlet boundary. This undesirable situation can be practically alleviated by applying a simple unsteady convection equation for the pressure disturbances at the outlet boundary. The

  3. Proximity to Fast-Food Outlets and Supermarkets as Predictors of Fast-Food Dining Frequency.

    Science.gov (United States)

    Athens, Jessica K; Duncan, Dustin T; Elbel, Brian

    2016-08-01

    This study used cross-sectional data to test the independent relationship of proximity to chain fast-food outlets and proximity to full-service supermarkets on the frequency of mealtime dining at fast-food outlets in two major urban areas, using three approaches to define access. Interactions between presence of a supermarket and presence of fast-food outlets as predictors of fast-food dining were also tested. Residential intersections for respondents in point-of-purchase and random-digit-dial telephone surveys of adults in Philadelphia, PA, and Baltimore, MD, were geocoded. The count of fast-food outlets and supermarkets within quarter-mile, half-mile, and 1-mile street network buffers around each respondent's intersection was calculated, as well as distance to the nearest fast-food outlet and supermarket. These variables were regressed on weekly fast-food dining frequency to determine whether proximity to fast food and supermarkets had independent and joint effects on fast-food dining. The effect of access to supermarkets and chain fast-food outlets varied by study population. Among telephone survey respondents, supermarket access was the only significant predictor of fast-food dining frequency. Point-of-purchase respondents were generally unaffected by proximity to either supermarkets or fast-food outlets. However, ≥1 fast-food outlet within a 1-mile buffer was an independent predictor of consuming more fast-food meals among point-of-purchase respondents. At the quarter-mile distance, ≥1 supermarket was predictive of fewer fast-food meals. Supermarket access was associated with less fast-food dining among telephone respondents, whereas access to fast-food outlets were associated with more fast-food visits among survey respondents identified at point-of-purchase. This study adds to the existing literature on geographic determinants of fast-food dining behavior among urban adults in the general population and those who regularly consume fast food. Copyright

  4. Communicating Ebola through social media and electronic news media outlets: A cross-sectional study.

    Science.gov (United States)

    Househ, Mowafa

    2016-09-01

    Social media and electronic news media activity are an important source of information for the general public. Yet, there is a dearth of research exploring the use of Twitter and electronic news outlets during significant worldly events such as the recent Ebola Virus scare. The purpose of this article is to investigate the use of Twitter and electronic news media outlets in communicating Ebola Virus information. A cross-sectional survey of Twitter data and Google News Trend data from 30 September till 29 October, 2014 was conducted. Between 30 September and 29 October, there were approximately 26 million tweets (25,925,152) that contained the word Ebola. The highest number of correlated activity for Twitter and electronic news outlets occurred on 16 October 2014. Other important peaks in Twitter data occurred on 1 October, 6 October, 8 October, and 12 October, 2014. The main influencers of the Twitter feeds were news media outlets. The study reveals a relationship between electronic news media publishing and Twitter activity around significant events such as Ebola. Healthcare organizations should take advantage of the relationship between electronic news media and trending events on social media sites such as Twitter and should work on developing social media campaigns in co-operation with leading electronic news media outlets (e.g. CNN, Yahoo, Reuters) that can have an influence on social media activity. © The Author(s) 2015.

  5. Regularities pertinent to formation of hydraulic nonuniformities at the outlet from the reactor plant header system

    Science.gov (United States)

    Gabrianovich, B. N.; Del'nov, V. N.

    2014-05-01

    Maintaining the preset distribution of coolant mass flow rate at the outlet from the header system organized as a back turn with lateral admission of coolant to the header and central removal of coolant from it is one of the conditions essential for securing reliable and efficient operation of a reactor plant. In the header system, coolant passes through the annular lateral channel formed by the vessel and central barrel, after which it enters into the header, changes the motion direction in it, and goes out through the channels of the grid placed in the central barrel. The results obtained from experimental investigations of the hydrodynamics in the header system flow paths carried out on models with flat and cylindrical shapes are presented. A previously unknown regularity pertinent to formation of hydraulic irregularities at the header system outlet is revealed, and semi-empirical correlations for determining the coolant mass flow rate distribution at the header system outlet are obtained. The regularity connected with formation of hydrodynamic nonuniformities at the header system outlet lies in the fact that the position of the maximum coolant velocity at the grid outlet coincides with the position of the maximum velocity in the core of the incident jet attacking the grid, and that the maximal average coolant velocity in the grid holes is proportional to the average coolant velocity in the incident jet.

  6. Bursting Events in Pressure Flushing with Expanding Bottom Outlet Channel within Dam Reservoir

    Directory of Open Access Journals (Sweden)

    soheila Tofighi

    2017-01-01

    Full Text Available Introduction: Currently, large dams in the world, due to the high amount of sediments in the reservoir, especially around the intake, have operational problems. One of the solutions for this problem is pressure flushing. In this type of flushing, a mixture of water and sediment is removed from bottom outlets form dam reservoir and a funnel shaped crater is created in the vicinity of the outlet opening. In laboratory experiments carried out in this study, pressure flushing with the expansion of bottom outlet within the reservoir and its statistical analysis of bursting events were investigated. The structure of the turbulent flow is not fully understood due to their complexity and random nature. Klein et al. Introduced the turbulence bursting in this kind of flow and Nezo and Nakagora suggested that the events resulting from turbulence bursting has a significant effect of transferring the sediment particles. Materials and Methods: For the purposes of this study, the experiments were conducted with a physical model with 7m length, 1.4m width, and 1.5m height, consisting of three parts namely the inlet of the model, the main reservoir, and settling basin. The main reservoir of the model was 5m long and the sediments were placed within this part of the model. The sediment particles were non-cohesive silica with uniform size and with median diameter (d50 1.15mm and geometrics standard deviation (σg 1.37. Experiments carried out with different discharges and water depths above the bottom outlet in different expansion size of outlet channel in constant sediment level of 20cm above the center of the outlet channel. The model was slowly filled with water until the water surface elevation reached to a desired level. The bottom outlet was manually opened, after a while sedimentwere discharged with the water flow in very high concentrations through the outlet channel (sudden discharge and a funnel shaped crater was formed in front of it. After the run of

  7. Sociodemographic Disparities in Proximity of Schools to Tobacco Outlets and Fast-Food Restaurants.

    Science.gov (United States)

    D'Angelo, Heather; Ammerman, Alice; Gordon-Larsen, Penny; Linnan, Laura; Lytle, Leslie; Ribisl, Kurt M

    2016-09-01

    To examine the association of school sociodemographic characteristics with tobacco outlet and fast-food restaurant availability near schools in a national study. Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in 97 US counties. More than 50% of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21% of schools with a majority of White students. In adjusted models, each 10% increase in the number of low-income and Hispanic students enrolled in a school led to a 3% to 5% increase in the odds of the school having both a fast-food restaurant and a tobacco outlet nearby. Low-income and Hispanic students are disproportionately exposed to both tobacco outlets and fast-food restaurants near their schools. Easy access to tobacco products and fast food may influence youth smoking initiation and contribute to poor dietary intake.

  8. Validation of commercial business lists as a proxy for licensed alcohol outlets.

    Science.gov (United States)

    Carlos, Heather A; Gabrielli, Joy; Sargent, James D

    2017-05-19

    Studies of retail alcohol outlets are restricted to regions due to lack of U.S. national data. Commercial business lists (BL) offer a possible solution, but no data exists to determine if BLs could serve as an adequate proxy for license data. This paper compares geospatial measures of alcohol outlets derived from a commercial BL with license data for a large US state. We validated BL data as a measure of off-premise alcohol outlet density and proximity compared to license data for 5528 randomly selected California residential addresses. We calculated three proximity measures (Euclidean distance, road network travel time and distance) and two density measures (kernel density estimation and the count within a 2-mile radius) for each dataset. The data was acquired in 2015 and processed and analyzed in 2015 and 2016. Correlations and reliabilities between density (correlation 0.98; Cronbach's α 0.97-0.99) and proximity (correlations 0.77-0.86; α 0.87-0.92) measures were high. For proximity, BL data matched license in 55-57% of addresses, overstated distance in 19%, and understated in 24-26%. BL data can serve as a reliable proxy for licensed alcohol outlets, thus extending the work that can be performed in studies on associations between retail alcohol outlets and drinking outcomes.

  9. [Endoscopic treatment of a "gastric outlet syndrome" after Mason Vertical Banded Gastroplasty. Case report].

    Science.gov (United States)

    Geraci, Girolamo; Sciumè, Carmelo; Pisello, Franco; Volsi, Francesco Li; Facella, Tiziana; Modica, Giuseppe

    2007-01-01

    Mason's Vertical Banded Gastroplasty (VBG) is characterized by peculiar complications, related to surgical pitfalls, from "outlet syndrome" (5%) to complete outlet obstruction (3%), passing to reflux oesophagitis (45%), that require redo. We report a case of "outlet syndrome" treated by operative endoscopy with success. 40 yrs male, operated by VBG 2 years ago for morbid obesity (BMI > 40). After surgery, initial ponderal decrement as attended. Since about 2 months the patients reports epigastralgia and retrosternal pyrosis; since 10 days incoercibile vomiting. The EGDS visualized distal oesophagitis (Los Angeles C), mucosal prolapse of superior pouch leading to outlet obstruction and scalloping of Kerkring's fold in second part of duodenum. The patient was submitted to multiple elastic ligature of exuberant gastric mucosa with multiband ligator and indication to oral therapy with PPI and procinetics drugs at the dismission. after 30 days, at EGDS, oesophagitis is regressed to Los Angeles B stage, the outlet of pouch is patent and the transit is objectively regular. At oesophago-gastric radiologic control with gastrographin, the transit was satisfing. At 1 year follow-up the patient has a regular weight, no vomiting and is wellbeing and use irregularly PPI Follow-up EGDS confirmed the stabilization of endoscopic picture and the total regression of oesophagitis. the endoscopic elastic ligature of mucosal gastric prolapse with multiband after VBG, if confirmed and validated by randomized and prospective trials on a big sample of people, will constitute a valid alternative to surgical treatment of this rare complication.

  10. KORELASI PENGGUNAAN BAHASA INGGRIS DALAM PENAMAAN FACTORY OUTLET (FO DI BANDUNG TERHADAP KEPUTUSAN PEMBELIAN

    Directory of Open Access Journals (Sweden)

    Gartika Rahmasari

    2016-03-01

        Abstrak - Bahasa Inggris merupakan bahasa yang memiliki prestise atau kedudukan yang tinggi, bahkan di Indonesia yang memiliki bahasa Indonesia sebagai bahasa nasional. Bahasa Inggris sebagai bahasa internasional mendapatkan apresiasi lebih tinggi dibandingkan dengan bahasa Indonesia, khususnya di bidang pariwisata. Bandung sebagai salah satu tujuan pariwisata, khususnya wisata kuliner dan tujuan belanja, tidak terkecuali mendapat pengaruh yang besar dalam hal penggunaan bahasa Inggris. Hal ini dapat dilihat dari penggunaan sejumlah nama Factory Outlet yang ada di Bandung, yang hampir sebagian besar menggunakan bahasa Ingris atau serapan bahasa Inggris sebagai “brand” atau nama yang digunakan oleh Factory Outlet yang tersebar di seluruh Bandung. Jurnal ini merupakan study literatur yang meneliti tentang hubungan penggunaan bahasa Asing dalam nama Factory Outlet  (FO terhadap keputusan pembelian. Yang menjadi responden yang diteliti dalam penelitian ini adalah mahasiswa Ilmu Komunikasi, Universitas Telkom sebanyak 55 responden, dengan rentang usia 17-20 tahun. Dari hasil penelitian, diketahui bahwa secara umum, penggunaan bahasa Inggris dalam penamaan Factory Outlet (FO mempengaruhi keputusan responden untuk berbelanja ke FO tersebut.   Kata Kunci: Keputusan Pembelian, Factory Outlet, FO, Bahasa Inggris.

  11. Ayurvedic medicine in Mauritius: Profile of Ayurvedic outlet, use, sale, distribution, regulation and importation.

    Science.gov (United States)

    Elaheebocus, Naailah; Mahomoodally, M Fawzi

    2017-02-02

    Ayurvedic medicine (AM) is a legalised alternative traditional medical system in the multicultural tropical island of Mauritius. A panoply of Ayurvedic specialised shops/centres involved in the provision of Ayurvedic services hereafter termed as 'outlets' operates in different regions of the island and is extensively exploited by a significant number of Mauritians. Nonetheless, there is currently no study geared towards studying the status of AM and profile of Ayurvedic outlets in Mauritius and there is undoubtedly a dearth of standardized regulatory framework governing the practice of AM in Mauritius. The present study attempts to study the profile of Ayurvedic outlets, sale, distribution, regulation and importation of AM in Mauritius. To evaluate the characteristics profile of Ayurvedic shops/clinics/pharmacies/centres, to document common Ayurvedic products used in the treatment and management of diseases, and to analyse existing regulatory control of AM in Mauritius. Ayurvedic outlets were identified using a random approach. Once permission granted, outlets were visited where face-to-face interviews with Ayurvedic practitioners/directors/dispensers were undertaken using a semi-structured questionnaire. The characteristics of the outlets with respect to the type of business registration, procurement and dispensing of products, registration and qualification of personnels employed amongst others were studied. The International Classification of Diseases (ICD) 10 was used to classify common AM dispensed to patients. Additionally, information was sought from local authorities pertaining to existing legislation governing the importation and regulation of AM in Mauritius. A total of 16 Ayurvedic outlets ('pharmacies' (n=3), clinics (n=2), shops (n=5) and centres (n=6)) was surveyed. Six outlets dispensed AM strictly on prescription only after consultation with an onsite full-time employed registered Ayurvedic practitioner. Seven outlets offered AM both on prescription

  12. EFFECTS OF THE 1906 EARTHQUAKE ON THE BALD HILL OUTLET SYSTEM, SAN MATEO COUNTY, CALIFORNIA.

    Science.gov (United States)

    Pampeyan, Earl H.

    1986-01-01

    Following the earthquake of April 18, 1906, it was discovered that a brick forebay and other parts of the reservoir outlet system were in the slip zone of the San Andreas fault. The original outlet through which water was directed to San Francisco consisted of two tunnels joined at the brick forebay; one tunnel extends 2,820 ft to the east under Bald Hill on Buri Buri Ridge, and the other tunnel intersects the lake bottom about 250 ft west of the forebay. In 1897 a second intake was added to the system, also joining the original forebay. During the present study the accessible parts of this original outlet system were examined with the hope of learning how the system had been affected by fault slip in 1906.

  13. Fruit and vegetable intake in adolescents: SES and exposure to supermarkets and fast food outlets

    DEFF Research Database (Denmark)

    Svastisalee, Chalida; Holstein, Bjørn Evald; Due, Pernille

    backgrounds. Methods Data from the Health Behavior in School Aged Children Study (n = 6,034) were supplemented with geocoded information regarding supermarkets and fast food outlets, 300 meters from each school (n = 80). We used multilevel logistic regression to examine the relationship between infrequent...... fruit and vegetable intake and supermarket and fast food outlet concentration, stratifying by levels of family social class. Results Examining supermarket exposure alone, children from low social class backgrounds had the greatest odds of infrequent vegetable (OR = 1.50; CI: 1.03-2.20) and fruit (OR = 1.......43;CI: 1.06-1.93) intake, attending schools with low concentration of supermarkets. Children from low social class families attending schools with high fast food outlet and low supermarket concentration had the greatest odds of infrequent vegetable (OR = 1.79;CI: 0.99-3.21) and fruit (OR = 1.59; CI: 1...

  14. Proximity of off-premise alcohol outlets and heavy alcohol consumption: a cohort study.

    Science.gov (United States)

    Halonen, Jaana I; Kivimäki, Mika; Virtanen, Marianna; Pentti, Jaana; Subramanian, S V; Kawachi, Ichiro; Vahtera, Jussi

    2013-09-01

    Availability of alcohol has been associated with alcohol consumption in cross-sectional studies. We examined longitudinally whether change in proximity to off-premise (i.e., no consumption on the premises) beer and liquor outlets is associated with heavy alcohol consumption. Distances from 54,778 Finnish Public Sector study participants' homes to the nearest off-premise beer and liquor outlets were calculated using Global Positioning System-coordinates. Between-individual analyses were used to study the effects of distance to the nearest outlet on heavy alcohol use, and within-individual analyses to study the effects of a change in distance on change in heavy use. Mean follow-up time in 2000-2009 was 6.8 (standard deviation 2.0) years. In a between-individual analysis, decrease from ≥500 m to alcohol use in women (odds ratio 1.23, 95% CI 1.05-1.44), but not in men. In a within-individual analysis decrease from 500 m to 0m in log-transformed continuous distance to the nearest beer outlet increased the odds of heavy alcohol consumption in women by 13% (odds ratio 1.13, 95% CI 1.01-1.27). For the corresponding change in distance to liquor outlet the increase was 3% (odds ratio 1.03, 95% CI 0.97-1.09). Change in distance from home to the nearest off-premise alcohol outlet affects the risk of heavy alcohol consumption in women. This evidence supports policies that restrict physical availability of alcohol. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Evaluation of a 'healthiness' rating system for food outlet types in Australian residential communities.

    Science.gov (United States)

    Moayyed, Hamid; Kelly, Bridget; Feng, Xiaoqi; Flood, Victoria

    2017-02-01

    To obtain expert consensus to develop and evaluate a rating system on the relative healthiness of Australian suburbs' food outlet types. Twenty-four food outlet types and 10 local suburbs were identified from previous mapping studies and based on a scan of suburbs across one large Australian geographical region. Initial food outlet 'scores' for relative healthiness were proposed based on available literature, classified into five categories, from 'most' to 'least' healthy. In round 1 of a modified Delphi survey, participants, Australian public health and nutrition experts, were given each outlet type's definition and the proposed scores and invited to modify the scores based on their perceived 'healthiness'. In round 2, participants were able to revise or adjust their scores. Median scores for food outlet types from both rounds highly correlated with the originally proposed scores (two-tailed Pearson's correlation coefficient 0.97 and 0.96, respectively, P = 0.01), and scores from round 1 highly correlated with those from round 2 (Pearson's coefficient 0.998, P = 0.01). Round 2 scores were used to calculate suburbs' overall food environment score, healthiness score, unhealthiness score and a ratio of unhealthiness to healthiness scores. There was strong positive correlation between suburbs' ratio of unhealthiness to healthiness scores and a previously recognised scoring ratio, Retail Food Environment Index (Spearman's rho 0.847, P healthiness of food outlet types found in Australian neighbourhoods. Proposed scores can be used to assess and compare healthiness of community food environments and to explore their associations with area characteristics, population's diet and health outcomes. © 2016 Dietitians Association of Australia.

  16. Statistical Approaches Used to Assess the Equity of Access to Food Outlets: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Karen E. Lamb

    2015-07-01

    Full Text Available BackgroundInequalities in eating behaviours are often linked to the types of food retailers accessible in neighbourhood environments. Numerous studies have aimed to identify if access to healthy and unhealthy food retailers is socioeconomically patterned across neighbourhoods, and thus a potential risk factor for dietary inequalities. Existing reviews have examined differences between methodologies, particularly focussing on neighbourhood and food outlet access measure definitions. However, no review has informatively discussed the suitability of the statistical methodologies employed; a key issue determining the validity of study findings. Our aim was to examine the suitability of statistical approaches adopted in these analyses.MethodsSearches were conducted for articles published from 2000-2014. Eligible studies included objective measures of the neighbourhood food environment and neighbourhood-level socio-economic status, with a statistical analysis of the association between food outlet access and socio-economic status.ResultsFifty-four papers were included. Outlet accessibility was typically defined as the distance to the nearest outlet from the neighbourhood centroid, or as the number of food outlets within a neighbourhood (or buffer. To assess if these measures were linked to neighbourhood disadvantage, common statistical methods included ANOVA, correlation, and Poisson or negative binomial regression. Although all studies involved spatial data, few considered spatial analysis techniques or spatial autocorrelation.ConclusionsWith advances in GIS software, sophisticated measures of neighbourhood outlet accessibility can be considered. However, approaches to statistical analysis often appear less sophisticated. Care should be taken to consider assumptions underlying the analysis and the possibility of spatially correlated residuals which could affect the results.

  17. Aneurysmal Bone Cyst Arising from the First Rib: A Rare Cause of Thoracic Outlet Syndrome.

    Science.gov (United States)

    Medina, Manuel; Paul, Subroto

    2016-12-01

    Aneurysmal bone cyst is a rare benign cystic bone lesion with an incidence of only 0.14 per 100,000 individuals and most commonly affects the metaphyses of long bones, spine, and pelvis. We present a very rare case of a 17-year-old boy with a rapidly expanding aneurysmal bone cyst arising from the first rib, resulting in neurogenic thoracic outlet syndrome secondary to its compression of the brachial plexus. The patient's symptoms resolved after en bloc resection. To our knowledge there have been no other reports in the literature of thoracic outlet syndrome due to aneurysmal bone cyst arising from the first rib.

  18. Assessment of veterinary drug retail outlets in two rural areas of ...

    African Journals Online (AJOL)

    ADEYEYE

    2017-07-07

    Jul 7, 2017 ... Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara state,. Nigeria ... Lafiagi rural areas of Kwara state, to asses the owners', sales persons' and business characteristics of veterinary retail outlets with the aid of ... patronise veterinary hospitals. Furthermore, there.

  19. 77 FR 74454 - Media Outlets for Publication of Legal and Action Notices in the Southern Region

    Science.gov (United States)

    2012-12-14

    ...: Stone County Leader, published weekly (Wednesday) in Mountain View, AR. National Forests and Grasslands...; ] DEPARTMENT OF AGRICULTURE Forest Service Media Outlets for Publication of Legal and Action Notices in the Southern Region AGENCY: Forest Service, USDA. ACTION: Notice. SUMMARY: Deciding Officers in the Southern...

  20. 77 FR 21078 - Media Outlets for Publication of Legal and Action Notices in the Southern Region

    Science.gov (United States)

    2012-04-09

    ...: Stone County Leader, published weekly (Wednesday) in Mountain View, AR. National Forests and Grasslands... Forest Service Media Outlets for Publication of Legal and Action Notices in the Southern Region AGENCY: Forest Service, USDA. ACTION: Notice. SUMMARY: Deciding Officers in the Southern Region will publish...

  1. Malignant gastric outlet obstruction managed by endoscopic stenting: a prospective single-centre study

    DEFF Research Database (Denmark)

    Havemann, Maria Cecilie; Adamsen, Sven; Wøjdemann, Morten

    2008-01-01

    -to-treat principle. All patients were offered endoscopic stenting. Oral intake before and after stenting was assessed using the gastric outlet obstruction score system (GOOSS). Various lengths of duodenal Hanaro(R) self-expanding nitinol stents were delivered through a therapeutic endoscope. Outcome criteria were...

  2. Biomass bale stack and field outlet locations assessment for efficient infield logistics

    Science.gov (United States)

    Harvested hay or biomass are traditionally baled for better handling and they are transported to the outlet for final utilization. For better management of bale logistics, producers often aggregate bales into stacks so that bale-hauling equipment can haul multiple bales for improved efficiency. Obje...

  3. Alcohol outlets near schools in a midsize Romanian city. Prevalence and chararteristics

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; Reijlink, Lian M.J.; van Dalen, Wim E.

    2010-01-01

    Objective: alcohol availability is one of the strongest predictors of adolescent alcohol use, and subsequent harm. Alcohol outlets near schools are an important indicator of three types of availability related to adolescent alcohol use; physical (number), economic (price), and legal (compliance with

  4. Sudden increase in tidal response linked to calving and acceleration at a large Greenland outlet glacier

    DEFF Research Database (Denmark)

    de Juan, Julia; Elósegui, Pedro; Nettles, Meredith

    2010-01-01

    Large calving events at Greenland's largest outlet glaciers are associated with glacial earthquakes and near-instantaneous increases in glacier flow speed. At some glaciers and ice streams, flow is also modulated in a regular way by ocean tidal forcing at the terminus. At Helheim Glacier, analysi...

  5. Three-dimensional stereology as a tool for evaluating bladder outlet obstruction

    DEFF Research Database (Denmark)

    Van Der Wijk, Jasper; Van Der Wijk, Jan; Horn, Thomas

    2008-01-01

    Objective. In a pilot study we evaluated whether implementation of a novel 3D stereologic technique can prove that bladder outlet obstruction (BOO) is associated with morphologic changes in the bladder wall. Material and methods. Ten males (mean age 69.7 years; range 58-84 years) with lower urina...

  6. The geographical location of retail outlets/ service stations in the Nigerian petroleum industry

    Directory of Open Access Journals (Sweden)

    M. O. Lawal

    2013-07-01

    Full Text Available This paper examinie the channels of petroleum distribution in Nigeria from the Refineries to Depot and Retail Outlets/Service Stations where the consumers finally purchase their products. Specifically the paper considers some of the geographical factors that are influencing the location of service stations in the Nigerian Petroleum Industry.

  7. Local concentration of fast-food outlets is associated with poor nutrition and obesity.

    Science.gov (United States)

    Kruger, Daniel J; Greenberg, Emily; Murphy, Jillian B; DiFazio, Lindsay A; Youra, Kathryn R

    2014-01-01

    We investigated the relationship of the local availability of fast-food restaurant locations with diet and obesity. We geocoded addresses of survey respondents and fast-food restaurant locations to assess the association between the local concentration of fast-food outlets, BMI, and fruit and vegetable consumption. The survey was conducted in Genesee County, Michigan. There were 1345 individuals included in this analysis, and the response rate was 25%. The Speak to Your Health! Community Survey included fruit and vegetable consumption items from the Behavioral Risk Factor Surveillance System, height, weight, and demographics. We used ArcGIS to map fast-food outlets and survey respondents. Stepwise linear regressions identified unique predictors of body mass index (BMI) and fruit and vegetable consumption. Survey respondents had 8 ± 7 fast-food outlets within 2 miles of their home. Individuals living in close proximity to fast-food restaurants had higher BMIs t(1342) = 3.21, p food availability, which may constrain the success of nutrition promotion efforts. Efforts to decrease the local availability of unhealthy foods as well as programs to help consumers identify strategies for obtaining healthy meals at fast-food outlets may improve health outcomes.

  8. A CLINICAL STUDY ON GASTRIC OUTLET OBSTRUCTION IN A SOUTH INDIAN TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sailaja

    2015-10-01

    Full Text Available Gastric outlet obstruction is defined as a clinical and patho - physiological consequence of any disease process that produces a mechanical impediment to gastric emptying which may be extrinsic or intrinsic. Gastric outlet obstruction can be a diagnostic and treatment dilemma. Endoscopy of upper gastrointestinal tract has been a sensitive and specific investigation to study the status of gastric outlet - the pylorus and has enabled early detection of lesions of both stomach a nd duodenum. We undertook a prospective clinical study regarding incidence, etiology, investigation and management of cases of Gastric outlet obstruction in adults in a period of three years. In our study the m ost common cause of GOO is Carcinoma stomach a ntral region 46.6% , duodenal ulcer 33.3% , corrosive acid ingestion sequel 8.3%, peri ampullary carcinoma 6.6%, Ca pancreas 3.3%% , cholangio Carcinoma 1.6%. Males are more commonly involved in a ratio of M: F=3:1. Surgical procedures done varied from defini tive resections to palliative bypass or feeding jejunostomy for enteral feeding

  9. Inlet and Outlet Casings of the Turbojet Engines – Design and Experiment

    Directory of Open Access Journals (Sweden)

    D. Hanus

    2000-01-01

    Full Text Available The paper presents special design method for three-dimensional design of the inlet and outlet channels of the turboprop engines. The method is based on the solution of indirect problem in internal aerodynamics, which is realised by mechanical construction of the flow field between inlet and outlet sections of the designed channel. The flow field is represented by number of flow tubes made of special plastic material, of optimised geometrical shape and their course in the space. The method was applied on the design of inlet channel of the three-shaft turboprop engine Walter M 602 and the aircraft L 610 and on the outlet channel of the two-shaft turboprop engine Walter M 601. Both channels have been manufactured and proved excellent aerodynamic properties. The channels have satisfied the airworthiness requirements and have been certified by the Czech Aviation Administration and by Federal Aviation Administration of the U.S.A. as well. The application of the new outlet channel have contributed to considerable improvement of the performance of the engine of more than 3 % at the same absolute fuel consumption and at 5 °C lower temperature of the gases at the inlet section of the turbine. The mass of the new channel is of 1 kg lower than the original one.

  10. Mass balance of Greenland's three largest outlet glaciers - 2000–2010

    NARCIS (Netherlands)

    Howat, I.M.; Ahn, Y.; Joughin, I.; van den Broeke, M.R.; Lenaerts, J.T.M.; Smith, B.

    2011-01-01

    Acceleration of Greenland's three largest outlet glaciers, Helheim, Kangerdlugssuaq and Jakobshavn Isbræ, accounted for a substantial portion of the ice sheet's mass loss over the past decade. Rapid changes in their discharge, however, make their cumulative mass-change uncertain. We derive monthly

  11. Vascular thoracic outlet syndrome. Longer posterior rib stump causes poor outcome

    NARCIS (Netherlands)

    Geven, Leontien I.; Smit, Andries J.; Ebels, Tjark

    Objective: To assess the role of the relative length of the posterior rib stump in outcome after transaxittary first rib resection for thoracic outlet syndrome. Methods: All patients with a transaxittary first rib resection between January 1990 and February 2004 were selected. Relative rib stump

  12. Quantification of the weakness and fatigue in thoracic outlet syndrome with isokinetic measurements

    OpenAIRE

    Ozcakar, L; Inanici, F; Kaymak, B; Abali, G; Cetin, A; Hascelik, Z

    2005-01-01

    Objectives: Patients with thoracic outlet syndrome (TOS) complain of many subjective symptoms that are difficult to measure and quantify. In this study we have tried to assess the weakness (muscle strength) and fatigue (endurance) of these patients with an objective measurement method, isokinetic muscle testing.

  13. Disadvantageous closure of the interventricular communication in double outlet right ventricle.

    OpenAIRE

    Gerlis, L. M.; Dickinson, D F; Anderson, R H

    1984-01-01

    A double outlet right ventricle was diagnosed in a 10 week old infant, in whom the ventricular septum was intact at the time of presentation. A large aneurysm of a membranous septal remnant was present, and this appears to be the first recorded instance of closure of a malalignment ventricular septal defect by such a mechanism.

  14. The Quiet Plug Crisis: A Digital Generation Scours the Library for Electrical Outlets

    Science.gov (United States)

    Kelley, Michael

    2011-01-01

    Thirty years ago, the only person in a library looking for an electrical outlet was a blue-smocked cleaning person who had to plug in a vacuum cleaner with a very long cord. Now, hordes of patrons outfitted with amp-devouring laptops and cell phones expect and need the library to offer an endless supply of electricity. The overall demand for…

  15. Change in alcohol outlet density and alcohol-related harm to population health (CHALICE

    Directory of Open Access Journals (Sweden)

    Fone David

    2012-06-01

    Full Text Available Abstract Background Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community. Methods/Design A natural experiment of the effect of change in outlet density between 2005–09, in Wales, UK; population 2.4 million aged 16 years and over. Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. The study outcomes are change in (1 alcohol consumption using data from annual Welsh Health Surveys, (2 alcohol-related hospital admissions using the Patient Episode Database for Wales, (3 Accident & Emergency department attendances between midnight–6am, and (4 alcohol-related violent crime against the person, using Police data. The data will be anonymously record-linked within the Secure Anonymised Information Linkage Databank at individual and 2001 Census Lower Super Output Area levels. New methods of network analysis will be used to estimate outlet density. Longitudinal statistical analysis will use (1 multilevel ordinal models of consumption and logistic models of admissions and Accident & Emergency attendance as a function of change in individual outlet exposure, adjusting for confounding variables, and (2 spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration. Discussion This inter-disciplinary study requires expertise in epidemiology and public health, health informatics, medical statistics

  16. Access to food retail outlets in County Durham, UK: a pragmatic cross-sectional study.

    Science.gov (United States)

    Mills, Susanna; Wright, Tim

    2015-02-26

    Strong links exist between deprivation, obesity, and dietary quality. Increasing interest has focussed on the concept of access to food and so-called food deserts, defined by a policy working group of the UK Low Income Project Team in 1995 as "areas of relative exclusion where people experience physical and economic barriers to accessing healthy food". We aimed to establish the accessibility of food retail outlets in County Durham, a county in north-east England, UK, considering physical access, affordability, and food range and quality. In a pragmatic cross-sectional study in County Durham, we used information from town surveys and food business databases to locate and identify food retail outlets. The prevalence of deprivation, obesity, retail outlets, takeaway outlets, and ratio of retail to takeaway outlets was mapped, to establish local food access, and any associations with deprivation and obesity. The times taken to travel from residences to supermarkets using private car and public transport were also measured. 400 members of the community participated in eight focus groups and commissioned on-street surveys. Focus group transcripts were reviewed alongside the on-street survey responses to identify key issues. Most residents shopped at least weekly for food (n=368, 92%), used a supermarket for their main food shop (372, 93%), travelled for up to 15 min (340, 85%), and used a car for transport (188, 47%). Many survey respondents indicated high levels of satisfaction with food retail outlets (average rating 8·7 out of 10 for agreement with the statement "Overall I am satisfied with the shop where I do my main food shopping"), although financial constraints and transport inconvenience were identified as barriers. Difficulties with food shopping were more widely described in focus groups, and many individuals felt that local shopping provision had declined, with an emergent excess of takeaway outlets. Food retail access was reduced for the disabled, full

  17. Are conventional inlet and outlet radiographs obsolete in the evaluation of pelvis fractures?

    Science.gov (United States)

    Pekmezci, Murat; Kandemir, Utku; Toogood, Paul; Morshed, Saam

    2013-06-01

    The new-generation multidetector computed tomographic (CT) scanners allow for the generation of virtual x-rays from the data acquired during the evaluation of pelvic fractures. Special software allows technicians to obtain the appropriate orientation required for adequate inlet and outlet views, which would eliminate repeat trips to the radiography suite to acquire adequate x-rays. The purpose of this study is to compare the quality virtual x-rays and conventional x-rays that are used in evaluating pelvis fractures. A retrospective database review was performed to identify patients who were operated on with a diagnosis of pelvis fracture. The inclusion criteria were AO/OTA type B or C pelvic fractures, age older than 18 years, complete set of anteroposterior (AP) pelvis, inlet, and outlet x-rays and a multidetector pelvis CT scan. Virtual AP pelvis, inlet, and outlet views were generated from the CT scan data. Two fellowship-trained orthopedic trauma surgeons reviewed the virtual and conventional studies separately in association with CT scans and graded the quality of the studies on a custom developed questionnaire. Twenty patients were eligible for the study. The AP pelvis image quality was similar for both conventional and virtual images except for the rotation of the pelvis, which was improved in the virtual images. The inlet and outlet image quality was better in all domains in the virtual x-ray group when compared with the conventional x-rays. The percentage of adequate inlet and outlet images was higher in the virtual x-ray group when compared with the conventional x-ray group. The results show that the virtual inlet and outlet images consistently provided higher rates of adequate x-rays when compared with the conventional x-rays. In the evaluation of patients with pelvis fractures, the use of the virtual inlet and outlet views instead of the conventional x-rays may provide some advantages, such as decreased radiation exposure to the patient, reduced overall

  18. Mir-29 repression in bladder outlet obstruction contributes to matrix remodeling and altered stiffness.

    Directory of Open Access Journals (Sweden)

    Mari Ekman

    Full Text Available Recent work has uncovered a role of the microRNA (miRNA miR-29 in remodeling of the extracellular matrix. Partial bladder outlet obstruction is a prevalent condition in older men with prostate enlargement that leads to matrix synthesis in the lower urinary tract and increases bladder stiffness. Here we tested the hypothesis that miR-29 is repressed in the bladder in outlet obstruction and that this has an impact on protein synthesis and matrix remodeling leading to increased bladder stiffness. c-Myc, NF-κB and SMAD3, all of which repress miR-29, were activated in the rat detrusor following partial bladder outlet obstruction but at different times. c-Myc and NF-κB activation occurred early after obstruction, and SMAD3 phosphorylation increased later, with a significant elevation at 6 weeks. c-Myc, NF-κB and SMAD3 activation, respectively, correlated with repression of miR-29b and miR-29c at 10 days of obstruction and with repression of miR-29c at 6 weeks. An mRNA microarray analysis showed that the reduction of miR-29 following outlet obstruction was associated with increased levels of miR-29 target mRNAs, including mRNAs for tropoelastin, the matricellular protein Sparc and collagen IV. Outlet obstruction increased protein levels of eight out of eight examined miR-29 targets, including tropoelastin and Sparc. Transfection of human bladder smooth muscle cells with antimiR-29c and miR-29c mimic caused reciprocal changes in target protein levels in vitro. Tamoxifen inducible and smooth muscle-specific deletion of Dicer in mice reduced miR-29 expression and increased tropoelastin and the thickness of the basal lamina surrounding smooth muscle cells in the bladder. It also increased detrusor stiffness independent of outlet obstruction. Taken together, our study supports a model where the combined repressive influences of c-Myc, NF-κB and SMAD3 reduce miR-29 in bladder outlet obstruction, and where the resulting drop in miR-29 contributes to

  19. Supermarket and fast-food outlet exposure in Copenhagen: associations with socio-economic and demographic characteristics

    DEFF Research Database (Denmark)

    Svastisalee, Chalida; Nordahl, Helene; Glümer, Charlotte

    2011-01-01

    To investigate whether exposure to fast-food outlets and supermarkets is socio-economically patterned in the city of Copenhagen.......To investigate whether exposure to fast-food outlets and supermarkets is socio-economically patterned in the city of Copenhagen....

  20. Is neighbourhood access to tobacco outlets related to smoking behaviour and tobacco-related health outcomes and hospital admissions?

    Science.gov (United States)

    Barnes, Rosanne; Foster, Sarah A; Pereira, Gavin; Villanueva, Karen; Wood, Lisa

    2016-07-01

    Although the harms of tobacco use are widely accepted, few studies have examined the relationship between access to tobacco outlets and hospital admissions. This study aimed to examine the relationship between neighbourhood access to tobacco outlets, smoking and hospital admissions and self-reported morbidity. Responses as to smoking behaviour were obtained from 12,270 adult participants in Western Australia (2003-2009) and individually record-linked to hospital admissions and geographically linked to tobacco outlets. Neighbourhood access to tobacco outlets was marginally positively associated with being a current versus a past smoker. Tobacco outlet access was also positively associated with heart disease for smokers but not non-smokers. For smokers, each additional outlet within 1600m of home was associated with a 2% increase in the odds of heart disease. Smokers with greater access to tobacco outlets were more likely to be diagnosed with or admitted to hospital for heart disease. Regulating the density of tobacco outlets in the community has immense potential to improve health benefits and our results motivate the need for future longitudinal studies to confirm this hypothesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Future sea-level rise from Greenland's main outlet glaciers in a warming climate.

    Science.gov (United States)

    Nick, Faezeh M; Vieli, Andreas; Andersen, Morten Langer; Joughin, Ian; Payne, Antony; Edwards, Tamsin L; Pattyn, Frank; van de Wal, Roderik S W

    2013-05-09

    Over the past decade, ice loss from the Greenland Ice Sheet increased as a result of both increased surface melting and ice discharge to the ocean. The latter is controlled by the acceleration of ice flow and subsequent thinning of fast-flowing marine-terminating outlet glaciers. Quantifying the future dynamic contribution of such glaciers to sea-level rise (SLR) remains a major challenge because outlet glacier dynamics are poorly understood. Here we present a glacier flow model that includes a fully dynamic treatment of marine termini. We use this model to simulate behaviour of four major marine-terminating outlet glaciers, which collectively drain about 22 per cent of the Greenland Ice Sheet. Using atmospheric and oceanic forcing from a mid-range future warming scenario that predicts warming by 2.8 degrees Celsius by 2100, we project a contribution of 19 to 30 millimetres to SLR from these glaciers by 2200. This contribution is largely (80 per cent) dynamic in origin and is caused by several episodic retreats past overdeepenings in outlet glacier troughs. After initial increases, however, dynamic losses from these four outlets remain relatively constant and contribute to SLR individually at rates of about 0.01 to 0.06 millimetres per year. These rates correspond to ice fluxes that are less than twice those of the late 1990s, well below previous upper bounds. For a more extreme future warming scenario (warming by 4.5 degrees Celsius by 2100), the projected losses increase by more than 50 per cent, producing a cumulative SLR of 29 to 49 millimetres by 2200.

  2. Role of TREK-1 potassium channel in bladder overactivity after partial bladder outlet obstruction in mouse.

    Science.gov (United States)

    Baker, Salah A; Hatton, William J; Han, Junguk; Hennig, Grant W; Britton, Fiona C; Koh, Sang Don

    2010-02-01

    Mouse models of partial bladder outlet obstruction cause bladder hypertrophy. Expression of a number of ion channels is altered in hypertrophic detrusor muscle, resulting in bladder dysfunction. We determined whether mechanosensitive TREK-1 channels are present in the murine bladder and whether their expression is altered in partial bladder outlet obstruction, resulting in abnormal filling responses. Partial bladder outlet obstruction was surgically induced in CD-1 mice and the mice recovered for 14 days. Cystometry was done to evaluate bladder pressure responses during filling at 25 microl per minute in partial bladder outlet obstruction mice and sham operated controls. TREK-1 channel expression was determined at the mRNA and protein levels by quantitative reverse transcriptase-polymerase chain reaction and Western blotting, respectively, and localized in the bladder wall using immunohistochemistry. Obstructed bladders showed about a 2-fold increase in weight vs sham operated bladders. TREK-1 channel protein expression on Western blots from bladder smooth muscle strip homogenates was significantly decreased in obstructed mice. Immunohistochemistry revealed a significant decrease in TREK-1 channel immunoreactivity in detrusor smooth muscle in obstructed mice. On cystometry the TREK-1 channel blocker L-methioninol induced a significant increase in premature contractions during filling in sham operated mice. L-methioninol had no significant effect in obstructed mice, which showed an overactive detrusor phenotype. TREK-1 channel down-regulation in detrusor myocytes is associated with bladder overactivity in a murine model of partial bladder outlet obstruction. Copyright 2010 American Urological Association. Published by Elsevier Inc. All rights reserved.

  3. A temporal analysis of the spatial clustering of food outlets around schools in Christchurch, New Zealand, 1966 to 2006.

    Science.gov (United States)

    Day, Peter L; Pearce, Jamie R; Pearson, Amber L

    2015-01-01

    To explore changes in urban food environments near schools, as potential contributors to the rising prevalence of overweight and obesity among children. Addresses of food premises and schools in 1966, 1976, 1986, 1996 and 2006 were geo-coded. For each year, the number and proportion of outlets by category (supermarket/grocery; convenience; fast-food outlet) within 800 m of schools were calculated. The degree of spatial clustering of outlets was assessed using a bivariate K-function analysis. Food outlet categories, school level and school social deprivation quintiles were compared. Christchurch, New Zealand. All schools and food outlets at 10-year snapshots from 1966 to 2006. Between 1966 and 2006, the median number of supermarkets/grocery stores within 800 m of schools decreased from 5 to 1, convenience stores decreased from 2 to 1, and fast-food outlets increased from 1 to 4. The ratio of fast-food outlets to total outlets increased from 0·10 to 0·67. The clustering of fast-food outlets was greatest within 800 m of schools and around the most socially deprived schools. Over the 40-year study period, school food environments in Christchurch can be characterized by increased densities of fast-food outlets within walking distance of schools, especially around the most deprived schools. Since the 1960s, there have been substantial changes to the food environments around schools which may increasingly facilitate away-from-home food consumption for children and provide easily accessible, cheap energy-dense foods, a recognized contributor to the rise in prevalence of overweight and obesity among young people.

  4. How should we diagnose and differentiate hearts with double-outlet right ventricle?

    Science.gov (United States)

    Bharucha, Tara; Hlavacek, Anthony M; Spicer, Diane E; Theocharis, Paraskevi; Anderson, Robert H

    2017-01-01

    Many, if not most, of the controversies regarding the description of the congenitally malformed heart have been resolved over the turn of the 20th century. A group of lesions that remains contentious is the situation in which both arterial trunks, in their greater part, are supported by the morphologically right ventricle. It was considered, for many years, that presence of bilateral infundibulums, or conuses, was a necessity for such a diagnosis. It has now been appreciated that this suggestion founders on many counts. In the first instance, such bilateral infundibulums are to be found in patients with other ventriculo-arterial connections, including the otherwise normal heart. In the second instance, it is clear that such an approach abrogates the important principle now known as the morphological method. This states that entities should be defined in terms of their intrinsic morphology and not on the basis of other variable features. It is now also clear that, when assessed simply on the basis of the ventricular origin of the arterial trunks, a significant number of patients fulfil the criteria for so-called "200%" origin of the trunks from the right ventricle when there is fibrous continuity between the leaflets of the atrioventricular and arterial valves. In this review, we show how attention to the morphology of the channel between the ventricles now provides the key to accurately diagnose the ventriculo-arterial connection in patients with suspected double-outlet right ventricle. This is because, when both arterial trunks arise exclusively or predominantly from the morphologically right ventricle, the outlet septum, of necessity, is itself a right ventricular structure. The channel between the ventricles, therefore, is roofed by the inner heart curvature, whether that structure is fibrous or muscular. Our observations then confirm that it is the attachment of the outlet septum, which itself can be muscular or fibrous, which determines the commitment of the

  5. Comparison of fast food consumption and dietary guideline practices for children and adolescents by clustering of fast food outlets around schools in the Gyeonggi area of Korea

    National Research Council Canada - National Science Library

    Joo, Soonnam; Ju, Seyoung; Chang, Hyeja

    2015-01-01

    Objectives: This study investigated the distribution density of fast food outlets around schools, and the relationship between dietary health of children and adolescents and the density of fast food outlets in Korea. Methods...

  6. Fruit and Vegetable Intake in Adolescents: Association with Socioeconomic Status and Exposure to Supermarkets and Fast Food Outlets

    Directory of Open Access Journals (Sweden)

    Chalida M. Svastisalee

    2012-01-01

    Full Text Available Background. We investigated differences in family social class associations between food outlet exposure and fruit and vegetable intake. Methods. We supplemented data from the 2006 Health Behavior in School Aged Children Study (n=6,096 with geocoded food outlet information surrounding schools (n=80. We used multilevel logistic regression to examine associations between infrequent fruit and vegetable intake and supermarket and fast food outlet concentration, stratified by family social class. Results. Boys and older children were most likely to eat fruit and vegetables infrequently. High fast food outlet exposure was marginally significant for low fruit intake in low social class children only. Children from middle and low social class backgrounds attending schools with combined high fast food outlet/low supermarket exposure were most likely to report infrequent fruit intake (ORlow=1.60; CI:  1.02–2.45; ORmid=1.40; CI:  1.03–190. Children from low social class backgrounds were also likely to report infrequent vegetable intake, given low supermarket and high fast food outlet exposure (OR=1.79; CI:  0.99–3.21. Conclusion. Our findings suggest social class modifies the relationship between intake and food outlet concentration. School interventions improving fruit and vegetable intake should consider neighborhood surroundings, targetting older children from low social class backgrounds.

  7. Food outlet availability, deprivation and obesity in a multi-ethnic sample of pregnant women in Bradford, UK.

    Science.gov (United States)

    Fraser, L K; Edwards, K L; Tominitz, M; Clarke, G P; Hill, A J

    2012-09-01

    The obesogenic environment model would suggest that increased availability or access to energy dense foods which are high in saturated fat may be related to obesity. The association between food outlet location, deprivation, weight status and ethnicity was analysed using individual level data on a sample of 1198 pregnant women in the UK Born in Bradford cohort using geographic information systems (GIS) methodology. In the non South Asian group 24% were obese as were 17% of the South Asian group (BMI > 30). Food outlet identification methods revealed 886 outlets that were allocated into 5 categories of food shops. More than 95% of all participants lived within 500 m of a fast food outlet. Women in higher areas of deprivation had greater access to fast food outlets and to other forms of food shops. Contrary to hypotheses, there was a negative association between BMI and fast food outlet density in close (250 m) proximity in the South Asian group. Overall, these women had greater access to all food stores including fast food outlets compared to the non South Asian group. The stronger association between area level deprivation and fast food density than with area level deprivation and obesity argues for more detailed accounts of the obesogenic environment that include measures of individual behaviour. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Is long-term bladder deterioration inevitable following successful isolated bladder outlet procedures in children with neuropathic bladder dysfunction?

    Science.gov (United States)

    Dave, Sumit; Pippi Salle, Joao L; Lorenzo, Armando J; Braga, Luis H P; Peralta-Del Valle, Maria Helena; Bägli, Darius; Khoury, Antoine E

    2008-05-01

    Bladder decompensation is well described following artificial urinary sphincter implantation in neurogenic bladders. We evaluated the long-term results of various bladder outlet procedures in a subset of patients with neurogenic bladder and isolated outlet deficiency. We retrospectively reviewed the charts of 15 consecutive patients who underwent bladder outlet procedures during a 10-year period for urinary incontinence associated with neuropathic bladder dysfunction. Postoperative success was defined as a dry interval of at least 4 hours. Preoperative evaluation showed a smooth bladder in 11 patients with vesicoureteral reflux and hydronephrosis in 2. Using the minimal acceptable capacity for age, mean percent expected bladder capacity for age was 89% +/- 25%, capacity below 20 cm H(2)O was 81% and capacity below 30 cm H(2)O was 89%. Mean preoperative expected capacity for age was 60% +/- 18%. Mean postoperative followup was 11.2 years. Postoperatively, 11 patients achieved initial dryness but 9 subsequently presented with recurrent incontinence and 2 presented with upper tract deterioration. Four cases failed the initial bladder outlet procedure. Salvage procedures included augmentation cystoplasty in all 15 patients, combined with repeat bladder outlet procedure in 4 and bladder neck closure in 2. Mean time to augmentation cystoplasty was 39.6 +/- 28 months. Isolated bladder outlet procedures for neurogenic incontinence portend a poor long-term outcome, requiring augmentation cystoplasty despite the use of anticholinergic medications and strict followup. Preoperative urodynamic evaluation does not predict the need or timing from the initial bladder outlet procedure for future augmentation cystoplasty.

  9. A Comparative Analysis of the Distributions of KFC and McDonald’s Outlets in China

    Directory of Open Access Journals (Sweden)

    Yikang Rui

    2016-03-01

    Full Text Available Mainland China has become one of the most important markets for international fast-food chains over the past decade. To study the regional spread of KFC and McDonald’s outlets in Chinese cities, the correlation of their distributions and degree of market expansion were explored and compared to analyze both the local and the global spatial autocorrelations. A geographically weighted Poisson regression model was also used to examine the influence of demographic, economic, and geographic factors on their spatial distributions. The findings of this comparative study reveal the site selection criteria at the city level by studying the differences and similarities in outlet distributions for KFC and McDonald’s. The presented results can guide other chains to enhance business location planning and formulate regional development policy.

  10. Vascular thoracic outlet syndrome developed after minimally invasive repair of pectus excavatum.

    Science.gov (United States)

    Kılıç, Burcu; Demirkaya, Ahmet; Turna, Akif; Kaynak, Kamil

    2013-09-01

    The Nuss procedure is a minimally invasive surgical repair technique for pectus excavatum with fewer delayed complications compared to open procedures. We report the case of a 22-year-old man with deep pectus excavatum who developed vascular thoracic outlet syndrome after the Nuss procedure. Further evaluation demonstrated that the first rib was causing severe obstruction of the right subclavian artery. The patient showed clinical features of subclavian artery compression. A first rib resection, division of the anterior scalene muscle and fibrous bands provided complete relief of the complaints. The forced structural and spatial changes produced by the elevation of the depressed upper chest might have caused this complication. Vascular thoracic outlet syndrome should be kept in mind as a possible complication in patients who have undergone minimally invasive repair of pectus excavatum, and this complication can be treated by first rib resection.

  11. CFD Study of Industrial FCC Risers: The Effect of Outlet Configurations on Hydrodynamics and Reactions

    Directory of Open Access Journals (Sweden)

    Gabriela C. Lopes

    2012-01-01

    Full Text Available Fluid catalytic cracking (FCC riser reactors have complex hydrodynamics, which depend not only on operating conditions, feedstock quality, and catalyst particles characteristics, but also on the geometric configurations of the reactor. This paper presents a numerical study of the influence of different riser outlet designs on the dynamic of the flow and reactor efficiency. A three-dimensional, three-phase flow model and a four-lump kinetic scheme were used to predict the performance of the reactor. The phenomenon of vaporization of the liquid oil droplets was also analyzed. Results showed that small changes in the outlet configuration had a significant effect on the flow patterns and consequently, on the reaction yields.

  12. The use and misuse of 'legacy data' in identifying a typology of retail outlets at Pompeii

    Directory of Open Access Journals (Sweden)

    Steven J.R. Ellis

    2008-07-01

    Full Text Available This article commences with a summary of the ways in which various types of retail outlets have been identified at Pompeii. The conventional approach has been to identify them, and to determine their supposed activities, by the Latin terms that were casually attached to them on their discovery in the 18th and 19th centuries, even though these labels have no corroboration in the archaeological record. Subsequent scholars have commonly treated this interpretative compilation as 'primary data'. I propose a different approach to the identification of Pompeii's different types of retail food and drink outlets, one that draws on the available primary archaeological data, as well as to the use of excavation records to create 'legacy data'.

  13. Predicting the Population Health Impacts of Community Interventions: The Case of Alcohol Outlets and Binge Drinking.

    Science.gov (United States)

    Ahern, Jennifer; Colson, K Ellicott; Margerson-Zilko, Claire; Hubbard, Alan; Galea, Sandro

    2016-11-01

    A substitution estimator can be used to predict how shifts in population exposures might change health. We illustrated this method by estimating how an upper limit on alcohol outlet density might alter binge drinking in the New York Social Environment Study (n = 4000), and provided statistical code and sample data. The largest differences in binge drinking were for an upper limit of 70 outlets per square mile; there was a -0.7% difference in binge drinking prevalence for New York City overall (95% confidence interval [CI] = -0.2%, -1.3%) and a -2.4% difference in binge drinking prevalence for the subset of communities the intervention modified (95% CI = -0.5%, -4.0%). A substitution estimator is a flexible tool for estimating population intervention parameters and improving the translation of public health research results to practitioners.

  14. Influence of the outlet air temperature on the thermohydraulic behaviour of air coolers

    Directory of Open Access Journals (Sweden)

    Đorđević Emila M.

    2003-01-01

    Full Text Available The determination of the optimal process conditions for the operation of air coolers demands a detailed analysis of their thermohydraulic behaviour on the one hand, and the estimation of the operating costs, on the other. One of the main parameters of the thermohydraulic behaviour of this type of equipment, is the outlet air temperature. The influence of the outlet air temperature on the performance of air coolers (heat transfer coefficient overall heat transfer coefficient, required surface area for heat transfer air-side pressure drop, fan power consumption and sound pressure level was investigated in this study. All the computations, using AirCooler software [1], were applied to cooling of the process fluid and the condensation of a multicomponent vapour mixture on two industrial devices of known geometries.

  15. Association of the availability of beer, wine, and liquor outlets with beverage-specific alcohol consumption: a cohort study.

    Science.gov (United States)

    Halonen, Jaana I; Kivimäki, Mika; Pentti, Jaana; Virtanen, Marianna; Subramanian, S V; Kawachi, Ichiro; Vahtera, Jussi

    2014-04-01

    Little evidence exists on whether beverage-specific alcohol availability is associated with beverage-specific consumption. We longitudinally examined whether the number and change in number of beer, wine, and liquor outlets near one's home are associated with alcohol consumption by beverage type. The study population consisted of 28,074 women and 6,639 men of the Finnish Public Sector Study who reported their alcohol use at baseline (in 2004/2005) and follow-up (in 2008/2009). The coordinates of their residence and alcohol outlets during the study period were obtained from national registers. Associations of the number and change in the number of beer, wine, and liquor outlets with beer, wine, and liquor consumption were analyzed using 2-level cumulative logistic regression adjusted for individual- and area-level characteristics. Having ≥3 wine outlets within 0.5 km of home was associated with a higher likelihood of wine consumption compared with having no outlets within 0.5 km: the cumulative odds ratios (CORs) 1.20 (95% confidence interval [CI] 1.10 to 1.31) in women and 1.29 (95% CI 1.08 to 1.56) in men. For an increase in the number of wine outlets, the COR for wine consumption was 1.16 (95% CI 1.08 to 1.25) among all women and 1.10 (95% CI 1.01 to 1.21) among those who did not move between surveys. No corresponding beverage-specific outlet-consumption associations were observed for beer and liquor. A high number of wine outlets near home may increase wine consumption among men and women. In addition, an increase in the number of wine outlets may add to its consumption among women, independent of the individuals' choice to move to areas of better availability. Copyright © 2014 by the Research Society on Alcoholism.

  16. Design of an Adapter for Air Outlet Filter on the M431 Chemical Agent Detector

    Science.gov (United States)

    1990-08-01

    lank SUMMARY SRI International has developed an adapter that will allow an outlet air filter to be easily attah Cd to and removed from the exhaust port...AGENT DETECTOR E1LECTE f EO-. -- _j Larry S. Gu~lman Thomas P. Low SRI INTERNATIONAL Menlo Park, CA 94025-3493 August 1990 U.S. ARMY ARMAMEN NJ...projected operating temperatures. SRI has investigated adapter design alternatives, including the selection of appropriate materials and methods of

  17. Employee Anonymous Online Dissent: Dynamics and Ethical Challenges for Employees, Targeted Organisations, Online Outlets and Audiences

    DEFF Research Database (Denmark)

    Ravazzani, Silvia; Mazzei, Alessandra

    2018-01-01

    This article aims to enhance understanding of employee anonymous online dissent (EAOD), a controversial phenomenon in contemporary digital environments. We conceptualise and scrutinise EAOD as a communicative and interactional process among four key actors: dissenting employees, online outlet...... administrators, audiences and targeted organisations. This multi-actor, dialectical process encompasses actor-related tensions that may generate unethical consequences if single voices are not brought out and confronted. Appropriating a Habermasian ethical and discursive lens, we examine and disentangle three...

  18. Fourth Ventricle Outlet Obstruction with Expanding Space on the Surface of Cerebellum.

    Science.gov (United States)

    Shimoda, Yoshiteru; Murakami, Kensuke; Narita, Norio; Tominaga, Teiji

    2017-04-01

    Hydrocephalus is classified as noncommunicating and communicating based on whether all ventricular and subarachnoid spaces are communicating. Although the diagnosis between the two different states is crucial, it is difficult in certain conditions. In particular, communicating hydrocephalus and noncommunicating hydrocephalus owing to fourth ventricle outlet obstruction are highly misdiagnosed. We describe a case of fourth ventricle outlet obstruction of unknown origin that was initially misdiagnosed as communicating hydrocephalus. A 66-year-old woman with gait disturbance and incontinence caused by hydrocephalus underwent ventriculoperitoneal shunt surgery. After 9 months, her fourth ventricle became enlarged and could not be controlled by lowering the shunt pressure. Magnetic resonance imaging (MRI) demonstrated obstruction at the foramen of Magendie, foramina of Luschka, and the cerebral aqueduct. Endoscopic surgery for aqueduct plasty with third ventriculostomy was planned. Because the aqueduct was observed to open spontaneously, only the standard third ventriculostomy was performed. When MRI findings were reviewed retrospectively, an unnatural space was observed between the lower cranial nerves and cerebellar hemisphere that grew along with the fourth ventricular enlargement. This space was determined by MRI cisternography to be the cystic membrane ballooning out from the foramen of Luschka. The primary hydrocephalus likely resulted from fourth ventricle outlet obstruction. Enlargement of the whole ventricular system with an expanded space between the lower cranial nerves and cerebellar hemisphere can be caused by fourth ventricle outlet obstruction. In such cases, preoperative evaluation of anatomic architecture and cerebrospinal fluid obstruction using MRI cisternography is essential and leads to a successful endoscopic strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 40 CFR Table 3 to Subpart Kkkk of... - Emission Limits for Affected Sources Using the Control Efficiency/Outlet Concentration Compliance...

    Science.gov (United States)

    2010-07-01

    ... Using the Control Efficiency/Outlet Concentration Compliance Option 3 Table 3 to Subpart KKKK of Part 63... of Part 63—Emission Limits for Affected Sources Using the Control Efficiency/Outlet Concentration... following table as required by § 63.3490(d). If you use the control efficiency/outlet concentration option...

  20. Climatology, hydrology, and simulation of an emergency outlet, Devils Lake basin, North Dakota

    Science.gov (United States)

    Wiche, Gregg J.; Vecchia, A.V.; Osborne, Leon; Wood, Carrie M.; Fay, James T.

    2000-01-01

    Devils Lake is a natural lake in northeastern North Dakota that is the terminus of a nearly 4,000-square-mile subbasin in the Red River of the North Basin. The lake has not reached its natural spill elevation to the Sheyenne River (a tributary of the Red River of the North) in recorded history. However, geologic evidence indicates a spill occurred sometime within the last 1,800 years. From 1993 to 1999, Devils Lake rose 24.5 feet and, at the present (August 2000), is about 13 feet below the natural spill elevation. The recent lake-level rise has caused flood damages exceeding $300 million and triggered development of future flood-control options to prevent further infrastructure damage and reduce the risk of a potentially catastrophic uncontrolled spill. Construction of an emergency outlet from the west end of Devils Lake to the Sheyenne River is one flood-control option being considered. This report describes the climatologic and hydrologic causes of the recent lake level rise, provides information on the potential for continued lake-level rises during the next 15 years, and describes the potential effectiveness of an emergency outlet in reducing future lake levels and in reducing the risk of an uncontrolled spill. The potential effects of an outlet on downstream water quantity and quality in the upper Sheyenne River also are described.

  1. Use of Mobile Pipeline with Self-regulated Water Outlets for Furrow Irrigation

    Directory of Open Access Journals (Sweden)

    Vysochkina L.I.

    2016-03-01

    Full Text Available Surface irrigation is one of the most common irrigation methods, but it has its own significant drawbacks. A mobile pipeline for furrow irrigation from closed irrigation network was designed and its parameters were proved in order to improve furrow irrigation. The mobile pipeline consists of plastic pipes based on 10 pairs of spring skis connected in the middle by a flexible connection. It is known that water flow into the furrow decreases along the pipeline due to pressure losses along the length of the pipeline. It was proposed to use water outlets ensuring uniform supply of water to each furrow by the presence of the butterfly valve in housing of the water outlet in the mobile pipeline. In order to ensure sustainable valve position, an equation was derived and values of the area of the upper and bottom parts of the valve were obtained. According to the pipeline field test results, water distribution uniformity coefficient through the outlets was 0.98, at a flow rate of 1.0-3.0 l∙s-1 and hydraulic slopes along the pipeline of 0.001−0.005.

  2. Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support

    Science.gov (United States)

    Freisthler, Bridget; Johnson-Motoyama, Michelle; Kepple, Nancy J.

    2014-01-01

    Supervisory neglect, or the failure of a caregiver to appropriately supervise a child, is one of the predominant types of neglectful behaviors, with alcohol use being considered a key antecedent to inadequate supervision of children. The current study builds on previous work by examining the role of parental drinking and alcohol outlet densities while controlling for caregiver and child characteristics. Data were obtained from 3,023 participants via a telephone survey from 50 cities throughout California. The telephone survey included items on neglectful parenting practices, drinking behaviors, and socio-demographic characteristics. Densities of alcohol outlets were measured for each of the 202 zip codes in the study. Multilevel Bernoulli models were used to analyze the relationship between four supervisory neglect parenting practices and individual-level and zip code-level variables. In our study, heavy drinking was only significantly related to one of our four outcome variables (leaving a child where he or she may not be safe). The density of on premise alcohol outlets was positively related to leaving a child home alone when an adult should be present. This study demonstrates that discrete relationships exist between alcohol related variables, social support, and specific supervisory neglect subtypes at the ecological and individual levels. PMID:25061256

  3. Greater access to fast-food outlets is associated with poorer bone health in young children.

    Science.gov (United States)

    Vogel, C; Parsons, C; Godfrey, K; Robinson, S; Harvey, N C; Inskip, H; Cooper, C; Baird, J

    2016-03-01

    A healthy diet positively influences childhood bone health, but how the food environment relates to bone development is unknown. Greater neighbourhood access to fast-food outlets was associated with lower bone mass among infants, while greater access to healthy speciality stores was associated with higher bone mass at 4 years. Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long-term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. One thousand one hundred and seven children participating in the Southampton Women's Survey, UK, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and 4 and/or 6 years by dual-energy X-ray absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant's neighbourhood were used to derive three measures of the food environment: the counts of fast-food outlets, healthy speciality stores and supermarkets. Neighbourhood exposure to fast-food outlets was associated with lower BMD in infancy (β = -0.23 (z-score): 95% CI -0.38, -0.08) and lower BMC after adjustment for bone area and confounding variables (β = -0.17 (z-score): 95% CI -0.32, -0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at 4 and 6 years (β = 0.16(z-score): 95% CI 0.00, 0.32 and β = 0.13(z-score): 95% CI -0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at 4 years, but not at 6 years. The neighbourhood food environment that pregnant mothers and young children are exposed may affect bone development during early childhood. If confirmed in

  4. Management of musculoskeletal pain in retail drug outlets within a Nigerian community: a descriptive study

    Directory of Open Access Journals (Sweden)

    Abdu-Aguye SN

    2017-03-01

    Full Text Available Objective: This work aimed to describe attitudes and practices of both community pharmacies and patent and proprietary medicine vendor (PPMV outlets towards over-the-counter (OTC analgesic use for musculoskeletal pain states within Zaria, Nigeria. Methods: The study was carried out in 2 phases from May to August 2016. Phase one was a cross-sectional survey of 40 retail drug outlets (10 community pharmacies and 30 PPMVs. A simulated patient scenario of a young adult male complaining of acute onset back pain was used to collect data on the type and quality of analgesic recommended, duration of consultation, as well as nature of information provided during the drug dispensing process. The second phase involved semi structured interviews with 7 drug vendors (4 pharmacists and 3 patent medicine vendors. The interviewees were asked questions to assess their knowledge of analgesics as well as what type of analgesic they would recommend in three hypothetical patient scenarios. Results: A wide variety of therapeutic agents were recommended for the simulated patient. Majority of these drugs were oral analgesics and contained NSAIDS either alone or in combination. Less than half of both patent medicine outlets and pharmacies (26.7% and 40% respectively provided the simulated patient with information on duration of therapy, and asked the patient questions about their past medical and medication history (30% and 33.3% respectively. All analgesics purchased from the pharmacies were registered with the Nigerian drug regulatory agency and had expiry dates compared to only 66.7% and 90% of those bought from patent medicine outlets. Interviewed drug vendors admitted to obtaining a large amount of their knowledge on analgesics from drug information leaflets and prior learning. They also showed some knowledge deficits when questioned on side effects of analgesics and appropriate drug selection in the hypothetical scenarios. Conclusions: There are problems with both

  5. The representativeness of water samples from the outlet of flowing wells in an unconfined aquifer

    Science.gov (United States)

    Jiang, Xiao-Wei; Zhang, Zhi-Yuan; Wan, Li; Wang, Xu-Sheng; Wang, Jun-Zhi

    2017-04-01

    The representativeness of a groundwater sample is often confused by the mixture of groundwater from different depths of a well, especially when length of well screen is long. In a basin where groundwater flow is driven by topography, a well without casing could become a flowing well in topographic lows as long as the well is drilled deep enough. In this case, a water sample could be easily collected at the outlet of the flowing well without pumping. A recent field study in the Ordos basin shows that groundwater samples from the outlets of flowing wells with different depths differs greatly in chemical components. For the flowing wells penetrates to the deep part of the basin with depths ranging between 700 m and 970 m, it was found out that the concentrations of most chemical components of waters sampled at the outlets increases significantly with well depth. However, the hydraulic mechanism of the well depth-dependent hydrochemistry of mixed water sample is not clear. In this study, a 3-D unit basin expanded from Tóth's classic 2-D unit basin model was adopted to study the origin of water from different depths and the representativeness of water sampled at the outlet of a flowing well. The flowing well was modeled by the revised multi-node well (MNW2) Package in MODFLOW by setting a limit head equaling to the land surface and specifying an artificially high discharge rate. By considering well loss, we found the zone with development of flowing wells is smaller than the zone with positive values of head exceeding land surface. As long as the water table is a subdued replica of the land surface, the deep part of the flowing well receives discharge from the aquifer, while part of groundwater in the shallow part of the flowing well returns to the aquifer. The boundary between groundwater inflow and outflow is found to be sensitive to the ratio of water table to land surface, the distance away from the valley and the depth of the flowing well. In the segment of

  6. Sea ice breakup and marine melt of a retreating tidewater outlet glacier in northeast Greenland (81 degrees N)

    DEFF Research Database (Denmark)

    Bendtsen, Jorgen; Mortensen, John; Lennert, Kunuk

    2017-01-01

    Rising temperatures in the Arctic cause accelerated mass loss from the Greenland Ice Sheet and reduced sea ice cover. Tidewater outlet glaciers represent direct connections between glaciers and the ocean where melt rates at the ice-ocean interface are influenced by ocean temperature and circulation...... glacier is a floating ice shelf with near-glacial subsurface temperatures at the freezing point. Melting from the surface layer significantly influenced the ice foot morphology of the glacier terminus. Hence, melting of the tidewater outlet glacier was found to be critically dependent on the retreat....... However, few measurements exist near outlet glaciers from the northern coast towards the Arctic Ocean that has remained nearly permanently ice covered. Here we present hydrographic measurements along the terminus of a major retreating tidewater outlet glacier from Flade Isblink Ice Cap. We show...

  7. Sea ice breakup and marine melt of a retreating tidewater outlet glacier in northeast Greenland (81°N)

    DEFF Research Database (Denmark)

    Bendtsen, Jørgen; Mortensen, John; Lennert, Kunuk

    2017-01-01

    Rising temperatures in the Arctic cause accelerated mass loss from the Greenland Ice Sheet and reduced sea ice cover. Tidewater outlet glaciers represent direct connections between glaciers and the ocean where melt rates at the ice-ocean interface are influenced by ocean temperature and circulation...... glacier is a floating ice shelf with near-glacial subsurface temperatures at the freezing point. Melting from the surface layer significantly influenced the ice foot morphology of the glacier terminus. Hence, melting of the tidewater outlet glacier was found to be critically dependent on the retreat....... However, few measurements exist near outlet glaciers from the northern coast towards the Arctic Ocean that has remained nearly permanently ice covered. Here we present hydrographic measurements along the terminus of a major retreating tidewater outlet glacier from Flade Isblink Ice Cap. We show...

  8. Albanian and UK Consumers’ Perceptions of Farmers’ Markets and Supermarkets as Outlets for Organic Food: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Athina-Evera Qendro

    2015-05-01

    Full Text Available The purpose of this paper is to elicit UK and Albanian consumers’ perceptions of food outlets in order to understand their views on supermarkets and farmers’ markets as outlets for organic food. A qualitative research methodology was chosen as the best way to get an in-depth understanding of how consumers of these two different countries understand and evaluate buying organic food from two different food outlets. This exploratory research is a first step to find out how and why organic food is being bought in supermarkets and farmers’ markets. The results show that respondents associated organic with vegetables and fruit, that taste good, are healthy, and are free of pesticides and hormones. The importance of motives varies between the outlets they prefer for buying organic food. An interesting finding is the fact that Albanian respondents refer to the farmers’ markets as the villagers’ market.

  9. Alcohol outlet densities and alcohol price: the British Columbia experiment in the partial privatization of alcohol sales off-premise.

    Science.gov (United States)

    Treno, Andrew J; Ponicki, William R; Stockwell, Tim; Macdonald, Scott; Gruenewald, Paul J; Zhao, Jinhui; Martin, Gina; Greer, Alissa

    2013-05-01

    Alcohol beverage prices or taxes have been shown to be related to alcohol sales and use and related problems. What is not clear are the mechanisms underlying these relationships. This study examines the relationship between alcohol outlet density under conditions of the partial privatization of off-premise consumption in British Columbia (BC) occurring over the past decade. Two hypotheses are tested. First, reflecting basic supply-demand principles, greater geographic densities of alcohol outlets will be directly related to reductions in beverage prices in response to greater competition. Second, reflecting the effects of niche marketing and resulting market stratification, increased densities of private liquor stores will be especially related to reductions in beverage prices within this outlet category. Data were collected from: (i) a survey of BC private store prices and practices, (ii) alcohol outlet location information, and (iii) data on demographic characteristics. Multilevel models examine the relationships between prices at individual private liquor stores and the densities of government liquor stores, private liquor stores, bars, and restaurants, controlling for background demographics and geographic unit level effects. Spatial dependencies were also examined. Increased densities of private liquor stores were associated with lower mean prices of beer and all alcohol aggregated across brands at the store level. There appeared to be no outlet level effect on discounting patterns, however, with the mean price differences apparently reflecting differences in the quality of brands carried rather than unequal prices for any given brand. Increased densities of private off-sale alcohol outlets appear to result in lower prices charged at said establishments independently of other types of alcohol outlets suggesting that they represent an emerging marketing niche in the context of off-sale outlet privatization. Copyright © 2012 by the Research Society on

  10. The role of independent fast-food outlets in obesogenic environments: a case study of East London in the UK

    OpenAIRE

    Susan Bagwell

    2011-01-01

    In the battle to curb rising levels of obesity the focus has moved from individual interventions towards addressing factors within the ‘obesogenic environment’. Fast-food outlets are argued to be an increasingly important aspect of this environment and recent UK government policy has suggested that local authorities should use their planning powers to restrict the opening of new fast-food outlets in local neighbourhoods. This policy has a particular impact on the growing number of independent...

  11. Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity? A cross-sectional study12

    Science.gov (United States)

    Forouhi, Nita G; Griffin, Simon J; Brage, Søren; Wareham, Nicholas J

    2016-01-01

    Background: Greater exposures to fast-food outlets and lower levels of education are independently associated with less healthy diets and obesity. Little is known about the interplay between these environmental and individual factors. Objective: The purpose of this study was to test whether observed differences in fast-food consumption and obesity by fast-food outlet exposure are moderated by educational attainment. Design: In a population-based cohort of 5958 adults aged 29–62 y in Cambridgeshire, United Kingdom, we used educational attainment–stratified regression models to estimate the food-frequency questionnaire–derived consumption of energy-dense “fast foods” (g/d) typically sold in fast-food restaurants and measured body mass index (BMI; in kg/m2) across geographic information system–derived home and work fast-food exposure quartiles. We used logistic regression to estimate the odds of obesity (BMI ≥30) and calculated relative excess risk due to interaction (RERI) on an additive scale. Participant data were collected during 2005–2013 and analyzed in 2015. Results: Greater fast-food consumption, BMI, and odds of obesity were associated with greater fast-food outlet exposure and a lower educational level. Fast-food consumption and BMI were significantly different across education groups at all levels of fast-food outlet exposure (P fast-food outlet exposure amplified differences in fast-food consumption across levels of education. The relation between fast-food outlet exposure and obesity was only significant among those who were least educated (OR: 2.05; 95% CI: 1.08, 3.87; RERI = 0.88), which suggested a positive additive interaction between education and fast-food outlet exposure. Conclusion: These findings suggest that efforts to improve diets and health through neighborhood-level fast-food outlet regulation might be effective across socioeconomic groups and may serve to reduce observed socioeconomic inequalities in diet and obesity. PMID

  12. Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity? A cross-sectional study 1 2

    OpenAIRE

    Burgoine, Thomas; Forouhi, Nita G.; Simon J Griffin; Brage, S?ren; Wareham, Nicholas J; Monsivais, Pablo

    2016-01-01

    Background: Greater exposures to fast-food outlets and lower levels of education are independently associated with less healthy diets and obesity. Little is known about the interplay between these environmental and individual factors. Objective: The purpose of this study was to test whether observed differences in fast-food consumption and obesity by fast-food outlet exposure are moderated by educational attainment. Design: In a population-based cohort of 5958 adults aged 29?62 y in Cambridge...

  13. Does neighborhood fast-food outlet exposure amplify inequalities in diet and obesity? A cross-sectional study.

    Science.gov (United States)

    Burgoine, Thomas; Forouhi, Nita G; Griffin, Simon J; Brage, Søren; Wareham, Nicholas J; Monsivais, Pablo

    2016-06-01

    Greater exposures to fast-food outlets and lower levels of education are independently associated with less healthy diets and obesity. Little is known about the interplay between these environmental and individual factors. The purpose of this study was to test whether observed differences in fast-food consumption and obesity by fast-food outlet exposure are moderated by educational attainment. In a population-based cohort of 5958 adults aged 29-62 y in Cambridgeshire, United Kingdom, we used educational attainment-stratified regression models to estimate the food-frequency questionnaire-derived consumption of energy-dense "fast foods" (g/d) typically sold in fast-food restaurants and measured body mass index (BMI; in kg/m(2)) across geographic information system-derived home and work fast-food exposure quartiles. We used logistic regression to estimate the odds of obesity (BMI ≥30) and calculated relative excess risk due to interaction (RERI) on an additive scale. Participant data were collected during 2005-2013 and analyzed in 2015. Greater fast-food consumption, BMI, and odds of obesity were associated with greater fast-food outlet exposure and a lower educational level. Fast-food consumption and BMI were significantly different across education groups at all levels of fast-food outlet exposure (P food outlet exposure amplified differences in fast-food consumption across levels of education. The relation between fast-food outlet exposure and obesity was only significant among those who were least educated (OR: 2.05; 95% CI: 1.08, 3.87; RERI = 0.88), which suggested a positive additive interaction between education and fast-food outlet exposure. These findings suggest that efforts to improve diets and health through neighborhood-level fast-food outlet regulation might be effective across socioeconomic groups and may serve to reduce observed socioeconomic inequalities in diet and obesity.

  14. Utilization of Cupping Therapy in the Treatment of Vascular Thoracic Outlet Syndrome in a Collegiate Pitcher: A Case Study

    Directory of Open Access Journals (Sweden)

    Stephen A. Cage

    2017-12-01

    Full Text Available Objective: Present a clinical case detailing the effectiveness of dry cupping therapy in treating thoracic outlet syndrome. The utilization of dry cupping therapy on a 20-year-old collegiate baseball pitcher with diagnosed thoracic outlet syndrome is presented. Background: Thoracic outlet syndrome is a relatively rare musculoskeletal condition affecting 1/100,000 patients annually. Dry cupping therapy is an ancient therapeutic modality that utilizes various means of suction with the goal of decompressing myofascial layers. Treatment: Following diagnosis, patient was successfully treated in two weeks using dry cupping therapy. The patient experienced no further incidence of thoracic outlet syndrome symptoms and was able to complete the remainder of his competitive season. Uniqueness: The patient’s thoracic outlet syndrome was diagnosed at an early stage, leading to the need of clearance from a vascular specialist before returning to competition. To the author’s knowledge, there are currently no published case reports detailing the use of cupping therapy to treat thoracic outlet syndrome. Conclusion: Cupping therapy may be a viable treatment option when seeking to address tight musculature. Further research needs to be conducted to determine optimal parameters for cupping therapy as a therapeutic modality.

  15. Patterns of fruit and vegetable availability and price competitiveness across four seasons are different in local food outlets and supermarkets.

    Science.gov (United States)

    Valpiani, Natalie; Wilde, Parke; Rogers, Beatrice; Stewart, Hayden

    2015-10-01

    To explore the effect of seasonality on fruit and vegetable availability and prices across three outlet types (farmers' markets, roadside stands and conventional supermarkets). Cross-sectional survey of geographically clustered supermarkets, farmers' markets and roadside stands. Enumerators recorded the availability and lowest price for eleven fruits and eighteen vegetables in each season of 2011. Price data were collected at retail outlets located in central and eastern North Carolina. The sample consisted of thirty-three supermarkets, thirty-four farmers' markets and twenty-three roadside stands. Outside the local harvest season, the availability of many fruits and vegetables was substantially lower at farmers' markets and roadside stands compared with supermarkets. Given sufficient availability, some items were significantly cheaper (Pmarkets than supermarkets). Although small samples limited statistical power in many non-peak comparisons, these results also showed some differences by item: two-thirds of fruits were cheaper at one or both direct outlets in the spring and autumn, whereas five of eighteen vegetables cost more at direct retail year-round. Commonly consumed fruits and vegetables were more widely available at supermarkets in central and eastern North Carolina than at direct retail outlets, in each season. Contingent on item availability, price competitiveness of the direct retail outlets varied by fruit and vegetable. For many items, the outlets compete on price in more than one season.

  16. Dose reduction in spiral CT angiography of thoracic outlet syndrome by anatomically adapted tube current modulation

    Energy Technology Data Exchange (ETDEWEB)

    Mastora, I.; Remy-Jardin, M.; Remy, J. [Dept. of Radiology, University Center Hospital Calmette, Lille (France); Medical Research Group, Lille (France); Suess, C.; Scherf, C. [Siemens Medical Systems, Forcheim (Germany); Guillot, J.P. [Dept. of Radiology, University Center Hospital Calmette, Lille (France)

    2001-04-01

    The aim of this study was to evaluate dose reduction in spiral CT angiography of the thoracic outlet by on-line tube-current control. Prospectively, 114 patients undergoing spiral CT angiography of the subclavian artery for thoracic outlet arterial syndromes were evaluated with and without tube-current modulation at the same session (scanning parameters for the two successive angiograms, one in the neutral position and one after the postural maneuver): 140 kV; 206 mA; scan time 0.75 s; collimation 3 mm; pitch = (1). The dose reduction system was applied in the neutral position in the first 92 consecutive patients and after postural maneuver in the remaining 22 consecutive patients. Dose reduction and image quality were analyzed in the overall study group (group 1; n = 114). The influence of the arm position was assessed in 44 of the 114 patients (group 2), matched by the transverse diameter of the upper thorax. The mean dose reduction was 33 % in group 1 (range 22-40 %) and 34 % in group 2 (range 26-40 %). In group 2 the only difference in image quality was a significantly higher frequency of graininess on low-dose scans compared with reference scans whatever the patient's arm position, graded as minimal in 38 of the 44 patients (86 %). When the low-dose technique was applied after postural maneuver in group 2: (a) the mean dose reduction was significantly higher (35 vs 32 % in the neutral position; p = 0.006); (b) graininess was less frequent (82 vs 91 % in the neutral position); and (c) the percentage of graininess graded as minimal was significantly higher (83 vs 70 % in the neutral position; p = 0.2027). On-line tube-current modulation enables dose reduction on high-quality, diagnostic spiral CT angiograms of the thoracic outlet and should be applied during data acquisition in the neutral position and after postural maneuver for optimal use. (orig.)

  17. Combined diurnal variations of discharge and hydrochemistry of the Isunnguata Sermia outlet, Greenland Ice Sheet

    Science.gov (United States)

    Graly, Joseph; Harrington, Joel; Humphrey, Neil

    2017-05-01

    In order to examine daily cycles in meltwater routing and storage in the Isunnguata Sermia outlet of the Greenland Ice Sheet, variations in outlet stream discharge and in major element hydrochemistry were assessed over a 6-day period in July 2013. Over 4 days, discharge was assessed from hourly photography of the outlet from multiple vantages, including where midstream naled ice provided a natural gauge. pH, electrical conductivity, suspended sediment, and major element and anion chemistry were measured in samples of stream water collected every 3 h.Photography and stream observations reveal that although river width and stage have only slight diurnal variation, there are large diurnal changes in discharge shown by the doubling in width of what we term the active channel, which is characterized by large standing waves and fast flow. The concentration of dissolved solutes follows a sinusoidal diurnal cycle, except for large and variable increases in dissolved solutes during the stream's waning flow. Solute concentrations vary by ˜ 30 % between diurnal minima and maxima. Discharge maxima and minima lag temperature and surface melt by 3-7 h; diurnal solute concentration minima and maxima lag discharge by 3-6 h.This phase shift between discharge and solute concentration suggests that during high flow, water is either encountering more rock material or is stored in longer contact with rock material. We suggest that expansion of a distributed subglacial hydrologic network into seldom accessed regions during high flow could account for these phenomena, and for a spike of partial silicate reaction products during waning flow, which itself suggests a pressure threshold-triggered release of stored water.

  18. Repair of double outlet right ventricle with doubly-committed ventricular septal defect.

    Science.gov (United States)

    Uemura, H; Yagihara, T; Kadohama, T; Kawahira, Y; Yoshikawa, Y

    2001-07-01

    To investigate our surgical results of intraventricular rerouting in patients having double outlet right ventricle with doubly-committed ventricular septal defect. We undertook repair in 8 patients with this particular feature. Of these, 2 patients had pulmonary stenosis, and another had interruption of the aortic arch. The subarterial defect was unequivocally related to both the aortic and the-pulmonary orifices in all, albeit slightly deviated towards the aortic orifice in one, and towards the pulmonary orifice in another. Intraventricular rerouting was carried out via incisions to the right atrium and the pulmonary trunk. To ensure reconstruction of an unobstructed pulmonary pathway, a limited right ventriculotomy was made in 5. All patients survived the procedure, and are currently doing well, with follow-up of 25 to 194 months, with a mean of 117+/-68 months. Catheterization carried out 16+/-6 months after repair demonstrated excellent ventricular parameters. Mean pulmonary arterial pressure was 16+/-7 mmHg, being higher than 20 mmHg in 2 patients. No significant obstruction was found between the right ventricle and the pulmonary arteries. A pressure gradient across the left ventricular outflow tract became significant in one patient in whom a small outlet septum was present, and a heart-shaped baffle had been used for intraventricular rerouting. Reoperation was eventually needed in this patient for treatment of the obstruction, which proved to be progressive. Precise recognition of the morphologic features is of paramount importance when choosing the optimal options for biventricular repair in patients with double outlet right ventricle and doubly-committed interventricular communication.

  19. Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture.

    Science.gov (United States)

    Puttmann, Kathleen T; Satiani, Bhagwan; Vaccaro, Patrick

    2016-11-01

    Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult.

  20. Consumer Preferences for Animal Source Foods in Uganda: Quality, Retail Forms and Retail Outlets

    Directory of Open Access Journals (Sweden)

    Nadhem Mtimet

    2013-10-01

    Full Text Available This paper presents the results of a rapid consumer survey undertaken in Uganda. The survey aimed at identifying preferred quality and safety attributes, retail forms and retail outlets for major livestock products and by type of consumers. Results of the survey, combined with nationally representative household datasets, allows description of both the quantitative and qualitative dimensions of the developing market for animal-source foods, which is anticipated to provide major business opportunities for small-scale livestock producers in the short and medium terms.

  1. Delayed Diagnosis of Gastric Outlet Obstruction from Bouveret Syndrome in a Young Woman

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    Smith, Zachary

    2014-11-01

    Full Text Available Bouveret syndrome is a rare presentation of gastric outlet obstruction caused by a gallstone in the proximal duodenum via a bilioenteric fistula. This is an infrequent although clinically significant cause of abdominal pain, almost exclusively in the elderly. The clinical presentation is similar to that of a small bowel obstruction with abdominal pain, nausea and vomiting. Surgery or endoscopy is often required for definitive diagnosis and therapy. We describe the case of a young woman with this condition who had a delayed diagnosis in part because of her age and the rarity of the condition. [West J Emerg Med. 2015;16(1:151-153.

  2. Coolant mixing in LMFBR rod bundles and outlet plenum mixing transients

    Science.gov (United States)

    Todreas, N. E.; Cheng, S. K.; Basehore, K.

    1984-08-01

    The thermal hydraulic performance of wire wrapped fuel bundles of LMFBR configuration was investigated. Results obtained included phenomenological models for friction factors, flow split and mixing characteristics; correlations for predicting these characteristics suitable for insertion in design codes; numerical codes for analyzing bundle behavior both of the lumped subchannel and distributed parameter categories and experimental techniques for pressure velocity, flow split, salt conductivity and temperature measurement in water cooled mockups of bundles and subchannels. Flow regimes investigated included laminar, transition and turbulent flow under forced convection and mixed convection conditions. Forced convections conditions are emphasized. Outlet plenum behavior is also investigated.

  3. Unusual Case of an Arterial Thoracic Outlet Syndrome due to Srb Anomaly.

    Science.gov (United States)

    Rustum, Saad; Rodt, Thomas; Teebken, Omke; Schrimpf, Claudia; Aper, Thomas; Wilhelmi, Mathias

    2013-12-01

    A thoracic outlet syndrome (TOS) is caused by arterial or nervous obstruction because of skeletal or muscular anomalies and hypertrophies. Congenital rib anomalies occur with low incidences (0.15-0.31%), predominantly affect the right side and are normally diagnosed at a young age or remain asymptomatic throughout life. Here, we report on the unusual case of a 71-year-old female patient with subacute ischemia of the left arm due to a TOS resulting from Srb anomaly, a very rare congenital rib anomaly.

  4. Water outlet control mechanism for fuel cell system operation in variable gravity environments

    Science.gov (United States)

    Vasquez, Arturo (Inventor); McCurdy, Kerri L. (Inventor); Bradley, Karla F. (Inventor)

    2007-01-01

    A self-regulated water separator provides centrifugal separation of fuel cell product water from oxidant gas. The system uses the flow energy of the fuel cell's two-phase water and oxidant flow stream and a regulated ejector or other reactant circulation pump providing the two-phase fluid flow. The system further uses a means of controlling the water outlet flow rate away from the water separator that uses both the ejector's or reactant pump's supply pressure and a compressibility sensor to provide overall control of separated water flow either back to the separator or away from the separator.

  5. Gastric outlet obstruction secondary to paraesophageal herniation of gastric antrum after laparoscopic fundoplication

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    Selcuk Coskun

    2015-04-01

    Full Text Available The most common causes of acute gastric outlet obstruction (GOO are duodenal and type 3 gastric ulcers. However, mechanical or functional causes may also lead to this pathology. Acute GOO is characterized by delayed gastric emptying, anorexia, or nausea accompanied by vomiting. Herein we report a 56-year-old man diagnosed with GOO secondary to paraesophageal hiatal herniation of gastric antrum after laparoscopic fundoplication. Because of the rarity of this disease, common gastrointestinal complaints may mislead the emergency physician to diagnose a nonsurgical gastrointestinal disease if a detailed history and physical examinations are not obtained.

  6. Endoscopic management of multiple large antral hyperplastic polyps causing gastric outlet obstruction.

    Science.gov (United States)

    Pontone, Stefano; Pironi, Daniele; Eberspacher, Chiara; Pontone, Paolo; Filippini, Angelo

    2011-01-01

    Gastric hyperplastic polyps are often asymptomatic and are found incidentally at upper endoscopy performed for unrelated reasons. Although they are considered a benign lesion, all symptomatic polyps should be removed for a more reliable histological diagnosis, resolution of symptoms and to prevent potential malignant transformation. In fact, there are no significant difference between pure gastric hyperplastic polyps and gastric hyperplastic polyps with neoplastic transformation in the number, location, or gross appearance of polyps. If symptomatic, patients usually complain of dyspepsia, heartburn, abdominal pain or upper gastrointestinal bleeding leading to anaemia. Complete or incomplete gastric outlet obstruction with intermittent symptoms, may rarely be caused by gastric hyperplastic polyps. We described the management of a rare case of intermittent gastric outlet obstruction caused by a large hyperplastic antral polyp prolapsing through the pylorus. Using hydroxypropylmethylcellulose, a new lifting agent, firstly from pyloric side, we obtained a reliable long-lasting submucosal cushion under the lesion which allowed a stable repositioning of the polyp in the gastric lumen without making additional infiltration during the endoscopic mucosal resection. Innovative lifting agents could significantly reduce the procedure time, but additional studies should be performed on this area to confirm preliminary results. Endoscopic mucosal resection not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves symptomatic treatment.

  7. Dynamic Fluctuations of an East Antarctic Outlet Glacier Since the Pliocene

    Science.gov (United States)

    Mackintosh, A.; Jones, R. S.; Norton, K. P.; Anderson, J. T.; Kubik, P.; Vockenhuber, C.; Wittmann, H.; Wilson, G. S.; Golledge, N. R.; Mckay, R. M.

    2016-12-01

    Understanding past changes in the Antarctic ice sheet provides insight into how the future ice sheet might respond to climate warming. During the Pliocene and Pleistocene, the East Antarctic Ice Sheet responded to glacial and interglacial cycles by remaining relatively stable in its interior, and oscillating at its marine-based margin. It is currently not clear how outlet glaciers, which connect the ice sheet interior to its margin, responded to these orbitally-paced climate cycles. Here we report new ice surface constraints from Skelton Glacier, an outlet of the East Antarctic ice sheet,which drains into the Ross Ice Shelf. Our multiple-isotope (10Be and 26Al) data indicate that currently ice-free areas adjacent to the glacier underwent substantial periods of ice cover and exposure in the past. Using a burial-exposure model to determine the probable ice surface history implied by our data, we show that: 1) the glacier surface has likely fluctuated since at least the Pliocene; 2) the ice surface was >200 m higher than today during glacial periods, and the glacier has been thicker than present for 80-90% of each glacial-interglacial cycle; and 3) ice cover at higher elevations occurred for a relatively shorter time per Pliocene cycle than Pleistocene cycle. Our work demonstrates that dynamic glacial-interglacial oscillations of the marine-based ice margin propagated upstream to the edge of the East Antarctic plateau during both Pliocene and Pleistocene climates.

  8. Neighborhoods, Alcohol Outlets and Intimate Partner Violence: Addressing Research Gaps in Explanatory Mechanisms

    Directory of Open Access Journals (Sweden)

    Carol B. Cunradi

    2010-03-01

    Full Text Available Indices of heavy drinking have consistently been linked with increased risk for intimate partner violence (IPV among couples in the general household population. Because IPV is a ‘private’ event, most IPV research has focused on individual-level risk factors, but current social ecological theory suggests that alcohol outlets can act with neighborhood conditions to increase risks for IPV. This paper reviews the theoretical and empirical literatures relevant to identifying specific social mechanisms linking IPV to alcohol use in community settings, and discusses three social mechanisms relevant to these effects: greater numbers of alcohol outlets within a neighborhood may (1 be a sign of loosened normative constraints against violence; (2 promote problem alcohol use among at-risk couples, and; (3 provide environments where groups of persons at risk for IPV may form and mutually reinforce IPV-related attitudes, norms, and problem behaviors. Understanding these mechanisms is of critical public health importance for developing environmental strategies aimed at prevention of IPV, such as changes in zoning, community action and education, and policing.

  9. Flow dynamical behavior and performance of a micro viscous pump with unequal inlet and outlet areas

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    Chenhui Hu

    2016-01-01

    Full Text Available The micro viscous pump is an important type of fluidic device. Optimizing the working performance of the pump is crucial for its wider application. A micro viscous pump design with unequal inlet and outlet areas is proposed in this paper. The flow field of the viscous pump is investigated using 2D laminar simulations. The mass flow rate and driving power are studied with different opening angles. The effects of the Reynolds number and the pressure load on the working performance are discussed in detail. Flow structures and vortex evolution are analyzed. With larger inlet and outlet areas, a higher mass flow rate is obtained and less driving power is achieved. A high pressure load results in a reduction in mass flow rate and an increase in driving power. Pumps with large opening angles are more susceptive to the Reynolds number and the pressure load. The adverse impact of the pressure load can be reduced by increasing the rotor speed. The vortex structure is affected by the geometric and operating parameters in the flow field. The flow dynamical behavior of the viscous pump exerts significant influence on its pumping ability. The present work gives rise to performance improvements for the micro viscous pump.

  10. Have drivers at alcohol outlets changed their behavior after the new traffic law?

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    Raquel B. De Boni

    2014-03-01

    Full Text Available Objective: In an attempt to reduce high levels of traffic crashes, a new legislation was approved in Brazil in 2008. This study aimed to assess behavioral change among drivers who had drunk at alcohol outlets (AO after implementation of the law. Method: A three-stage probability sampling survey was conducted in Porto Alegre, state of Rio Grande do Sul, Brazil. Individuals seen leaving AOs after drinking were approached (n=3,018. Selected drivers (n=683 answered a structured interview, were breathalyzed, and had saliva specimens collected for drug screening. Results: Overall, 60.3% (SE 4.5 of drivers reported they did not change their behavior. Among those who reported behavioral changes, most reported drinking less as their main strategy toward safer driving behavior. Variables independently associated with behavior change included having drunk at a high outlet density area (odds ratio [OR] 1.7 [1.1-2.8] and having a favorable opinion about the law (OR 4.3 [2.1-8.9]. Conclusions: Our findings suggest that awareness of the law has not been enough to promote behavioral change. As most drivers had a favorable opinion of the law and this variable was found to be the strongest predictor of behavior change, efforts to better integrate education and enforcement seem to be pivotal and might be well received by the population.

  11. Ultrasonographic Diagnosis of Thoracic Outlet Syndrome Secondary to Brachial Plexus Piercing Variation

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    Vanessa Leonhard

    2017-07-01

    Full Text Available Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants. We tested the association between BP piercing and nTOS symptoms, and evaluated the capability of ultrasonographic identification of patients with clinically relevant variations. Eighty-two cadaveric necks were first dissected to assess BP variation frequency. In 62.1%, C5, superior trunk, or superior + middle trunks pierced the anterior scalene. Subsequently, 22 student subjects underwent screening with detailed questionnaires, provocative tests, and BP ultrasonography. Twenty-one percent demonstrated atypical BP branching anatomy on ultrasound; of these, 50% reported symptoms consistent with nTOS, significantly higher than subjects with classic BP anatomy (14%. This group, categorized as a typical TOS, would be missed by provocative testing alone. The addition of ultrasonography to nTOS diagnosis, especially for patients with BP branching variation, would allow clinicians to visualize and identify atypical patient anatomy.

  12. Measurement of heat and momentum eddy diffusivities in recirculating LMFBR outlet plenum flows

    Energy Technology Data Exchange (ETDEWEB)

    Manno, V.P.; Golay, M.W.

    1978-06-01

    An optical technique has been developed for the measurement of the eddy diffusivity of heat in a transparent flowing medium. The method uses a combination of two established measurement tools: a Mach-Zehnder interferometer for the monitoring of turbulently fluctuating temperature and a Laser Doppler Anemometer (LDA) for the measurement of turbulent velocity fluctuations. The technique is applied to the investigation of flow fields characteristic of the LMFBR outlet plenum. The study is accomplished using air as the working fluid in a small scale Plexiglas test section. Lows are introduced into both the /sup 1///sub 15/ scale FFTF outlet plenum and the /sup 3///sub 80/ scale CRBR geometry plenum at inlet Reynolds numbers of 22,000. Measurements of the eddy diffusivity of heat and the eddy diffusivity of momentum are performed at a total of 11 measurement stations. Significant differences of the turbulence parameters are found between the two geometries, and the higher chimney structure of the CRBR case is found to be the major cause of the distinction. Spectral intensity studies of the fluctuating electronic analog signals of velocity and temperature are also performed. Error analysis of the overall technique indicates an experimental error of 10% in the determination of the eddy diffusivity of heat and 6% in the evaluation of turbulent momentum viscosity. In general it is seen that the turbulence in the cases observed is not isotropic, and use of isotropic turbulent heat and momentum diffusivities in transport modelling would not be a valid procedure.

  13. Conceptualization of Karstic Aquifer with Multiple Outlets Using a Dual Porosity Model.

    Science.gov (United States)

    Hosseini, Seiyed Mossa; Ataie-Ashtiani, Behzad

    2017-07-01

    In this study, two conceptual models, the classic reservoir (CR) model and exchange reservoirs model embedded by dual porosity approach (DPR) are developed for simulation of karst aquifer functioning drained by multiple outlets. The performances of two developed models are demonstrated at a less developed karstic aquifer with three spring outlets located in Zagros Mountain in the south-west of Iran using 22-years of daily data. During the surface recharge, a production function based on water mass balance is implemented for computing the time series of surface recharge to the karst formations. The efficiency of both models has been assessed for simulation of daily spring discharge during the recession and also surface recharge periods. Results indicate that both CR and DPR models are capable of simulating the ordinates of spring hydrographs which drainage less developed karstic aquifer. However, the goodness of fit criteria indicates outperformance of DPR model for simulation of total hydrograph ordinates. In addition, the DPR model is capable of quantifying hydraulic properties of two hydrologically connected overlapping continua conduits network and fissure matrix which lays important foundations for the mining operation and water resource management whereas homogeneous model representations of the karstic subsurface (e.g., the CR) do not work accurately in the karstic environment. © 2017, National Ground Water Association.

  14. The surgical anatomy of ventricular septal defect part IV: double outlet ventricle.

    Science.gov (United States)

    Anderson, R H; Ho, S Y; Wilcox, B R

    1996-01-01

    In this fourth part of our series of articles concerned with the surgical anatomy of ventricular septal defects (VSDs), we have analyzed the arrangements when both arterial trunks arise from the same ventricle. The essence of these anomalies is that the interventricular communication is an integral part of the circulation. Unless the surgeon constructs an alternative route of exit, closure of this defect would isolate one of the ventricles. The usual surgical approach, therefore, is to patch the hole between the ventricles into one or other of the subarterial outflow tracts. This means that all the components of the ventricular outflow tracts are of potential surgical importance. In hearts with double outlet right ventricle, the VSD can be categorized as being subaortic, subpulmonary, doubly committed, or non-committed. It is also important to determine whether its anatomical borders, as seen from the right ventricle, are in part fibrous or exclusively muscular, so as to establish the location of the atrioventricular conduction axis. It is possible, according to the nature of these borders, to place the defects into one of three groups, perimenbranous, muscular, or doubly committed and juxta-arterial. The size of the defect is another important surgical consideration. Double outlet left ventricle is a significantly more rare malformation, but the rules for determining the disposition of the conducting tissues are the same.

  15. Epigastric heteropagus associated with an omphalocele and double outlet right ventricle

    Directory of Open Access Journals (Sweden)

    Tatsuma Sakaguchi

    2015-10-01

    Full Text Available Incomplete or asymmetrical conjoined twins are extremely rare congenital anomalies. We report a case of epigastric heteropagus associated with an omphalocele and double outlet right ventricle. The cystic legion of the epigastrium was detected in our patient by an ultrasound scan at 28 weeks' gestation. He was born at 37 weeks' gestation by scheduled caesarean section. A parasite with an incomplete head and lower limb was attached to the epigastrium of the autosite. Surgical separation of the parasite and silo placement for an omphalocele was successfully performed on the 4th day of life. He underwent secondary surgical closure of the omphalocele on the 10th day. For treatment of the cardiac anomaly, he underwent an operation of Blalock–Taussig shunt because of pulmonary artery stenosis at the age of 3 months and correction of double outlet right ventricle at the age of 10 months. At the 20-month follow-up, he was alive and showed a normal growth pattern.

  16. Associations between access to alcohol outlets and alcohol intake and depressive symptoms in women from socioeconomically disadvantaged neighbourhoods in Australia

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    Karen E. Lamb

    2017-01-01

    Full Text Available Abstract Background This study examined associations between alcohol outlet access and alcohol intake, depressive symptoms score and risk of depression among women residing in disadvantaged neighbourhoods in Victoria, Australia. Methods Data on depressive symptoms, alcohol intake and socio-demographic characteristics were obtained from a sample of 995 adult women from Victoria, Australia who were surveyed as part of the Resilience in Eating and Activity Despite Inequality (READI study. The location of all licensed alcohol outlets in Victoria was obtained from the Victorian Commission for Gambling and Liquor Regulation. Participant and alcohol outlet addresses were geocoded to calculate individual alcohol outlet access, defined as the number of outlets (all and by sub-type within 0.4 km and 3 km of participants’ homes. Separate regression models with clustered standard errors were fitted to examine associations between access and alcohol intake according to national recommended limits for short- and long-term harm, frequency of consumption above long-term harm guidelines, depressive symptoms score and risk of depression. Results Odds of consumption within short-term harm guidelines (≤4 drinks on any day decreased with increasing access within 3 km, irrespective of outlet type. Typically, there was no evidence to support associations between access and consumption above long-term harm guidelines (>2 drinks on any day unless considering frequency of consumption at this level where results showed decreased odds of ‘don’t drink’ versus frequently drinking above long-term harm guidelines (i.e., >2 drinks at least once per week with increasing access at either distance. Although there was no evidence of an association between any of the alcohol outlet access measures and depressive symptoms score, odds of being at risk of depression decreased with increasing access within 3 km. Conclusions This study found some evidence to support an

  17. Component Analysis of Unsteady Hydrodynamic Force of Closed-Type Centrifugal Pump with Single Blades of Different Blade Outlet Angles

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    Yasuyuki Nishi

    2015-01-01

    Full Text Available Single-blade centrifugal impellers for sewage systems undergo both unsteady radial and axial thrusts. Therefore, it is extremely important for the improvement of pump reliability to quantitatively grasp these fluctuating hydrodynamic forces and determine the generation mechanism behind them. In this study, we conducted component analyses of radial and axial thrusts of closed, single-blade centrifugal pumps with different blade outlet angles by numerical analysis while considering leakage flow. The results revealed the effect of the blade outlet angle on the components of radial and axial thrusts. For increased flow rates, the time-averaged values of the pressure component were similar for all impellers, although its fluctuating components were higher for impellers with larger blade outlet angles. Moreover, the fluctuating inertia component of the impeller with a blade outlet angle of 8° decreased as the flow rate increased, whereas those with 16° and 24° angles increased. Therefore, the radial thrust on the hydraulic part was significantly higher for impellers with high blade outlet angles.

  18. Associations between childhood obesity and the availability of food outlets in the local environment: a retrospective cross-sectional study.

    Science.gov (United States)

    Miller, Laura J; Joyce, Sarah; Carter, Shannon; Yun, Grace

    2014-01-01

    Examine whether individual-level childhood obesity is related to residential availability of fast food and healthy food outlets. Retrospective cross-sectional study. Perth, Western Australia. A total of 1850 children aged 5 to 15 years in 2005-2010 who participated in the Western Australian Health and Wellbeing Surveillance System survey. Geographical Information Systems were used to calculate a range of measures of fast food and healthy food outlet access and availability. For example, distance to nearest and access and density measures within 800 m and 3 km of each child's residence were all tested. Multivariate logistic regression analysis, controlling for individual-level sociodemographic factors and lifestyle behaviors. An increasing number of healthy food outlets within 800 m of a child's home was associated with a significantly reduced risk of being overweight/obese in all models tested. After controlling for age, physical activity, time spent sedentary, weekly takeaway consumption, area disadvantage, and count of fast food outlets, each additional healthy food outlet within 800 m was associated with a 20% decrease in the likelihood of a child being overweight or obese (odds ratio: .800, 95% confidence intervals: .686-.933). The local food environment around children's homes has an independent effect on child weight status. These findings highlight the importance of the built environment as a potential contributor towards child health, which should be considered when developing community health promotion programs.

  19. Sea ice breakup and marine melt of a retreating tidewater outlet glacier in northeast Greenland (81°N).

    Science.gov (United States)

    Bendtsen, Jørgen; Mortensen, John; Lennert, Kunuk; K Ehn, Jens; Boone, Wieter; Galindo, Virginie; Hu, Yu-Bin; Dmitrenko, Igor A; Kirillov, Sergei A; Kjeldsen, Kristian K; Kristoffersen, Yngve; G Barber, David; Rysgaard, Søren

    2017-07-10

    Rising temperatures in the Arctic cause accelerated mass loss from the Greenland Ice Sheet and reduced sea ice cover. Tidewater outlet glaciers represent direct connections between glaciers and the ocean where melt rates at the ice-ocean interface are influenced by ocean temperature and circulation. However, few measurements exist near outlet glaciers from the northern coast towards the Arctic Ocean that has remained nearly permanently ice covered. Here we present hydrographic measurements along the terminus of a major retreating tidewater outlet glacier from Flade Isblink Ice Cap. We show that the region is characterized by a relatively large change of the seasonal freshwater content, corresponding to ~2 m of freshwater, and that solar heating during the short open water period results in surface layer temperatures above 1 °C. Observations of temperature and salinity supported that the outlet glacier is a floating ice shelf with near-glacial subsurface temperatures at the freezing point. Melting from the surface layer significantly influenced the ice foot morphology of the glacier terminus. Hence, melting of the tidewater outlet glacier was found to be critically dependent on the retreat of sea ice adjacent to the terminus and the duration of open water.

  20. The impact of inlet angle and outlet angle of guide vane on pump in reversal based hydraulic turbine performance

    Science.gov (United States)

    Shi, F. X.; Yang, J. H.; Wang, X. H.; Zhang, R. H.; Li, C. E.

    2012-11-01

    In this paper, in order to research the impact of inlet angle and outlet angle of guide vane on hydraulic turbine performance, a centrifugal pump in reversal is adopted as turbine. A numerical simulation method is adopted for researching outer performance and flow field of turbine. The results show: inlet angle has a crucial role to turbine, to the same flow, there is a noticeable decline for the efficiency and head of turbine with the inlet angle increases. At the best efficiency point(EFP),to a same inlet angle, when the inlet angle greater than inlet angle, velocity circulation in guide vane outlet decreases, which lead the efficiency of turbine to reduce, Contrarily, the efficiency rises. With the increase of inlet angle and outlet angle, the EFP moves to the big flow area and the uniformity of pressure distribution becomes worse. The paper indicates that the inlet angle and outlet angle have great impact on the turbine performance, and the best combination exists for the inlet angle and outlet angle of the guide vane.

  1. Greater access to healthy food outlets in the home and school environment is associated with better dietary quality in young children.

    Science.gov (United States)

    Barrett, Millie; Crozier, Sarah; Lewis, Daniel; Godfrey, Keith; Robinson, Sian; Cooper, Cyrus; Inskip, Hazel; Baird, Janis; Vogel, Christina

    2017-12-01

    To explore associations between dietary quality and access to different types of food outlets around both home and school in primary school-aged children. Cross-sectional observational study. Hampshire, UK. Children (n 1173) in the Southampton Women's Survey underwent dietary assessment at age 6 years by FFQ and a standardised diet quality score was calculated. An activity space around each child's home and school was created using ArcGIS. Cross-sectional observational food outlet data were overlaid to derive four food environment measures: counts of supermarkets, healthy specialty stores (e.g. greengrocers), fast-food outlets and total number of outlets, and a relative measure representing healthy outlets (supermarkets and specialty stores) as a proportion of total retail and fast-food outlets. In univariate multilevel linear regression analyses, better diet score was associated with exposure to greater number of healthy specialty stores (β=0·025 sd/store: 95 % CI 0·007, 0·044) and greater exposure to healthy outlets relative to all outlets in children's activity spaces (β=0·068 sd/10 % increase in healthy outlets as a proportion of total outlets, 95 % CI 0·018, 0·117). After adjustment for mothers' educational qualification and level of home neighbourhood deprivation, the relationship between diet and healthy specialty stores remained robust (P=0·002) while the relationship with the relative measure weakened (P=0·095). Greater exposure to supermarkets and fast-food outlets was associated with better diet only in the adjusted models (P=0·017 and P=0·014, respectively). The results strengthen the argument for local authorities to increase the number of healthy food outlets to which young children are exposed.

  2. A 70-year record of outlet glacier retreat in northern Greenland

    Science.gov (United States)

    Hill, Emily; Carr, Rachel; Stokes, Chris; Gudmundsson, Hilmar

    2017-04-01

    Over the past two decades, the Greenland Ice Sheet (GrIS) has undergone accelerated mass loss increasing its contribution to sea level rise. This is partly attributed to increased mass loss from dynamic marine-terminating outlet glaciers. Despite marine-terminating outlet glaciers in northern Greenland draining 40% of the ice sheet by area, they are comparatively less well-studied than other regions of the ice sheet (e.g. central west or south-east). This region could be susceptible to marine-ice sheet instability due to large proportions of the bedrock rested below sea level and is also unique in the presence of large floating ice tongues. Here, we use a range of satellite imagery sources, accompanied by historical maps, to examine multi-decadal front position changes at 21 outlet glaciers in northern Greenland between 1948 and 2016. We accompany these terminus changes, with annual records of ice velocity, climate-ocean forcing data, and glacier-specific factors (e.g. fjord-width and basal topography) to understand the dominant forcing on glacier dynamics in the region. Over the last 70 years, there has been a clear pattern of glacier retreat in northern Greenland. This is particularly notable during the last two decades, where 62% of our study glaciers showed accelerated retreat. This was most notable at Humboldt, Tracy, Hagen Brae, C. H. Ostenfeld and Petermann Glaciers, and in the case of the latter three glaciers, this involved substantial retreat of their floating ice tongues (> 10 km). Alongside retreat, several study glaciers underwent simultaneous velocity increases. However, the collapse of floating ice tongues did not always result in increased velocity. Similar to other regions of the ice sheet, recent glacier retreat in the northern regions of the Greenland Ice Sheet could be linked to climatic-oceanic forcing, but at this stage this remains largely unknown. This response to external forcing is further complicated by the presence of glacier

  3. Iatrogenic thoracic outlet syndrome secondary to vertical expandable prosthetic titanium rib expansion thoracoplasty: pathogenesis and strategies for prevention/treatment.

    Science.gov (United States)

    Nassr, Ahmad; Larson, Annalise Noelle; Crane, Benjamin; Hammerberg, Kim W; Sturm, Peter F; Mardjetko, Steven M

    2009-01-01

    An innovative treatment for thoracic insufficiency syndrome involves a vertical expansion of the chest wall through a horizontal chest wall osteotomy maintained by a distraction device (vertical expandable prosthetic titanium rib or VEPTR). Upper-extremity neurovascular dysfunction has been reported after expansion. The purposes of this study are to identify potential etiologies for compression of the brachial plexus after expansion thoracoplasty and to suggest strategies to reduce the incidence of this complication. A simulated VEPTR procedure was performed on 8 fresh cadaveric specimens. Manometric measurements were taken in the 3 anatomic regions of the thoracic outlet after thoracotomy and rib distraction were performed. Confirmation of the location of compression was performed by placing barium-impregnated putty along the course of the brachial plexus and evaluating the effect of expansion using video fluoroscopy. A midclavicular osteotomy was then performed and video fluoroscopy repeated. A 20% increase in pressure was seen in the costoclavicular region of the thoracic outlet after expansion. Constriction of the midclavicular region of the thoracic outlet between the first rib and clavicle was confirmed using the putty model. Midclavicular osteotomy alleviated this region of compression. Expansion thoracoplasty with the VEPTR procedure causes increased pressure in the costoclavicular region of the thoracic outlet. A midclavicular osteotomy may be one method to alleviate thoracic outlet narrowing after VEPTR procedure, although the short- and long-term effects of this is procedure is not known. Our model supports an iatrogenic thoracic outlet syndrome caused by expansion thoracoplasty. Based on our data as well as a review of the literature, we recommend intraoperative neurologic monitoring of the ipsilateral upper extremity during the VEPTR procedure.

  4. Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services.

    Science.gov (United States)

    Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew

    2014-05-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Effect of nozzle outlet angle on flow and temperature field in a slab continuous casting mould

    Directory of Open Access Journals (Sweden)

    L. Sowa

    2011-04-01

    Full Text Available The mathematical and numerical simulation model of the growth of the solid metal phase within a continuous cast slab is presented in thispaper. The problem was treated as a complex one. The velocity fields are obtained by solving the momentum equations and the continuityequation, whereas the thermal fields are calculated by solving the conduction equation with the convection term. One takes intoconsideration in the mathematical model the changes of thermophysical parameters depending on the temperature and the solid phasevolume fractions in the mushy zone. The problem was solved by the finite element method. A numerical simulation of the cast slabsolidification process was made for different cases of continuous casting mould pouring by molten metal. The effect of nozzle outlet angle on the velocity fields in liquid phase and the solid phase growth kinetics of the cast slab were investigated, because these magnitudes have essential an influence on high-quality of a continuous steel cast slab.

  6. THE DIVERSITY OF PLANT COVER IN THE BASIN WITHOUT OUTLET IN RELATION TO THE MOISTURE CONDITIONS

    Directory of Open Access Journals (Sweden)

    Magdalena Franczak

    2015-01-01

    Full Text Available Changes in the degree of habitat moisture are one of the major factors affecting the variability of plant communities and their constituent species populations. The aim of the study was to find if the quantitative and qualitative structure of the vegetation cover exhibits variability in relation to the degree of habitat moisture. The investigations were carried out in basin without outlets, i.e. small isolated hydrogenic object located in the agricultural landscape of the Lublin Upland. In basin, a transect was established, along which floristic inventories were made. In the years 2006–2013, the level of surface water were monitored. On this basis, four areas of habitat moisture were identified. The results indicate that the flora of the analysed object is characterised by a very broad spectrum of ecological tolerance. The vegetation cover is influenced by habitat moisture whose gradient determines the occurrence range of many species.

  7. Bilateral thoracic outlet syndrome: An uncommon presentation of a rare condition in children

    Directory of Open Access Journals (Sweden)

    Arif Khan

    2012-01-01

    Full Text Available We report an adolescent girl who had left-sided neurogenic thoracic outlet syndrome (TOS due to impingement of the scalenus anterior muscle with bilateral changes on nerve conduction studies and responded well to surgical decompression. A 13-year-old Caucasian girl presented with intermittent pain, swelling, erythema, tingling and numbness of the palmar aspect of her left hand. Nerve conduction studies revealed bilateral ulnar sensory and motor conduction abnormalities, suggesting early compressive neuropathy in the asymptomatic arm as well. She underwent surgical exploration when it was noted that the scalenus anterior itself was impinging on the brachial plexus. She had a good clinical response to scalenectomy. The diagnosis of neurogenic TOS remains difficult as no single test has been accepted as a gold standard. But, once diagnosed using clinical symptoms, nerve conduction studies, electromyography and radiological investigations, it is a treatable condition with good prognosis.

  8. PENGARUH KUALITAS PRODUK DAN HARGA TERHADAP KEPUTUSAN PEMBELIAN DI THESECRET FACTORY OUTLET

    Directory of Open Access Journals (Sweden)

    Anugrah Janwar Tunis

    2016-12-01

    ABSTRAK Tujuan dari penelitian ini adalah untuk mengetahui pengaruh kualitas produk dan harga terhadap keputusan pembelian di The Secret Factory Outlet Kota Bandung. Penelitian ini berjenis deskriptif-verifikatif. Adapun teknik sampling yang digunakan adalah incidental sampling dengan jumlah sampel sebanyak 100 responden. Teknik analisis data yang digunakan adalah analisis regresi linear berganda dengan pengujian hipotesis menggunakan uji R2, uji t, dan uji F. Penelitian ini juga dibantu dengan uji asumsi klasik yang terdiri dari uji normalitas, uji multikolinieritas, uji heteroskedastisitas, dan uji autokorelasi. Dari hasil pengujian secara statistik, diketahui bahwa kualitas produk berpengaruh positif dan signifikan terhadap keputusan pembelian dengan koefisien regresi = 0,060, harga berpengaruh positif dan signifikan terhadap keputusan pembelian dengan koefisien regresi = 0,833, dan kualitas produk dan harga berpengaruh secara simultan sebesar 68,3% terhadap keputusan pembelian.   Kata Kunci: Kualitas Produk, Harga, dan Keputusan Pembelian.

  9. Seasonal and interannual phytoplankton production in a sub-arctic tidewater outlet glacier fjord, west Greenland

    DEFF Research Database (Denmark)

    Juul-Pedersen, T.; Arendt, K.; Mortensen, J.

    2015-01-01

    This study describes seasonal patterns and proposes likely drivers of an unusual phytoplankton primary production pattern in the outer-sill region of a tidewater outlet glacierinfluenced fjord (Godthåbsfjord) in SW Greenland. It is based on monthly measurements of pelagic primary production...... and hydrographic conditions during a 7 yr period. Total annual primary production during 2005 to 2012 was between 84.6 and 139.1 g C m−2 yr−1. Two phytoplankton blooms of similar magnitude reoccur in the fjord every year. A ‘classical’ spring bloom of up to 1743 mg C m−2 d−1 occurred in late April/early May...... the Greenland Ice Sheet are thus likely to affect phytoplankton dynamics in the fjord....

  10. Two Cases of Helicobacter pylori-Negative Gastric Outlet Obstruction in Children

    Directory of Open Access Journals (Sweden)

    Raza A. Patel

    2011-01-01

    Full Text Available Gastric outlet obstruction (GOO in children is most commonly caused by idiopathic hypertrophic pyloric stenosis. Prior to proton pump inhibitors and H2 blockers, peptic ulcer disease (PUD secondary to H. pylori was a cause of GOO. Both patients presented with a history of weight loss, vomiting, and abdominal pain. Their diagnosis of PUD and GOO was made by EGD and UGI. H. pylori testing was negative for both on multiple occasions but still received H. pylori eradication therapy. Patient 1 after failing pharmaceutical management underwent surgery for definitive treatment. Patient 2 underwent six therapeutic pyloric dilations before undergoing surgery as definitive treatment. These cases suggest that GOO secondary to PUD occurs in the absence of H. pylori infection and surgical management can provide definitive therapy.

  11. TEMPORARY OUTLET CENTER. Riuso e rivitalizzazione di aree dismesse attraverso il commercio itinerante

    Directory of Open Access Journals (Sweden)

    Gabriele Gaiti

    2011-12-01

    Full Text Available I luoghi dello shopping e del consumo sono diventati, in modo sempre più evidente, i nuovi luoghi pubblici di attrazione della città contemporanea. Com’è possibile sfruttare il potere attrattivo del commercio senza generare ulteriore consumo di suolo? Il Temporary Outlet Center (TOC cerca di conciliare queste due istanze, apparentemente così lontane tra loro, mediante lo sviluppo dei concetti di temporaneità e mobilità. Il progetto prevede un intervento a “cubatura zero” basato su strutture leggere interamente smontabili e aggregabili tra loro in infinite soluzioni, che non costruisca nulla di fisso ad eccezione delle urbanizzazioni primarie. L’esperienza dello shopping potrà quindi fungere da attivatore urbano per aree dismesse da riqualificare all’interno del tessuto urbano o aree degradate da rivitalizzare.

  12. Successful extensive enlargement of a non-committed ventricular septal defect in double outlet right ventricle.

    Science.gov (United States)

    Ishibashi, Nobuyuki; Aoki, Mitsuru; Fujiwara, Tadashi

    2005-08-01

    We performed an arterial switch operation in a patient with double outlet right ventricle with non-committed ventricular septal defect, and abnormal insertion of the tension apparatus of the tricuspid valve which produced moderate tricuspid regurgitation. This required extensive enlargement of the ventricular septal defect between the attachments of the cords of the tricuspid valve so as to create the interventricular rerouting that made possible the arterial switch operation. Postoperatively, we produced a straight, unobstructed, left ventricular outflow tract, improved the extent of tricuspid regurgitation, and achieved low right atrial pressures. Enlargement of the interventricular communication can set the scene for biventricular repair in this particular subset of patients with both arterial trunks arising from the morphologically right ventricle.

  13. Radiological evaluation of double-outlet right ventricle - An analysis of cinecardioangiography in 44 cases -

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheong Hee; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completely from the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; and usually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases of double-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department of Radiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to the segmental combinations, the height of conus, the relationship of great arteries, the location of ventricular septal defects, and associated anomalies. The results were as follows; 1. Among 44 cases, 36 cases had normal cardiac position, 4 cases had dextrocardia with situs inversus 2 cases had dextrocardia with situs solitus, 1 case had levocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were [S,D,D] in 36 cases, [I,L,L] in 3 cases, [I,D,D] in 2 cases, [S,D,L], [S,L,L] and [A,D,D] in 1 case respectively. 3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lower than pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2 cases. 4. The relation of the great arteries were normal in 15 cases, side-by-side in 13 cases, dextromalposition in 13 cases, and levomal position in 3 cases. 5. The position of the ventricular septal defects with respect to the origins of the great arteries is subaortic (type A and type B) in 23 cases, subpulmonary (type C) in 13 cases, doubly committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations are pulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C, left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery

  14. Seasonal speed-up of two outlet glaciers of Austfonna, Svalbard, inferred from continuous GPS measurements

    Directory of Open Access Journals (Sweden)

    T. Dunse

    2012-04-01

    Full Text Available A large part of the ice discharge from ice caps and ice sheets occurs through spatially limited flow units that may operate in a mode of steady flow or cyclic surge behaviour. Changes in the dynamics of distinct flow units play a key role in the mass balance of Austfonna, the largest ice cap on Svalbard. The recent net mass loss of Austfonna was dominated by calving from marine terminating outlet glaciers. Previous ice-surface velocity maps of the ice cap were derived by satellite radar interferometry (InSAR and rely on data acquired in the mid-1990s with limited information concerning the temporal variability. Here, we present continuous Global Positioning System (GPS observations along the central flowlines of two fast flowing outlet glaciers over 2008–2010. The data show prominent summer speed-ups with ice-surface velocities as high as 240% of the pre-summer mean. Acceleration follows the onset of the summer melt period, indicating enhanced basal motion due to input of surface meltwater into the subglacial drainage system. In 2008, multiple velocity peaks coincide with successive melt periods. In 2009, the major melt was of higher amplitude than in 2008. Flow velocities appear unaffected by subsequent melt periods, suggesting a transition towards a hydraulically more efficient drainage system. The observed annual mean velocities of Duvebreen and Basin-3 exceed those from the mid-1990s by factors two and four, respectively, implying increased ice discharge at the calving front. Measured summer velocities up to 2 m d−1 for Basin-3 are close to those of Kronebreen, often referred to as the fastest glacier on Svalbard.

  15. Vector Flow Visualization of Urinary Flow Dynamics in a Bladder Outlet Obstruction Model.

    Science.gov (United States)

    Ishii, Takuro; Yiu, Billy Y S; Yu, Alfred C H

    2017-11-01

    Voiding dysfunction that results from bladder outlet (BO) obstruction is known to alter significantly the dynamics of urine passage through the urinary tract. To non-invasively image this phenomenon on a time-resolved basis, we pursued the first application of a recently developed flow visualization technique called vector projectile imaging (VPI) that can track the spatiotemporal dynamics of flow vector fields at a frame rate of 10,000 fps (based on plane wave excitation and least-squares Doppler vector estimation principles). For this investigation, we designed a new anthropomorphic urethral tract phantom to reconstruct urinary flow dynamics under controlled conditions (300 mm H2O inlet pressure and atmospheric outlet pressure). Both a normal model and a diseased model with BO obstruction were developed for experimentation. VPI cine loops were derived from these urinary flow phantoms. Results show that VPI is capable of depicting differences in the flow dynamics of normal and diseased urinary tracts. In the case with BO obstruction, VPI depicted the presence of BO flow jet and vortices in the prostatic urethra. The corresponding spatial-maximum flow velocity magnitude was estimated to be 2.43 m/s, and it is significantly faster than that for the normal model (1.52 m/s) and is in line with values derived from computational fluid dynamics simulations. Overall, this investigation demonstrates the feasibility of using vector flow visualization techniques to non-invasively examine internal flow characteristics related to voiding dysfunction in the urethral tract. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  16. Cosmogenic nuclides constrain surface fluctuations of an East Antarctic outlet glacier since the Pliocene

    Science.gov (United States)

    Jones, R. S.; Norton, K. P.; Mackintosh, A. N.; Anderson, J. T. H.; Kubik, P.; Vockenhuber, C.; Wittmann, H.; Fink, D.; Wilson, G. S.; Golledge, N. R.; McKay, R.

    2017-12-01

    Understanding past changes in the Antarctic ice sheets provides insight into how they might respond to future climate warming. During the Pliocene and Pleistocene, geological data show that the East Antarctic Ice Sheet responded to glacial and interglacial cycles by remaining relatively stable in its interior, but oscillating at its marine-based margin. It is currently not clear how outlet glaciers, which connect the ice sheet interior to its margin, responded to these orbitally-paced climate cycles. Here we report new ice surface constraints from Skelton Glacier, an outlet of the East Antarctic ice sheet, which drains into the Ross Ice Shelf. Our multiple-isotope (10Be and 26Al) cosmogenic nuclide data indicate that currently ice-free areas adjacent to the glacier underwent substantial periods of exposure and ice cover in the past. We use an exposure-burial model driven by orbitally-paced glacial-interglacial cycles to determine the probable ice surface history implied by our data. This analysis shows that: 1) the glacier surface has likely fluctuated since at least the Pliocene; 2) the ice surface was >200 m higher than today during glacial periods, and the glacier has been thicker than present for ∼75-90% of each glacial-interglacial cycle; and 3) ice cover at higher elevations possibly occurred for a relatively shorter time per Pliocene cycle than Pleistocene cycle. Our multiple-nuclide approach demonstrates the magnitude of ice surface fluctuations during the Pliocene and Pleistocene that are linked to marine-based ice margin variability.

  17. Obesity and the built environment: does the density of neighborhood fast-food outlets matter?

    Science.gov (United States)

    Li, Fuzhong; Harmer, Peter; Cardinal, Bradley J; Bosworth, Mark; Johnson-Shelton, Deb

    2009-01-01

    Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics. Cross-sectional and multilevel design. Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boundary in Portland, Oregon. A total of 1221 residents (mean age, 65 years) recruited randomly from 120 neighborhoods (48% response rate). A geographic information system-based measure of fast food restaurant density across 120 neighborhoods was created. Residents within the sampled neighborhoods were assessed with respect to their body mass indices (BMI), frequency of visits to local fast food restaurants, fried food consumption, levels of physical activity, self-efficacy of eating fruits and vegetables, household income, and race/ethnicity. Multilevel logistic regression analyses. Significant associations were found between resident-level individual characteristics and the likelihood of being obese (BMI > or = 30) for neighborhoods with a high-density of fast food restaurants in comparison with those with a low density: odds ratios for obesity, 95% confidence intervals (CI), were 1.878 (CI, 1.006-3.496) for weekly visits to local fast food restaurants; 1.792 (CI, 1.006-3.190) for not meeting physical activity recommendations; 1.212 (CI, 1.057-1.391) for low confidence in eating healthy food; and 8.057 (CI, 1.705-38.086) for non-Hispanic black residents. Increased density of neighborhood fast food outlets was associated with unhealthy lifestyles, poorer psychosocial profiles, and increased risk of obesity among older adults.

  18. Compensatory Paracrine Mechanisms That Define The Urothelial Response to Injury in Partial Bladder Outlet Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Bassuk, James; Lendvay, Thomas S.; Sweet, Robert; Han, Chang-Hee; Soygur, Tarkan; Cheng, Jan-Fang; Plaire, J. Chadwick; Charleston, Jay S.; Charleston, Lynne B.; Bagai, Shelly; Cochrane, Kimberly; Rubio, Eric; Bassuk, James A.; Fuchs, Elaine

    2007-06-21

    Diseases and conditions affecting the lower urinary tract are a leading cause of dysfunctional sexual health, incontinence, infection, and kidney failure. The growth, differentiation, and repair of the bladder's epithelial lining are regulated, in part, by fibroblast growth factor (FGF)-7 and -10 via a paracrine cascade originating in the mesenchyme (lamina propria) and targeting the receptor for FGF-7 and -10 within the transitional epithelium (urothelium). The FGF-7 gene is located at the 15q15-q21.1 locus on chromosome 15 and four exons generate a 3.852-kb mRNA. Five duplicated FGF-7 gene sequences that localized to chromosome 9 were predicted not to generate functional protein products, thus validating the use of FGF-7-null mice as an experimental model. Recombinant FGF-7 and -10 induced proliferation of human urothelial cells in vitro and transitional epithelium of wild-type and FGF-7-null mice in vivo.To determine the extent that induction of urothelial cell proliferation during the bladder response to injury is dependent on FGF-7, an animal model of partial bladder outlet obstruction was developed. Unbiased stereology was used to measure the percentage of proliferating urothelial cells between obstructed groups of wild-type and FGF-7-null mice. The stereological analysis indicated that a statistical significant difference did not exist between the two groups, suggesting that FGF-7 is not essential for urothelial cell proliferation in response to partial outlet obstruction. In contrast, a significant increase in FGF-10 expression was observed in the obstructed FGF-7-null group, indicating that the compensatory pathway that functions in this model results in urothelial repair.

  19. Multilevel spatio-temporal dual changepoint models for relating alcohol outlet destruction and changes in neighbourhood rates of assaultive violence

    Science.gov (United States)

    Yu, Qingzhao; Scribner, Richard; Carlin, Brad; Theall, Katherine; Simonsen, Neal; Ghosh-Dastidar, Bonnie; Cohen, Deborah; Mason, Karen

    2008-01-01

    Many previous studies have suggested a link between alcohol outlets and assaultive violence. In this paper, we evaluate the impact of the “1992 Civil Unrest” in Los Angeles (which followed the “Rodney King incident”), in which many alcohol outlets were damaged leading to a decrease in alcohol outlet density, on crime. We leverage the natural experiment created by the closure of alcohol outlets in certain areas and not others to explore the effects of alcohol availability on assault crimes at the census tract level. We develop a hierarchical model that controls for important covariates (such as race and socio-economic status) and accounts for unexplained spatial and temporal variability. While our model is somewhat complex, its hierarchical Bayesian analysis is accessible via the WinBUGS software. Our results show that, keeping other effects fixed, the reduction in alcohol availability within a census tract was associated with a drop in the assaultive violence rate at the census tract level. Comparing several dual candidate changepoint models using the Deviance Information Criterion, the drop in assaultive violence rate is best seen as having occurred one year after the reduction in alcohol availability, with the effect lasting roughly five years. We also create maps of the fitted assault rates in Los Angeles, as well as spatial residual maps that suggest various spatially-varying covariates are still missing from our model. PMID:18686265

  20. Numerical Research about Influence of Blade Outlet Angle on Flow-Induced Noise and Vibration for Centrifugal Pump

    Directory of Open Access Journals (Sweden)

    Ailing Yang

    2014-03-01

    Full Text Available A hybrid numerical method was used to calculate the flow-induced noise and vibration of the centrifugal pump in the paper. The unsteady flows inside the centrifugal pumps with different blade outlet angles were simulated firstly. The unsteady pressure on the inner surface of the volute and the unsteady force applied on the impeller were analyzed. Then the vibration of the volute and sound field were calculated based on an acoustic-vibro-coupling method. The results show that the pump head has increased 7% while the hydraulic efficiency decreased 11.75% as blade outlet angles increased from 18° to 39°. The amplitude of pressure fluctuation at the first blade passing frequency has decreased but increased at the second-order blade passing frequency as the angle growing. The total fluctuation power near volute tongue goes up about 12% every 3° increment of blade outlet angle. The results also show that vibrating-velocity of the volute at second-order blade passing frequency is much higher than at other frequencies, and the velocity increases rapidly as blade outlet angle varies from 18° to 39°. At the same time, the sound pressure level outside the pump has increased about 8.6 dB when the angle increased from 18° to 39°.

  1. Highly temporally resolved response to seasonal surface melt of the Zachariae and 79N outlet glaciers in Northeast Greenland

    DEFF Research Database (Denmark)

    Rathmann, N. M.; Hvidberg, C. S.; Solgaard, A. M.

    2017-01-01

    The seasonal response to surface melting of the Northeast Greenland Ice Stream outlets, Zachariae and 79N, is investigated using new highly temporally resolved surface velocity maps for 2016 combined with numerical modelling. The seasonal speed-up at 79N of 0.15km/yr is suggested to be driven by ...

  2. Multilevel spatio-temporal dual changepoint models for relating alcohol outlet destruction and changes in neighbourhood rates of assaultive violence

    Directory of Open Access Journals (Sweden)

    Qingzhao Yu

    2008-05-01

    Full Text Available Many previous studies have suggested a link between alcohol outlets and assaultive violence. In this paper, we evaluate the impact of the “1992 Civil Unrest” in Los Angeles (which followed the “Rodney King incident”, in which many alcohol outlets were damaged leading to a decrease in alcohol outlet density, on crime. We leverage the natural experiment created by the closure of alcohol outlets in certain areas and not others to explore the effects of alcohol availability on assault crimes at the census tract level. We develop a hierarchical model that controls for important covariates (such as race and socio-economic status and accounts for unexplained spatial and temporal variability. While our model is somewhat complex, its hierarchical Bayesian analysis is accessible via the WinBUGS software. Our results show that, keeping other effects fixed, the reduction in alcohol availability within a census tract was associated with a drop in the assaultive violence rate at the census tract level. Comparing several dual candidate changepoint models using the Deviance Information Criterion, the drop in assaultive violence rate is best seen as having occurred one year after the reduction in alcohol availability, with the effect lasting roughly five years. We also create maps of the fitted assault rates in Los Angeles, as well as spatial residual maps that suggest various spatially-varying covariates are still missing from our model.

  3. Dirty money: an investigation into the hygiene status of some of the world's currencies as obtained from food outlets

    NARCIS (Netherlands)

    Vriesekoop, F.; Russel, C.; Alvarez-Mayorga, B.; Aidoo, K.; Yuan, Q.; Scannell, A.; Beumer, R.R.; Jiang, X.; Barro, N.; Otokunefor, K.; Smith-Arnold, C.; Heap, A.; Chen, J.; Iturriage, M.H.; Hazeleger, W.C.; DesLandes, J.; Kinley, B.; Wilson, K.; Menz, G.

    2010-01-01

    A total of 1280 banknotes were obtained from food outlets in 10 different countries (Australia, Burkina Faso, China, Ireland, the Netherlands, New Zealand, Nigeria, Mexico, the United Kingdom, and the United States), and their bacterial content was enumerated. The presence of bacteria on banknotes

  4. Bladder outlet obstruction in a 6-month-old alpaca secondary to pelvic displacement of the urinary bladder

    OpenAIRE

    McClanahan, Susan L.; Malone, Erin D.; Anderson, Kari L.

    2005-01-01

    A 6-month-old female alpaca was presented for stranguria. Based on the history, physical examination findings, and radiographic studies, the alpaca was diagnosed with bladder outlet obstruction, secondary to pelvic displacement of the bladder, a condition previously unreported in camelids. Cystopexy was performed and the alpaca recovered unremarkably.

  5. 26 CFR 48.4071-3 - Imposition of tax on tires and tubes delivered to manufacturer's retail outlet.

    Science.gov (United States)

    2010-04-01

    ... (unless, before such delivery, tax was imposed on the same tires and tubes). (3) Retail outlet maintained... tube at the rate set forth in section 4071 in the same manner as if the tire or tube had been sold at... consecutive calendar months during the 2-year period immediately preceding the first day included in the...

  6. Spatial analysis of the association of alcohol outlets and alcohol-related pedestrian/bicyclist injuries in New York City.

    Science.gov (United States)

    DiMaggio, Charles; Mooney, Stephen; Frangos, Spiros; Wall, Stephen

    2016-12-01

    Pedestrian and bicyclist injury is an important public health issue. The retail environment, particularly the presence of alcohol outlets, may contribute the the risk of pedestrian or bicyclist injury, but this association is poorly understood. This study quantifies the spatial risk of alcohol-related pedestrian injury in New York City at the census tract level over a recent 10-year period using a Bayesian hierarchical spatial regression model with Integrated Nested Laplace approximations. The analysis measures local risk, and estimates the association between the presence of alcohol outlets in a census tract and alcohol-involved pedestrian/bicyclist injury after controlling for social, economic and traffic-related variables. Holding all other covariates to zero and adjusting for both random and spatial variation, the presence of at least one alcohol outlet in a census tract increased the risk of a pedestrian or bicyclist being struck by a car by 47 % (IDR = 1.47, 95 % Credible Interval (CrI) 1.13, 1.91). The presence of one or more alcohol outlets in a census tract in an urban environment increases the risk of bicyclist/pedestrian injury in important and meaningful ways. Identifying areas of increased risk due to alcohol allows the targeting of interventions to prevent and control alcohol-related pedestrian and bicyclist injuries.

  7. Development of a noninvasive method to diagnose bladder outlet obstruction based on decorrelation of sequential ultrasound images

    NARCIS (Netherlands)

    Arif, M.; Idzenga, T.; Korte, C.L. de; Mastrigt, R. van

    2015-01-01

    OBJECTIVE: To develop an ultrasound (US)-based method for noninvasive diagnosing of bladder outlet obstruction, and the relationship between decorrelation of sequential US images and the degree of obstruction in a urethra model was studied. MATERIALS AND METHODS: A flexible model of a male urethra

  8. Experimental results showing the internal three-component velocity field and outlet temperature contours for a model gas turbine combustor

    CSIR Research Space (South Africa)

    Meyers, BC

    2011-09-01

    Full Text Available A three-component flow field inside a can-type, forward flow experimental combustor was measured under non-reacting conditions. The combustor was run at atmospheric conditions with the air flow supplied from a fan and the outlet was straight...

  9. Engineering geology model of the Crater Lake outlet, Mt. Ruapehu, New Zealand, to inform rim breakout hazard

    Science.gov (United States)

    Cook, Stefan C. W.; Kennedy, Ben M.; Villeneuve, Marlène C.

    2018-01-01

    Mt. Ruapehu, in the central North Island of New Zealand, hosts a hot acidic Crater Lake over the active volcanic vent with a surface elevation of c. 2530 m.a.s.l. Volcanic activity and other montane processes have previously resulted in catastrophic releases of some or all of the c. 10 Mm3 of water retained in the lake, creating serious hazards downstream. A major lahar in March 2007 exposed a 10 m high face representative of the rock units impounding the lake, providing an opportunity to conduct both field and laboratory analysis to characterise the rock mass conditions at the outlet to assess the stability of the outlet area. This paper presents an engineering geology model of Crater Lake outlet. Our model shows three andesitic geological units at the outlet, each with different geological histories and physical and mechanical properties, which impact its stability. Geotechnical methods used to characterise the outlet include laboratory testing of the strength, stiffness, porosity and unit weight, and field-based rock mass characterisation using the geological strength index (GSI) and rock mass rating (RMR). Field observations, geomorphology mapping, historic and contemporary photographs, and laboratory results are combined to create cross sections that provide key information for establishing the engineering geology model. The units are recognised in what is informally termed the Crater Lake Formation: i) The upper surface layer is a c. 2 m thick sub-horizontal dark grey lava unit (Armoured Lava Ledge) with sub-horizontal cooling joints spaced at 0.2 m to 2.0 m intervals. The intact rock has a porosity range of 15-27%, density range of 1723-2101 kg/m3, GSI range of 45-75, and unconfined compressive strength (UCS) range of 19-48 MPa. ii) Below this, and outcropping down the majority of the outlet waterfall is a poorly sorted breccia unit composed of block and matrix material (Lava Breccia). The blocks range from 0.1 m to 0.8 m in diameter with an average porosity

  10. Performance of different PEEP valves and helmet outlets at increasing gas flow rates: a bench top study.

    Science.gov (United States)

    Isgrò, S; Zanella, A; Giani, M; Abd El Aziz El Sayed Deab, S; Pesenti, A; Patroniti, N

    2012-10-01

    Aim of the paper was to assess the performance of different expiratory valves and the resistance of helmet outlet ports at increasing gas flow rates. A gas flow-meter was connected to 10 different expiratory peep valves: 1 water-seal valve, 4 precalibrated fixed PEEP valves and 5 adjustable PEEP valves. Three new valves of each brand, set at different pressure levels (5-7.5-10-12.5-15 cmH(2)O, if available), were tested at increasing gas flow rates (from 30 to 150 L/min). We measured the pressure generated just before the valves. Three different helmets sealed on a mock head were connected at the inlet port with a gas flow-meter while the outlet was left clear. We measured the pressure generated inside the helmet (due to the flow-resistance of the outlet port) at increasing gas flow rates. Adjustable valves showed a variable degree flow-dependency (increasing difference between the measured and the expected pressure at increasing flow rates), while pre-calibrated valves revealed a flow-independent behavior. Water seal valve showed low degree flow-dependency. The pressures generated by the outlet port of the tested helmets ranged from 0.02 to 2.29 cmH(2)O at the highest gas flow rate. Adjustable PEEP valves are not suggested for continuous-flow CPAP systems as their flow-dependency can lead to pressures higher than expected. Precalibrated and water seal valves exhibit the best performance. Different helmet outlet ports do not significantly affect the pressure generated during helmet CPAP. In order to avoid iatrogenic complications gas flow and pressure delivered during helmet CPAP must always be monitored.

  11. Food sales outlets, food availability, and the extent of nutrition policy implementation in schools in British Columbia.

    Science.gov (United States)

    Rideout, Karen; Levy-Milne, Ryna; Martin, Carla; Ostry, Aleck S

    2007-01-01

    The purpose of this study was to determine the number and types of different food sales outlets, the types of foods offered for sale in all school food outlets, and the extent of nutrition policy implementation in schools in British Columbia. We also directly measured the number and types of snack foods available for sale in each vending machine at each school. Based on a thorough literature review and guided by an expert panel of nutritionists, we developed an instrument to measure the quantity and types of foods offered for sale in vending machines, the types of food for sale in all school food outlets, and the extent of nutrition policy development. The survey response rate was approximately 70%. Approximately 60% of surveyed schools had a permanent food sales outlet. Snack and beverage vending machines were most common in secondary schools, while tuck shops and food-based fundraisers were more common in elementary schools. While few snack vending machines were present in elementary schools, tuck shops stocked items commonly found in snack machines. Approximately 25% of schools had a formal group responsible for nutrition. These schools were more likely to have nutrition policies in place. "Junk" foods were widely available in elementary, middle, and secondary schools through a variety of outlets. Although snack machines are virtually absent in elementary schools, tuck shops and school fundraisers sell foods usually found in snack machines, largely cancelling the positive effect of the absence of snack machines in these schools. Schools with a group responsible for nutrition appear to have a positive impact on nutrition policy implementation.

  12. Perturbation of dynamic response at short outlets glaciers of Jostedalsbreen, maritime South Norway?

    Science.gov (United States)

    Winkler, Stefan

    2010-05-01

    Mountain glaciers are key indicators of global climate change. Changes in glacier volume, area, and length are determined by the climate and related mass flux/glacier flow. For several aspects of sustainable development in high-mountain regions (hydro-electric energy, water supply, tourism, etc.) it is crucial to estimate future glacier variations. Therefore, the interactions and relationships between individual meteorological and glaciological parameters need to be known before any model can be applied. Due to their steep mass balance gradient and high mass turnover, maritime mountain glaciers might respond very sensitively to changes of predominant weather or climate conditions. The steep outlet glaciers of Jostedalsbreen, western South Norway, underwent two fairly contrasting periods during the past 20 years. Interpretation of this ‘extreme' behaviour presented here deserved special attention. Detailed analysis of mass-balance, length variation, and climate data from maritime Southern Norway reveals their variations are not entirely determined by air temperature changes. A considerable increase in ice mass and related frontal advance during the AD 1990s was caused by increased winter precipitation. By contrast, a frontal retreat starting around AD 2000 continued and accelerated in recent years. Although above-average summer air temperatures unambiguously were responsible for this retreat, its proportion significantly exceeded the slight contemporary glacier mass loss. Since 2000, length variations at the short outlets of Jostedalsbreen seem to be decoupled from the net mass-balance data series. Additionally, the dynamic response of the glacier front to net balance and mass flux variations has been disturbed. Previously applicable terminus reaction times of 3 to 4 years have been replaced by an immediate response to higher summer air temperatures. The correlation of net balance to length variation dropped significant since AD 2000. Comparable changes between

  13. Area deprivation and the food environment over time: A repeated cross-sectional study on takeaway outlet density and supermarket presence in Norfolk, UK, 1990–2008

    Science.gov (United States)

    Maguire, Eva R.; Burgoine, Thomas; Monsivais, Pablo

    2015-01-01

    Socioeconomic disparities in the food environment are known to exist but with little understanding of change over time. This study investigated the density of takeaway food outlets and presence of supermarkets in Norfolk, UK between 1990 and 2008. Data on food retail outlet locations were collected from telephone directories and aggregated within electoral wards. Supermarket presence was not associated with area deprivation over time. Takeaway food outlet density increased overall, and was significantly higher in more deprived areas at all time points; furthermore, socioeconomic disparities in takeaway food outlet density increased across the study period. These findings add to existing evidence and help assess the need for environmental interventions to reduce disparities in the prevalence of unhealthy food outlets. PMID:25841285

  14. Area deprivation and the food environment over time: A repeated cross-sectional study on takeaway outlet density and supermarket presence in Norfolk, UK, 1990-2008.

    Science.gov (United States)

    Maguire, Eva R; Burgoine, Thomas; Monsivais, Pablo

    2015-05-01

    Socioeconomic disparities in the food environment are known to exist but with little understanding of change over time. This study investigated the density of takeaway food outlets and presence of supermarkets in Norfolk, UK between 1990 and 2008. Data on food retail outlet locations were collected from telephone directories and aggregated within electoral wards. Supermarket presence was not associated with area deprivation over time. Takeaway food outlet density increased overall, and was significantly higher in more deprived areas at all time points; furthermore, socioeconomic disparities in takeaway food outlet density increased across the study period. These findings add to existing evidence and help assess the need for environmental interventions to reduce disparities in the prevalence of unhealthy food outlets. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Bed topography under Greenland outlet glaciers revealed by Operation IceBridge data and mass conservation

    Science.gov (United States)

    Morlighem, M.; Rignot, E. J.; Mouginot, J.; Seroussi, H. L.; Larour, E. Y.

    2012-12-01

    Detailed maps of bed elevation and ice thickness are essential to many glaciological applications, including ice sheet numerical models. These maps are typically obtained using airborne radar-sounding profiler data interpolated onto regular grids using geostatistical techniques, such as kriging. While this approach provides continuous maps of bedrock elevation, it generates products that are not consistent with ice flow dynamics and are impractical for high-resolution ice flow simulations. Here, we first analyze radar-sounding data from a dense survey of Russell Glacier, in central-west Greenland, collected in 2010 and 2011 by NASA's Operation IceBridge. We compare gridded maps of bed elevation obtained using (1) radar tomography, (2) ordinary kriging and (3) mass conversation. Radar tomography eliminates radar-sounding profiler errors caused by off-nadir bed reflections to yield reference bed elevations. Ordinary kriging yields a standard error of 50 m at 500 m resolution, but with model artifacts in between tracks and flux divergence errors larger than 200 m/yr, which confound ice sheet flow models. Mass conservation optimally combines radar-sounding profiler data with independently gridded ice velocity data to lower the standard error to 30 m and flux divergence errors smaller than 1 m/yr. More importantly, mass conservation uniquely reveals complex structural features in bed elevation, e.g. valleys, ridges, bumps and hollows, that play a central role in channelizing ice flow toward the ice sheet margin. We then apply this technique to other outlet glaciers along the west coast of Greenland. The application of the mass conservation method to the entire ice sheet periphery, combined with radar tomography, promises to be transformative in our knowledge of basal topography in coastal Greenland, especially for the modeling of its outlet glaciers. This work was performed at the University of California Irvine and the California Institute of Technology's Jet

  16. Comparative analysis of two methods for measuring sales volumes during malaria medicine outlet surveys.

    Science.gov (United States)

    Patouillard, Edith; Kleinschmidt, Immo; Hanson, Kara; Pok, Sochea; Palafox, Benjamin; Tougher, Sarah; O'Connell, Kate; Goodman, Catherine

    2013-09-05

    There is increased interest in using commercial providers for improving access to quality malaria treatment. Understanding their current role is an essential first step, notably in terms of the volume of diagnostics and anti-malarials they sell. Sales volume data can be used to measure the importance of different provider and product types, frequency of parasitological diagnosis and impact of interventions. Several methods for measuring sales volumes are available, yet all have methodological challenges and evidence is lacking on the comparability of different methods. Using sales volume data on anti-malarials and rapid diagnostic tests (RDTs) for malaria collected through provider recall (RC) and retail audits (RA), this study measures the degree of agreement between the two methods at wholesale and retail commercial providers in Cambodia following the Bland-Altman approach. Relative strengths and weaknesses of the methods were also investigated through qualitative research with fieldworkers. A total of 67 wholesalers and 107 retailers were sampled. Wholesale sales volumes were estimated through both methods for 62 anti-malarials and 23 RDTs and retail volumes for 113 anti-malarials and 33 RDTs. At wholesale outlets, RA estimates for anti-malarial sales were on average higher than RC estimates (mean difference of four adult equivalent treatment doses (95% CI 0.6-7.2)), equivalent to 30% of mean sales volumes. For RDTs at wholesalers, the between-method mean difference was not statistically significant (one test, 95% CI -6.0-4.0). At retail outlets, between-method differences for both anti-malarials and RDTs increased with larger volumes being measured, so mean differences were not a meaningful measure of agreement between the methods. Qualitative research revealed that in Cambodia where sales volumes are small, RC had key advantages: providers were perceived to remember more easily their sales volumes and find RC less invasive; fieldworkers found it more

  17. Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.

    Directory of Open Access Journals (Sweden)

    Theodoor Visser

    Full Text Available Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal access to prompt parasite-based diagnosis, many malaria-endemic countries are considering scaling up malaria rapid diagnostic tests (RDTs in these outlets, an intervention that may require legislative changes and major investments in supporting programs and infrastructures. This review identifies studies that introduced malaria RDTs in PMRs and examines study outcomes and success factors to inform scale up decisions.Published and unpublished studies that introduced malaria RDTs in PMRs were systematically identified and reviewed. Literature published before November 2016 was searched in six electronic databases, and unpublished studies were identified through personal contacts and stakeholder meetings. Outcomes were extracted from publications or provided by principal investigators.Six published and six unpublished studies were found. Most studies took place in sub-Saharan Africa and were small-scale pilots of RDT introduction in drug shops or pharmacies. None of the studies assessed large-scale implementation in PMRs. RDT uptake varied widely from 8%-100%. Provision of artemisinin-based combination therapy (ACT for patients testing positive ranged from 30%-99%, and was more than 85% in five studies. Of those testing negative, provision of antimalarials varied from 2%-83% and was less than 20% in eight studies. Longer provider training, lower RDT retail prices and frequent supervision appeared to have a positive effect on RDT uptake and provider adherence to test results. Performance of RDTs by PMR vendors was generally good, but disposal of medical waste and referral of patients to public facilities were common challenges.Expanding services of PMRs to include malaria diagnostic

  18. Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.

    Science.gov (United States)

    Visser, Theodoor; Bruxvoort, Katia; Maloney, Kathleen; Leslie, Toby; Barat, Lawrence M; Allan, Richard; Ansah, Evelyn K; Anyanti, Jennifer; Boulton, Ian; Clarke, Siân E; Cohen, Jessica L; Cohen, Justin M; Cutherell, Andrea; Dolkart, Caitlin; Eves, Katie; Fink, Günther; Goodman, Catherine; Hutchinson, Eleanor; Lal, Sham; Mbonye, Anthony; Onwujekwe, Obinna; Petty, Nora; Pontarollo, Julie; Poyer, Stephen; Schellenberg, David; Streat, Elizabeth; Ward, Abigail; Wiseman, Virginia; Whitty, Christopher J M; Yeung, Shunmay; Cunningham, Jane; Chandler, Clare I R

    2017-01-01

    Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal access to prompt parasite-based diagnosis, many malaria-endemic countries are considering scaling up malaria rapid diagnostic tests (RDTs) in these outlets, an intervention that may require legislative changes and major investments in supporting programs and infrastructures. This review identifies studies that introduced malaria RDTs in PMRs and examines study outcomes and success factors to inform scale up decisions. Published and unpublished studies that introduced malaria RDTs in PMRs were systematically identified and reviewed. Literature published before November 2016 was searched in six electronic databases, and unpublished studies were identified through personal contacts and stakeholder meetings. Outcomes were extracted from publications or provided by principal investigators. Six published and six unpublished studies were found. Most studies took place in sub-Saharan Africa and were small-scale pilots of RDT introduction in drug shops or pharmacies. None of the studies assessed large-scale implementation in PMRs. RDT uptake varied widely from 8%-100%. Provision of artemisinin-based combination therapy (ACT) for patients testing positive ranged from 30%-99%, and was more than 85% in five studies. Of those testing negative, provision of antimalarials varied from 2%-83% and was less than 20% in eight studies. Longer provider training, lower RDT retail prices and frequent supervision appeared to have a positive effect on RDT uptake and provider adherence to test results. Performance of RDTs by PMR vendors was generally good, but disposal of medical waste and referral of patients to public facilities were common challenges. Expanding services of PMRs to include malaria diagnostic services may hold

  19. Radiological evaluation of acromial characteristic using supraspinatus outlet view in shoulder impingement syndrome

    Directory of Open Access Journals (Sweden)

    Marcel Prasetyo

    2007-09-01

    Full Text Available Purpose of this study was to find the association between shoulder impingement syndrome (SIS and morphological characteristics of acromion (acromial tilt angle, type of acromion, subacromial osteophyte. Supraspinatus outlet view was performed using fluoroscopy. There were 40 SIS patients and 40 individuals with no shoulder pain examined and measured for their acromial tilt angle, type of acromion (according to Bigliani’s classification and Park’s criteria and for the presence of subacromial osteophyte. Average acromial tilt angle was 34.1° (SD 7.6 for SIS group and 32.1° (SD 7.7 for control group. Type II acromion was found more frequent in both groups (85% and 95%. The association between SIS and acromial tilt angle or between SIS and type of acromion were statistically insignificant (p=0.241 and p=0.221. Subacromial osteophyte was found in 52.5% of SIS group compare to 12.5% among the control group, and the association with SIS was statistically significant (p=0.0003. Subacromial osteophyte was found to have significant association with SIS. Such association was not found in acromial tilt angle and type of acromion. (Med J Indones 2007; 16:176-80 Keywords: shoulder impingement syndrome, acromion, supraspinatus

  20. Cognitive and Affective Uses of a Thoracic Outlet Syndrome Facebook Support Group.

    Science.gov (United States)

    Walker, Kimberly K

    2014-09-01

    There are currently many disease-specific groups on Facebook in which patients may take an active part (Greene, Choudhry, Kilabuk, & Shrank, 2011). Although uses and gratifications of patient-disease groups have begun to be identified for chronic diseases, rare diseases have been omitted, even though they collectively affect roughly 30 million people in the United States and 350 million people worldwide. This study is a content analysis of one Facebook rare disease patient group, the Thoracic Outlet Syndrome (TOS) Awareness group. All wall posts were recorded and content analyzed for cognitive and affective categories and subcategories between October 9, 2011 (date of site origin), and May 1, 2012. Analysis of cognitive needs indicated TOS patients used the site more to share information about their own TOS symptoms and journey with diagnosis than to seek information. Analysis of affective needs found patients were more likely to use the site to give support and encouragement to others than to express concerns and complaints. The complaints they did express were primarily related to their frustration with the general medical community's perceived inability to diagnose and understand their disease or to question a specific doctor's diagnosis/recommendation. Results point to needs specific to TOS patients that uses and gratifications research can help clarify.

  1. Prevalence and characterization of Campylobacter jejuni from chicken meat sold in French retail outlets.

    Science.gov (United States)

    Guyard-Nicodème, Muriel; Rivoal, Katell; Houard, Emmanuelle; Rose, Valérie; Quesne, Ségolène; Mourand, Gwenaëlle; Rouxel, Sandra; Kempf, Isabelle; Guillier, Laurent; Gauchard, Françoise; Chemaly, Marianne

    2015-06-16

    Campylobacter was detected in 76% of broiler meat products collected in retail outlets during a monitoring plan carried out in France throughout 2009. Campylobacter jejuni was the most prevalent species (64.7% of products being contaminated). The 175 C. jejuni isolates collected were characterized. MLST typing results confirmed substantial genetic diversity as the 175 C. jejuni isolates generated 76 sequence types (STs). The ST-21, ST-45 and ST-464 complexes predominated accounting for 43% of all isolates. A class-specific PCR to screen the sialylated lipooligosaccharide (LOS) locus classes A, B and C showed that 50.3% of the C. jejuni isolates harbored sialylated LOS. The antimicrobial resistance profiles established using a subset of 97 isolates showed that resistance to tetracycline was the most common (53.6%), followed with ciprofloxacin and nalidixic acid (32.9%, and 32.0% respectively). All the tested isolates were susceptible to erythromycin, chloramphenicol and gentamicin. Clear associations were demonstrated between certain clonal complexes and LOS locus classes and between certain clonal complexes and antimicrobial resistance. This work paints a representative picture of C. jejuni isolated from poultry products circulating in France, providing data on STs, LOS locus classes and antibiotic resistance profiles in isolates recovered from products directly available to the consumer. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Smolt Responses to Hydrodynamic Conditions in Forebay Flow Nets of Surface Flow Outlets, 2007

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Gary E.; Richmond, Marshall C.; Hedgepeth, J. B.; Ploskey, Gene R.; Anderson, Michael G.; Deng, Zhiqun; Khan, Fenton; Mueller, Robert P.; Rakowski, Cynthia L.; Sather, Nichole K.; Serkowski, John A.; Steinbeck, John R.

    2009-04-01

    This study provides information on juvenile salmonid behaviors at McNary and The Dalles dams that can be used by the USACE, fisheries resource managers, and others to support decisions on long-term measures to enhance fish passage. We researched smolt movements and ambient hydrodynamic conditions using a new approach combining simultaneous acoustic Doppler current profiler (ADCP) and acoustic imaging device (AID) measurements at surface flow outlets (SFO) at McNary and The Dalles dams on the Columbia River during spring and summer 2007. Because swimming effort vectors could be computed from the simultaneous fish and flow data, fish behavior could be categorized as passive, swimming against the flow (positively rheotactic), and swimming with the flow (negatively rheotactic). We present bivariate relationships to provide insight into fish responses to particular hydraulic variables that engineers might consider during SFO design. The data indicate potential for this empirical approach of simultaneous water/fish measurements to lead to SFO design guidelines in the future.

  3. The Effects of Pre-Operative Enteral Nutrition from Nasal Feeding Tubes on Gastric Outlet Obstruction.

    Science.gov (United States)

    Chen, Zhi-Hua; Lin, Su-Yong; Dai, Qi-Bao; Hua, Jin; Chen, Shao-Qin

    2017-04-10

    We examined gastric outlet obstruction (GOO) patients who received two weeks of strengthening pre-operative enteral nutrition therapy (pre-EN) through a nasal-jejenal feeding tube placed under a gastroscope to evaluate the feasibility and potential benefit of pre-EN compared to parenteral nutrition (PN). In this study, 68 patients confirmed to have GOO with upper-gastrointestinal contrast and who accepted the operation were randomized into an EN group and a PN group. The differences in nutritional status, immune function, post-operative complications, weight of patients, first bowel sound and first flatus time, pull tube time, length of hospital stay (LOH), and cost of hospitalization between pre-operation and post-operation were all recorded. Statistical analyses were performed using the chi square test and t-test; statistical significance was defined as p pneumonia, and a shorter first bowel sound time, first flatus time, and post-operation hospital stay than the PN group. Pre-EN through a nasal-jejunum feeding tube and placed under a gastroscope in GOO patients was safe, feasible, and beneficial to the nutrition status, immune function, and gastrointestinal function, and sped up recovery, while not increasing the cost of hospitalization.

  4. Novel Surgical Approach for Decompression of the Scalene Triangle in Neurogenic Thoracic Outlet Syndrome.

    Science.gov (United States)

    Hagan, Robert R; Ricci, Joseph A; Eberlin, Kyle R

    2018-02-02

    Thoracic outlet syndrome (TOS) is a cause of upper extremity and shoulder dysfunction. TOS can present with a wide range of symptoms due to compression of the brachial plexus or its branches during their passage through the cervicothoracobrachial region or scalene triangle. There are three types of TOS: arterial, venous, and neurogenic. Neurogenic TOS (nTOS) is by far the most frequent type and represents more than 95% of all cases. Historically, surgical intervention for all types of TOS has evolved based on the treatment for a vascular etiology and has typically included a first rib resection. Despite nTOS being by far the more common type, most previous interventions have not considered treatment via peripheral nerve decompression.We describe surgical treatment of nTOS, performed on an outpatient basis, which focuses on the surgical decompression of the structures associated with the scalene triangle in conjunction with release of the pectoralis minor insertion through limited incisions. The procedure avoids the morbidity associated with first rib resection and is successful in ameliorating nTOS symptoms. Further, we propose a nomenclature shift to scalene triangle syndrome (STS) to reflect the nerve and arterial compressions needing to be addressed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Neonatal gastric outlet obstruction by isolated pyloric atresia, an often forgotten diagnosis.

    Science.gov (United States)

    Mboyo, Antoine; Clermidi, Pauline; Podevin, Guillaume; Patkowski, Dariusz; Baglaj, Maciej; Gerus, Sylwester; Lalioui, Abdelfetah; Napoli-Cocci, Stéphan de; Robert, Michel

    2016-04-01

    Pyloric atresia (PA) is a rare condition, and may be misdiagnosed and especially confused for duodenal atresia pre-operatively. We looked for clues to avoiding pre-operative misdiagnosis and hence allow the best neonatal medical and surgical management. A retrospective case-note review was carried out of the five patients managed in four centres with the diagnosis of isolated PA. We focused on antenatal ultrasound findings, postnatal clinical and radiological features, operative findings, surgical procedures and outcomes. Four patients had polyhydramnios and one double bubble sign on antenatal ultrasound. After birth, non-bilious vomiting and upper abdominal distension were the main symptoms. Gastric decompression showed non-bilious gastric fluid. Radiological findings were a large gastric air bubble with no gas beyond in all cases. The diagnosis of duodenal atresia was postulated at first in all cases. The diagnosis of PA was established peroperatively. One patient referred late, died 13-day post-operatively of cardiopulmonary failure secondary to a severe pneumonia that may be related to aspiration syndrome. Outcomes were otherwise satisfactory. Even though it is a rare diagnosis, PA has a specific clinical and radiological presentation underlined here that should be kept in mind when managing a neonate with a gastric outlet obstruction.

  6. Effect of inlet and outlet flow conditions on natural gas parameters in supersonic separation process.

    Directory of Open Access Journals (Sweden)

    Yan Yang

    Full Text Available A supersonic separator has been introduced to remove water vapour from natural gas. The mechanisms of the upstream and downstream influences are not well understood for various flow conditions from the wellhead and the back pipelines. We used a computational model to investigate the effect of the inlet and outlet flow conditions on the supersonic separation process. We found that the shock wave was sensitive to the inlet or back pressure compared to the inlet temperature. The shock position shifted forward with a higher inlet or back pressure. It indicated that an increasing inlet pressure declined the pressure recovery capacity. Furthermore, the shock wave moved out of the diffuser when the ratio of the back pressure to the inlet one was greater than 0.75, in which the state of the low pressure and temperature was destroyed, resulting in the re-evaporation of the condensed liquids. Natural gas would be the subsonic flows in the whole supersonic separator, if the mass flow rate was less than the design value, and it could not reach the low pressure and temperature for the condensation and separation of the water vapor. These results suggested a guidance mechanism for natural gas supersonic separation in various flow conditions.

  7. Calorie-labelling in catering outlets: acceptability and impacts on food sales.

    Science.gov (United States)

    Nikolaou, Charoula K; Lean, Michael E J; Hankey, Catherine R

    2014-10-01

    Obesity is the biggest challenge facing preventive medicine. Calorie-labelling has been suggested as a way of changing the architecture of an 'obesogenic' environment without limiting consumer choice. This study examined the effect of calorie-labelling on sales of food items at catering outlets on a city-centre university campus. Sales data were collected for two consecutive months in 2013 on three UK university sites (two with calorie-labelling during second month, one control) and analysed with chi-square 'Goodness-of-Fit' tests. A questionnaire seeking consumers' views and use of the calorie-labelling was administered and analysed at group-level with chi-square tests. In intervention vs control sites, total sales of all labelled items fell significantly (-17% vs -2%, p<0.001) for the month with calorie-labelling. Calorie-labelling was associated with substantially reduced sales of high-calorie labelled items, without any compensatory changes in unlabelled alternative items. Among 1166 student- and 646 staff-respondents, 56% reported using the calorie-labels, 97% of them to make lower-calorie choices. More females (63%) than males (40%) reported being influenced by calorie-labels when choosing foods (p=0.01). This study provides evidence, beyond that from single-meal exposures, for the acceptability of meal calorie-labelling and its potential as an effective low-cost anti-obesity measure. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. AERODYNAMICS OF SWIRLING FLOWS IN GAS OUTLET PIPES OF HEAT GENERATING PLANTS

    Directory of Open Access Journals (Sweden)

    Vadim Kajumovich Ahmetov

    2012-10-01

    Full Text Available The intermixing of hot turbulent gases in an axisymmetric channel with lateral surfaces of arbitrary shape and a pre-swirled flow is considered in the paper. This problem is relevant in connection with the development of new high-tech designs of natural fuel combustion facilities. Any designs are to comply with specific requirements. The temperature of the flue gas must not fall below a certain limit to prevent promotion of condensation that facilitates pipe corrosion. The gas outlet velocity must exceed 4 m/s to prevent the downdraft. The concentration of pollutants released into the atmosphere must fall within permissible limits. The mathematical model is based on parabolized Navier-Stokes equations that restrict its applicability to continuous flows. However, in view of the mechanical nature of the problem considered, continuous flows are of particular interest. The method of equal flow-rate surfaces is used as a numerical solution. The system of equations is based on streamlines. The net of lines is not available beforehand; therefore, it is constructed alongside with the problem solution. The system of equations is completed by an algebraic turbulence model. The proposed method makes it possible to check for the optimal flow regimes inside high-rise stack structures to assure that pollutant-containing smokes and gases, emitted into the atmosphere, produce the minimal damage onto the environment.

  9. AERODYNAMICS OF SWIRLING FLOWS IN GAS OUTLET PIPES OF HEAT GENERATING PLANTS

    Directory of Open Access Journals (Sweden)

    Akhmetov Vadim Kayumovich

    2012-10-01

    Full Text Available The intermixing of hot turbulent gases in an axisymmetric channel with lateral surfaces of arbitrary shape and a pre-swirled flow is considered in the paper. This problem is relevant in connection with the development of new high-tech designs of natural fuel combustion facilities. Any designs are to comply with specific requirements. The temperature of the flue gas must not fall below a certain limit to prevent promotion of condensation that facilitates pipe corrosion. The gas outlet velocity must exceed 4 m/s to prevent the downdraft. The concentration of pollutants released into the atmosphere must fall within permissible limits. The mathematical model is based on parabolized Navier-Stokes equations that restrict its applicability to continuous flows. However, in view of the mechanical nature of the problem considered, continuous flows are of particular interest. The method of equal flow-rate surfaces is used as a numerical solution. The system of equations is based on streamlines. The net of lines is not available beforehand; therefore, it is constructed alongside with the problem solution. The system of equations is completed by an algebraic turbulence model. The proposed method makes it possible to check for the optimal flow regimes inside high-rise stack structures to assure that pollutant-containing smokes and gases, emitted into the atmosphere, produce minimal damage onto the environment.

  10. Performance improvement of a PEMFC system controlling the cathode outlet air flow

    Energy Technology Data Exchange (ETDEWEB)

    Feroldi, Diego; Serra, Maria; Riera, Jordi [Institut de Robotica i Informatica Industrial, Universitat Politecnica de Catalunya-Consejo Superior de Investigaciones Cientificas, C. Llorens i Artigas 4, 08028 Barcelona (Spain)

    2007-06-10

    This paper presents a stationary and dynamic study of the advantages of using a regulating valve for the cathode outlet flow in combination with the compressor motor voltage as manipulated variables in a fuel cell system. At a given load current, the cathode input and output flow rate determine the cathode pressure and stoichiometry, and consequently determine the oxygen partial pressure, the generated voltage and the compressor power consumption. In order to maintain a high efficiency during operation, the cathode output regulating valve has to be adjusted to the operating conditions, specially marked by the current drawn from the stack. Besides, the appropriate valve manipulation produces an improvement in the transient response of the system. The influence of this input variable is exploited by implementing a predictive control strategy based on dynamic matrix control (DMC), using the compressor voltage and the cathode output regulating valve as manipulated variables. The objectives of this control strategy are to regulate both the fuel cell voltage and oxygen excess ratio in the cathode, and thus, to improve the system performance. All the simulation results have been obtained using the MATLAB-Simulink environment. (author)

  11. Velocity profile of water vapor inside a cavity with two axial inlets and two outlets

    Science.gov (United States)

    Guadarrama-Cetina, José; Ruiz Chavarría, Gerardo

    2014-03-01

    To study the dynamics of Breath Figure phenomenon, a control of both the rate of flow and temperature of water vapor is required. The experimental setup widely used is a non hermetically closed chamber with cylindrical geometry and axial inlets and outlets. In this work we present measurements in a cylindrical chamber with diameter 10 cm and 1.5 cm height, keeping a constant temperature (10 °C). We are focused in the velocity field when a gradient of the temperatures is produced between the base plate and the vapor. With a flux of water vapor of 250 mil/min at room temperature (21 °C), the Reynolds number measured in one inlet is 755. Otherwise, the temperatures of water vapor varies from 21 to 40 °C. The velocity profile is obtained by hot wire anemometry. We identify the stagnations and the possibly instabilities regions for an empty plate and with a well defined shape obstacle as a fashion sample. Facultad de Ciencias, UNAM.

  12. Exceptional retreat of Novaya Zemlya's marine-terminating outlet glaciers between 2000 and 2013

    Science.gov (United States)

    Carr, J. Rachel; Bell, Heather; Killick, Rebecca; Holt, Tom

    2017-09-01

    Novaya Zemlya (NVZ) has experienced rapid ice loss and accelerated marine-terminating glacier retreat during the past 2 decades. However, it is unknown whether this retreat is exceptional longer term and/or whether it has persisted since 2010. Investigating this is vital, as dynamic thinning may contribute substantially to ice loss from NVZ, but is not currently included in sea level rise predictions. Here, we use remotely sensed data to assess controls on NVZ glacier retreat between 1973/76 and 2015. Glaciers that terminate into lakes or the ocean receded 3.5 times faster than those that terminate on land. Between 2000 and 2013, retreat rates were significantly higher on marine-terminating outlet glaciers than during the previous 27 years, and we observe widespread slowdown in retreat, and even advance, between 2013 and 2015. There were some common patterns in the timing of glacier retreat, but the magnitude varied between individual glaciers. Rapid retreat between 2000 and 2013 corresponds to a period of significantly warmer air temperatures and reduced sea ice concentrations, and to changes in the North Atlantic Oscillation (NAO) and Atlantic Multidecadal Oscillation (AMO). We need to assess the impact of this accelerated retreat on dynamic ice losses from NVZ to accurately quantify its future sea level rise contribution.

  13. Computing Air Demand Using the Takagi–Sugeno Model for Dam Outlets

    Directory of Open Access Journals (Sweden)

    Mohammad Zounemat-Kermani

    2013-09-01

    Full Text Available An adaptive neuro-fuzzy inference system (ANFIS was developed using the subtractive clustering technique to study the air demand in low-level outlet works. The ANFIS model was employed to calculate vent air discharge in different gate openings for an embankment dam. A hybrid learning algorithm obtained from combining back-propagation and least square estimate was adopted to identify linear and non-linear parameters in the ANFIS model. Empirical relationships based on the experimental information obtained from physical models were applied to 108 experimental data points to obtain more reliable evaluations. The feed-forward Levenberg-Marquardt neural network (LMNN and multiple linear regression (MLR models were also built using the same data to compare model performances with each other. The results indicated that the fuzzy rule-based model performed better than the LMNN and MLR models, in terms of the simulation performance criteria established, as the root mean square error, the Nash–Sutcliffe efficiency, the correlation coefficient and the Bias.

  14. Learning Team Review 2016-0001: Installing Outlets for Programmatic Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Dunwoody, John Tyler [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Obrey, Kimberly Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bridgewater, Jon S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Griego, Frank X. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brenner, Andrew Karl [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lopez, Ted T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Henderson, Kevin C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gordon, Lloyd Baumgardner [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Blumberg, Paul A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wilburn, Dianne Williams [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-09-08

    The purpose of a Learning Team is to transfer and communicate the information into operational feedback and improvement. We want to pay attention to the small things that go wrong because they are often early warning signals and may provide insight into the health of the whole system. An ESR was placed in the October of 2015 to move/install a number of 120V and 208V outlets in 455-104B to support programmatic furnace needs. Electrical design review was completed for ESR 22217 on February 22, 2016 and a Design Change Form completed describing the modification needed as: demolish 1 existing receptacle and circuit leaving conduit and jbox for use to install new receptacle and 5 new receptacles/circuits are required and one existing receptacle is to be relocated, listed under FSR 149229. The FSR scope of work was written:: Please have the Electricians come out to perform demolition (1ea.), installation (6ea.)& relocation (1ea.) of receptacles / circuits. ESR 22217 & DCF-16-35-0455-1281 is in place for this work. Coordinate final receptacle locations with Laboratory Resident. Contact John Dunwoody or O-MC for this information. WO# 545580-01 was signed on April 20, 2016.: Electricians to perform demolition, installation, & relocation of receptacles / circuits PER attached DCF-16-0455-1281-SK-1.

  15. Novel Measurements and Techniques for Outlet Glacier Fjord Ice/Ocean Interactions

    Science.gov (United States)

    Behar, A.; Howat, I. M.; Holland, D. M.; Ahlstrom, A. P.; Larsen, S. H.

    2014-12-01

    Glacier fjord bathymetry and conditions indicate that they play fundamental roles for outlet glacier dynamics and thus knowledge of these parameters is extremely beneficial to upcoming models that predict changes. In particular, the bathymetry of a fjord gives important information about the exchange between fjord waters close to marine-terminating glaciers and the shelf and ocean. Currently, only sparse bathymetric data near the ice fronts are available for the majority of fjords in Greenland. The challenge in obtaining these measurements is that the fjord melange environment is a terrible one for mechanical gear, or ship or any other kind of access. There is hope however, and this work focuses on novel ways of obtaining this data using a multitude of upcoming technologies and techniques that are now being tested and planned. The span of the techniques described include but are not limited to: 1) manned helicopter-based live-reading instruments and deployable/retriavable sensor packages http://www.motionterra.com/fjord/ 2) remote or autonomous unmanned miniature boats (Depth/CTD), and 3) UAV's that either read live data or deploy small sensors that can telemeter their data (ice-flow trackers, image acquisition, etc.). A review of current results obtained at Jakobshavn and Upernavik Glaciers will be given as well as a description of the techniques and hardware used.

  16. Internet cigarette vendors make tax-free claims and sell cigarettes cheaper than retail outlets.

    Science.gov (United States)

    Hall, Marissa G; Williams, Rebecca S; Gammon, Doris G; Ribisl, Kurt M

    2016-11-01

    This paper aims to (1) assess whether promotion of tax-free sales among Internet cigarette vendors (ICVs) changed between 2009 and 2011, (2) determine which types of ICVs are most likely to promote tax-free sales (eg, US-based, international or mixed location ICVs), and (3) compare the price of cigarettes advertised in ICVs to prices at brick-and-mortar retail outlets. We analysed data from the 200 most popular ICVs in 2009, 2010 and 2011 to assess promotion of tax-free sales and the price of Marlboro cigarette cartons. We used Nielsen scanner data from 2009, 2010 and 2011 to measure the price of Marlboro cartons in US grocery stores. The odds of ICVs claiming tax-free status were higher in 2011 than in 2009 (OR=1.58, pcigarette prices would save $1508 per year buying cigarettes online. ICVs commonly promote tax-free sales, and cigarettes are cheaper online compared to US grocery stores. Better enforcement of the Prevent All Cigarette Trafficking Act is needed to address tax-free cigarette sales among ICVs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. On-line, proximate analysis of ground beef directly at a meat grinder outlet.

    Science.gov (United States)

    Isaksson, T; Nilsen, B N; Tøgersen, G; Hammond, R P; Hildrum, K I

    1996-07-01

    The fat, moisture and protein contents of ground beef were determined on-line by a diffuse reflectance near infrared (NIR) spectroscopy instrument at the outlet of a meat grinder. Beef samples in the range of 6.2-21.7% fat, 59.6-72.9% moisture and 18.1-20.7% protein were studied. Calibrations from samples ground with hole diameters of 4, 8, 13 or 19 mm in the grinder plate were validated. In addition, calibrations of combinations of these samples from the different hole diameters were validated. Prediction errors, expressed as root mean square error of cross validation of the beef samples, were 0.73-1.50% for fat, 0.75-1.33% for moisture and 0.23-0.32% for protein, depending on the hole diameter of the grinder plate. Calibrations from samples ground with the smallest hole diameters gave lowest prediction errors. The present prediction error results are only slightly higher compared to reported prediction error results using conventional at- and off-line NIR instruments. It is concluded that the on-line NIR prediction results were acceptable for samples ground with grinder plates of 4, 8 or 13 mm hole diameter.

  18. Combustion Dynamic Characteristics Identification in a 9-point LDI Combustor Under Choked Outlet Boundary Conditions

    Science.gov (United States)

    He, Zhuohui J.; Chang, Clarence T.

    2017-01-01

    Combustion dynamics data were collected at the NASA Glenn Research Center's CE-5 flame tube test facility under combustor outlet choked conditions. Two 9-point Swirl-Venturi Lean Direct Injection (SV-LDI) configurations were tested in a rectangular cuboid combustor geometry. Combustion dynamic data were measured at different engine operational conditions up to inlet air pressure and temperature of 24.13 bar and 828 K, respectively. In this study, the effects of acoustic cavity resonance, precessing vortex core (PVC), and non-uniform thermal expansion on the dynamic noise spectrum are identified by comparing the dynamic data that collected at various combustor inlet conditions along with combustor geometric calculations. The results show that the acoustic cavity resonance noises were seen in the counter-rotating pilot configuration but not in the co-rotating pilot configuration. Dynamic pressure noise band at around 0.9 kHz was only detected at the P'41 location (9.8 cm after fuel injector face) but not at the P'42 location (29 cm after the fuel injector face); the amplitude of this noise band depended on the thermal expansion ratio (T4/T3). The noise band at around 1.8 kHz was found to depend on the inlet air pressure or the air density inside the combustor. The PVC frequency was not observed in these two configurations.

  19. Cigarette advertising and promotional strategies in retail outlets: results of a statewide survey in California.

    Science.gov (United States)

    Feighery, E C; Ribisl, K M; Schleicher, N; Lee, R E; Halvorson, S

    2001-06-01

    To examine the extent and types of cigarette advertising materials in stores and to assess tobacco company compliance with the 1998 Master Settlement Agreement (MSA). A cross-sectional analysis of a random sample of 586 stores that sold cigarettes. US state of California. Trained data collectors classified cigarette advertising materials by type (signs, displays, functional items), location (interior or exterior), and placement (below 3 feet (1 m) or near candy). California retail outlets featured 17.2 (SD 16.1) tobacco advertising materials on average, and 94% of stores featured at least some advertising. About 85% of these were within 4 feet (1.3 m) of the counter. About 50% of the stores had ads at or below 3 feet, and 23% had cigarette product displays next to candy. In violation of the MSA, 3% of stores featured signs with cartoons and 11% had large exterior signs. Tobacco companies are aggressively using stores to market cigarettes. Moreover, the spirit of the MSA-to protect children from cigarette advertising-has not been realised. Future studies should monitor industry use of this venue and assess the impact of exposure to cigarette advertising materials in stores on adult smokers and youth.

  20. Catheter ablation of three macroreentrant atrial tachycardias after surgical repair of Double-Outlet Right Ventricle

    Directory of Open Access Journals (Sweden)

    Tadashi Wada

    2012-06-01

    Full Text Available A 54-year-old man with a surgically repaired double-outlet right ventricle (DORV presented with palpitations and worsening right heart failure. His 12-lead ECG showed atrial tachycardia (AT with an atrial cycle length (CL of 300 ms and an inverted saw-tooth F-wave pattern in the inferior leads II, III, and aVF typical of atrial flutter. Electrophysiological study and radiofrequency catheter ablation were performed. A total of 3 sustained ATs (AT1–AT3 were induced. Using the electroanatomical mapping system, CARTO3, and conventional mapping techniques, the ATs were identified as macroreentrant tachycardias circling around an incisional line on the free wall of the right atrium (AT1, the tricuspid annulus (AT2, and low voltage area in the lateral wall including the right septum (AT3. Accuracy of CARTO3 in three-dimensional reconstruction was sufficient to elucidate anatomical features (including catheter sites, incision, and low voltage areas and macroreentrant circuits. However, conventional mapping techniques were also necessary to identify the mechanism of the tachycardias, and therefore to eliminate all of them successfully. This case demonstrates that the use of combined conventional and electroanatomical mapping techniques, such as CARTO3, can be helpful in identifying the critical isthmus for catheter ablation of macroreentrant AT in patients with surgically corrected congenital heart disease (CHD.

  1. [The assessment of functional capacity in workers with the thoracic outlet syndrome. A pilot study].

    Science.gov (United States)

    Capodaglio, P; Gibellini, R; Grilli, C; Bazzini, G

    1997-01-01

    Occupational specialists are well aware of the lack of objective measurements for the diagnosis and the functional evaluation of workers affected by thoracic outlet syndrome (TOS). Subjects affected by TOS refer pain, sensation of fatigue in the arm frequently aggravated by overhead work. A "stick-up" position tends to close the costoclavicular space and tense the neck and shoulder muscles to bring into play the abnormal compression mechanism that may affect the brachial plexus nerves and the subclavian vessels. In a previous study, we demonstrated the reliability of an isokinetic hand grip endurance test. In this pilot study we asked 7 industrial workers affected by TOS to perform a 30-second isokinetic endurance test for hand gripping with a Lido WorkSET dynamometer. Tests were performed in two positions (resting and "stick-up" position) before and after a 3-week intensive rehabilitation program. In addition, the subjects performed daily aerobic exercise with an arm crank ergometer. Objective indexes of posttreatment improvement were found. Subjects were able to generate higher grip forces during the isokinetic hand grip endurance test and to sustain higher mechanical workload with the arm ergometer at the same intensity level for longer duration after completion of the rehabilitation program.

  2. Bladder mechanoreceptor changes after artificial bladder outlet obstruction in the anesthetized rat.

    Science.gov (United States)

    Zeng, Jianwen; Xie, Keji; Jiang, Chonghe; Mo, Jianfeng; Lindström, Sivert

    2012-01-01

    Experimental animal models of bladder outlet obstruction (BOO) have reproduced several features of BOO in man, i.e., detrusor hypertrophy, instability, frequency, and residual urine. This study was focused on the mechanisms underlying the development of residual urine in patient with benign prostatic hyperplasia (BPH) by examining changes in tension sensitivity of bladder mechanoreceptors in rat model. Female adult Sprague-Dawley rats including 12 BOO and 17 sham operated rats were used in this study. Cystometrograms together with the bladder afferent activity were recorded. Tension sensitivity of the afferents was determined by plotting the normalized afferent response against the contraction evoked bladder pressure at different volumes. Degree of obstruction was assessed by the wet weight of the bladder at the end of the experiment. The bladder weight, maximal bladder capacity, micturition threshold volume, peak contraction force, and volume at peak contraction force were all significantly increased in obstructed animals. The threshold volume for afferent activation was increased (mean 0.60 ml compared to 0.15 ml in controls; P bladder weight (r = 0.74). The tension sensitivity of the bladder mechanoreceptors and the slope of their normalized pressure-response functions were significantly lower at the comparable volumes in the obstructed animals. Rats with BOO had bladder mechanoreceptors with higher threshold volumes and lower tension sensitivity. Such changes would result in a weaker afferent drive of the micturition reflex. Similar changes may contribute to the development of residual urine and retention in patients with BOO. Copyright © 2011 Wiley Periodicals, Inc.

  3. Exceptional retreat of Novaya Zemlya's marine-terminating outlet glaciers between 2000 and 2013

    Directory of Open Access Journals (Sweden)

    J. R. Carr

    2017-09-01

    Full Text Available Novaya Zemlya (NVZ has experienced rapid ice loss and accelerated marine-terminating glacier retreat during the past 2 decades. However, it is unknown whether this retreat is exceptional longer term and/or whether it has persisted since 2010. Investigating this is vital, as dynamic thinning may contribute substantially to ice loss from NVZ, but is not currently included in sea level rise predictions. Here, we use remotely sensed data to assess controls on NVZ glacier retreat between 1973/76 and 2015. Glaciers that terminate into lakes or the ocean receded 3.5 times faster than those that terminate on land. Between 2000 and 2013, retreat rates were significantly higher on marine-terminating outlet glaciers than during the previous 27 years, and we observe widespread slowdown in retreat, and even advance, between 2013 and 2015. There were some common patterns in the timing of glacier retreat, but the magnitude varied between individual glaciers. Rapid retreat between 2000 and 2013 corresponds to a period of significantly warmer air temperatures and reduced sea ice concentrations, and to changes in the North Atlantic Oscillation (NAO and Atlantic Multidecadal Oscillation (AMO. We need to assess the impact of this accelerated retreat on dynamic ice losses from NVZ to accurately quantify its future sea level rise contribution.

  4. Comparison of fast food consumption and dietary guideline practices for children and adolescents by clustering of fast food outlets around schools in the Gyeonggi area of Korea.

    Science.gov (United States)

    Joo, Soonnam; Ju, Seyoung; Chang, Hyeja

    2015-01-01

    This study investigated the distribution density of fast food outlets around schools, and the relationship between dietary health of children and adolescents and the density of fast food outlets in Korea. A distribution map of fast food outlets was drawn by collecting information on 401 locations of 16 brands within a 15-minute walk (800 meter) of 342 elementary and secondary schools in Suwon, Hwaseong and Osan. A questionnaire was used to gather data on the dietary life of 243 sixth and eighth grade students at eight schools. Schools in the upper 20% and lower 20% of the fast food outlet distribution were classified as high-density and low-density groups, respectively. The practice rate of dietary guidelines published by the Health and Welfare Ministry and the fast food consumption pattern of children and adolescents from low and high density groups were determined. The number of schools with a fast food outlet within 200 meters or in the Green Food Zone around its location was 48 of 189 (25.4%) in Suwon and 14 of 153 (9.2%) in Hwaseong and Osan. Students in the low-density group visited fast food outlets less often than those in the high-density group (pchildren did not show a significant difference between the two groups. The distribution map of fast food outlets within 200 meters of schools was useful for identifying the effectiveness of the Green Food Zone Act and nutrition education programs.

  5. Old enough for a beer? Compliance with minimum legal age for alcohol purchases in monopoly and other off-premise outlets in Finland and Norway.

    Science.gov (United States)

    Rossow, Ingeborg; Karlsson, Thomas; Raitasalo, Kirsimarja

    2008-09-01

    To assess whether government monopoly outlets comply better with minimum legal age for purchase of alcohol compared to other off-premise outlets for alcohol sales. Under-age-appearing 18-year-olds attempted to purchase alcohol in off-premise outlets applying identical procedures in Finland (n = 290) and Norway (n = 170). Outcomes were measured as whether or not the buyers were asked to present an identity (ID) card and whether or not they succeeded in purchasing alcohol. RESULTS The buyers were asked to present an ID card in slightly more than half the attempts, and they succeeded in purchasing alcohol in 48% of the cases. The buyers were more likely to be requested to present an ID card and less likely to succeed in purchasing alcohol in monopoly outlets compared to other types of outlets, and also when other outcome predictors, such as age and gender of salesperson and crowdedness in the outlet, were taken into account. Monopoly outlets may facilitate compliance with minimum legal age for purchase of alcohol.

  6. Is the number of fast-food outlets in the neighbourhood related to screen-detected type 2 diabetes mellitus and associated risk factors?

    Science.gov (United States)

    Bodicoat, Danielle H; Carter, Patrice; Comber, Alexis; Edwardson, Charlotte; Gray, Laura J; Hill, Sian; Webb, David; Yates, Thomas; Davies, Melanie J; Khunti, Kamlesh

    2015-06-01

    We investigated whether a higher number of fast-food outlets in an individual's home neighbourhood is associated with increased prevalence of type 2 diabetes mellitus and related risk factors, including obesity. Cross-sectional study. Three UK-based diabetes screening studies (one general population, two high-risk populations) conducted between 2004 and 2011. The primary outcome was screen-detected type 2 diabetes. Secondary outcomes were risk factors for type 2 diabetes. In total 10 461 participants (mean age 59 years; 53% male; 21% non-White ethnicity). There was a higher number of neighbourhood (500 m radius from home postcode) fast-food outlets among non-White ethnic groups (Pfast-food outlets was associated with significantly increased odds for diabetes (OR=1.02; 95% CI 1.00, 1.04) and obesity (OR=1.02; 95% CI 1.00, 1.03). This suggests that for every additional two outlets per neighbourhood, we would expect one additional diabetes case, assuming a causal relationship between the fast-food outlets and diabetes. These results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets.

  7. Study on Gas Field Optimization Distribution with Parameters Adjustment of the Air Duct Outlet for Mechanized Heading Face in Coal Mine

    Science.gov (United States)

    Gong, Xiao-Yan; Zhang, Xin-Yi; Wu, Yue; Xia, Zhi-Xin; Li, Ying

    2017-12-01

    At present, as the increasingly drilling dimensions with cross-section expansion and distance prolong in coal mine, the situation of gas accumulation in mechanized heading face becomes severe. In this paper, optimization research of gas distribution was carried out by adjusting parameters of the air duct outlet, including angle, caliber and the front and rear distance of air duct outlet. Mechanized heading face of Ningtiaota coal mine was taken as the research object, simulated and analyzed the problems of original gas field, the reasonable parameters range of the air duct outlet was determined according to the allowable range of wind speed and the effect of gas dilution, the adjustment range of each parameter of the air duct outlet is preliminarily determined. Base on this, the distribution of gas field under different parameters adjustment of air duct outlet was simulated. The specific parameters under the different distance between the air duct outlet and the mechanized heading face were obtained, and a new method of optimizing the gas distribution by adjusting parameters of the air duct outlet was provided.

  8. Heat sources for glacial ice melt in a West Greenland tidewater outlet glacier fjord: The role of subglacial freshwater discharge

    DEFF Research Database (Denmark)

    Bendtsen, Jørgen; Mortensen, John; Lennert, Kunuk

    2015-01-01

    The melting of tidewater outlet glaciers from the Greenland Ice Sheet contributes significantly to global sea level rise. Accelerated mass loss is related to melt-processes in front of calving glaciers, yet the role of ocean heat transports is poorly understood. Here we present the first direct...... measurements from a subglacial plume in front of a calving tidewater outlet glacier. Surface salinity in the plume corresponded to a meltwater content of 7 %, which is indicative of significant entrainment of warm bottom water and, according to plume model calculations, significant ice melt. Energy balance...... of the area near the glacier showed that ice melt was mainly due to ocean heat transport and that direct plume-associated melt was only important in periods with high meltwater discharge rates of ~100 m3 s−1. Ocean mixing outside of the plume area was thus the primary heat source for melting glacier ice....

  9. The role of off-licence outlets in binge drinking: a survey of drinking practices last Saturday night among young adults in Australia.

    Science.gov (United States)

    McKetin, Rebecca; Livingston, Michael; Chalmers, Jenny; Bright, David

    2014-01-01

    To examine where young adults purchase their alcohol on Saturday nights and how this relates to binge drinking. This study used an online survey of a non-probability-based quota sample of 2013 Australians aged 18-30 years who had consumed alcohol in the past year. Participants who purchased alcohol from off-licence outlets the Saturday night before answering the survey were compared with participants who purchased only from on-licence outlets with regard to how much they drank (binge drinking was defined as five or more drinks), how much they spent on alcohol, where they drank, their risk of an alcohol use disorder and other demographic factors. Of participants who drank the previous Saturday night (n=1106), 46% bought alcohol only from off-licence outlets (e.g. bottle shops), 19% bought from both off-licence and on-licence outlets (e.g. clubs, bars), and 23% bought only from on-licence outlets. Participants who bought alcohol from off-licence outlets were equally likely to binge-drink as participants who bought only from on-licence outlets (B=-0.02, P=0.912), but they drank more cheaply and usually drank at home. Participants who bought alcohol from both off-licence and on-licence outlets were more likely to binge-drink (B=1.39, Plicence outlets were a major source of alcohol in this sample of young Australian adults, many of whom binge-drank in private homes. © 2013 Australasian Professional Society on Alcohol and other Drugs.

  10. The Spatial Distribution of Food Outlet Type and Quality around Schools in Differing Built Environment and Demographic Contexts

    OpenAIRE

    Frank, Lawrence; Glanz, Karen; McCarron, Margaret; Sallis, James; Sealens, Brian; Chapman, James

    2006-01-01

    Safe and convenient access to healthy foods for all populations is a fundamental transportation and environmental justice concern. Emerging evidence suggests that residents of lower income communities have less access to healthy food choices than those in higher income areas. Most studies to date rely on an as- sumed level of food quality generalized across different types of food outlets (e.g., grocery versus convenience stores) mapped in space. The current study includes a detailed audit of...

  11. Fast-food outlets and grocery stores near school and adolescents' eating habits and overweight in Finland.

    Science.gov (United States)

    Virtanen, Marianna; Kivimäki, Hanne; Ervasti, Jenni; Oksanen, Tuula; Pentti, Jaana; Kouvonen, Anne; Halonen, Jaana I; Kivimäki, Mika; Vahtera, Jussi

    2015-08-01

    Environmental factors may affect adolescents' eating habits and thereby body weight. However, the contribution of school neighbourhood environment is poorly understood. This study examined the association between proximity of a fast-food outlet or grocery store to school and adolescents' eating habits and overweight. Participants were 23 182 adolescents (mean age 15 years) who responded to a classroom survey in 181 lower secondary schools in Finland (2008-09). School location was linked to data on distance from school to the nearest fast-food outlet or grocery store (≤100 m, 101-500 m, >500 m) using global positioning system-coordinate databases. Outcomes were irregular eating habits (skipping breakfast, skipping free school lunch, skipping free school-provided snacks and not having family dinners), the accumulation of these habits and overweight, including obesity (body mass index ≥ 25 kg/m(2)). Thirteen percentage of the participants were overweight. Having a fast-food outlet or grocery store near school was associated with skipping often breakfast and free school lunch, and the accumulation of irregular eating habits. The proximity of a fast-food outlet or grocery store was associated with a 1.25-fold (95% confidence interval 1.03-1.52) risk of overweight among adolescent with a low socioeconomic status but not among those with higher socioeconomic status. This association was partly (12%) explained by the accumulation of irregular eating habits. Among adolescents from low socioeconomic background, the presence of fast-food retailers near schools is associated with accumulation of irregular eating habits and greater overweight. These findings suggest that obesogenic school neighbourhoods may contribute to social inequalities in overweight. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Understanding the Role of Accredited Drug Dispensing Outlets in Tanzania's Health System.

    Directory of Open Access Journals (Sweden)

    Martha Embrey

    Full Text Available People in many low-income countries access medicines from retail drug shops. In Tanzania, a public-private partnership launched in 2003 used an accreditation approach to improve access to quality medicines and pharmaceutical services in underserved areas. The government scaled up the accredited drug dispensing outlet (ADDO program nationally, with over 9,000 shops now accredited. This study assessed the relationships between community members and their sources of health care and medicines, particularly antimicrobials, with a specific focus on the role ADDOs play in the health care system.Using mixed methods, we collected data in four regions. We surveyed 1,185 households and audited 96 ADDOs and 84 public/nongovernmental health facilities using a list of 17 tracer drugs. To determine practices in health facilities, we interviewed 1,365 exiting patients. To assess dispensing practices, mystery shoppers visited 306 ADDOs presenting one of three scenarios (102 each about a child's respiratory symptoms.Of 614 household members with a recent acute illness, 73% sought outside care-30% at a public facility and 31% at an ADDO. However, people bought medicines more often at ADDOs no matter who recommended the treatment; of the 581 medicines that people had received, 49% came from an ADDO. Although health facilities and ADDOs had similar availability of antimicrobials, ADDOs had more pediatric formulations available (p<0.001. The common perception was that drugs from ADDOs are more expensive, but the difference in the median cost to treat pneumonia was relatively minimal (US$0.26 in a public facility and US$0.30 in an ADDO. Over 20% of households said they had someone with a chronic condition, with 93% taking medication, but ADDOs are allowed to sell very few chronic care-related medicines. ADDO dispensers are trained to refer complicated cases to a health facility, and notably, 99% of mystery shoppers presenting a pneumonia scenario received an

  13. Outlet plenum mixing for transient overpower conditions of a one-exit nozzle LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Howard, P.A.

    1978-04-01

    Two types of transient tests were employed to model a one-exit nozzle LMFBR outlet plenum. Water was used as a test fluid in the simulation of constant flowrates, Transient Overpower (TOP) conditions. In the first test, simulated fuel flow was 85% and blanket flow was 15%, whereas in the second test, the fuel flow was 100%. This allowed the assessment of the mitigating effects of blanket flow upon the exit nozzle temperature transient. The flow field was clearly three-dimensional, and a less active, though not stagnant, region was observed diametrically opposite the exit nozzle. During steady state, oscillations above the fuel-blanket interface were found to be small. This is attributed to the existence above the reactor core of a recirculating flow field, which served as an effective mixing agent. A simple lumped-parameter model, EXIT1, was developed to simulate TOP transient conditions for the test with both fuel and blanket flows. The predicted temperature profiles for various regions in the plenum were in good agreement with the experimental profiles, except for the region immediately above the reactor blanket. In devising the computer model, the temperature in this region was assumed to remain constant throughout the transient. However, this constant temperature did not prevail owing to the mixing that occurred in this region as a result of the recirculating flow field above the reactor core. The computer model can be readily modified to take into account the mixing due to this recirculation. In the test without blanket flow, good agreement between predictions and data was again obtained. In comparing results of the two tests, it was found that the blanket flow had only a small mitigating influence on the transient at the exit nozzle. The computer model can easily be extrapolated to reactor conditions.

  14. Diagnosing bladder outlet obstruction can we do away with pressureflow studies?

    Directory of Open Access Journals (Sweden)

    Abraham Vinod Peedikayil

    2004-01-01

    Full Text Available Objective: To compare pressure-flow study on one hand with BWT, prostate volume, urine flow rate PVR and IPSS index in the other arm for diagnosis of BOO. Materials and methods: A prospective cross-sectional study was carried out in 48 men with lower urinary tract symptoms (LUTS. International prostate symptom score was completed by the patient who then underwent free urine flow study. Pressure-Flow study was performed as per recommendations of International continence Society. Abrams-Griffiths nomogram and number were used to diagnose BOO. Patients with diabetes, neurovesical dysfunction, acute urinary retention, prior pelvic surgery and known prostate cancer were excluded. Suprapubic ultrasonography was performed independently by a consultant radiologist, who was blinded to findings of Pressure-Flow study. Prevoid bladder volume, postvoid residue (PVR, prostate volume and bladder wall thickness (BWT were noted. Results: Based on objective evidence from Pressure-Flow study, 35 patients were obstructed, 13 were not. Multivariate analysis was performed using Backward Stepwise Logistic Regression Model. Bladder wall thickness, prostate volume and urine flow rate had statistically significant relationship with BOO. Their coefficients of correlation were +0.794, +0.084 and 0.393 respectively. Bladder outlet obstruction could be defined by using a mathematical formula as detailed in the text (Positive Predictive Value 96.97%. Post-void residue and IPSS index were statistically insignificant. Conclusion: In a select group of patients presenting with LUTS, it should be possible to diagnose BOO without the use of Pressure-Flow study.

  15. Structural integrity of a reinforced concrete structure and a pipe outlet under hydrogen detonation conditions

    Energy Technology Data Exchange (ETDEWEB)

    Saarenheimo, A.; Silde, A.; Calonius, K. [VTT Industrial Systems (Finland)

    2002-05-01

    Structural integrity of a reinforced concrete wall and a pipe penetration under detonation conditions in a selected reactor building room of Olkiluoto BWR were studied. Hydrogen leakage from the pressurised containment to the sur rounding reactor building is possible during a severe accident. Leaked hydrogen tends to accumulate in the reactor building rooms where the leak is located leading to a stable stratification and locally very high hydrogen concentration. If ignited, a possibility to flame acceleration and detonation cannot be ruled out. The structure may survive the peak detonation transient because the eigenperiod of the structure is considerably longer than the duration of the peak detonation. However, the relatively slowly decreasing static type pressure after a peak detonation damages the wall more severely. Elastic deformations in reinforcement are recoverable and cracks in these areas will close after the pressure decrease. But there will be remarkable compression crushing and the static type slowly decreasing over pressure clearly exceeds the loading capacity of the wall. Structural integrity of a pipe outlet was considered also under detonation conditions. The effect of drag forces was taken into account. Damping and strain rate dependence of yield strength were not taken into consideration. The boundary condition at the end of the pipe line model was varied in order to find out the effect of the stiffness of the pipeline outside the calculation model. The calculation model where the lower pipe end is free to move axially, is conservative from the pipe penetration integrity point of view. Even in this conservative study, the highest peak value for the maximum plastic deformation is 3.5%. This is well below the success criteria found in literature. (au)

  16. An Assessment of Radiologically Inserted Transoral and Transgastric Gastroduodenal Stents to Treat Malignant Gastric Outlet Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Bethany H. T., E-mail: bmiller@doctors.org.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Griffiths, Ewen A., E-mail: Eagriffiths@doctors.org.uk [The New Queen Elizabeth Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Pursnani, Kishore G., E-mail: Kish.Pursnani@lthtr.nhs.uk; Ward, Jeremy B., E-mail: Jeremy.Ward@lthtr.nhs.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Stockwell, Robert C., E-mail: Robert.Stockwell@lthtr.nhs.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Chorley and South Ribble Hospital, Department of Radiology (United Kingdom)

    2013-12-15

    IntroductionSelf-expanding metallic stents (SEMS) are used to palliate malignant gastric outlet obstruction (GOO) and are useful in patients with limited life expectancy or severe medical comorbidity, which would preclude surgery. Stenting can be performed transorally or by a percutaneous transgastric technique. Our goal was to review the outcome of patients who underwent radiological SEMS insertion performed by a single consultant interventional radiologist. Methods: Patients were identified from a prospectively collected database held by one consultant radiologist. Data were retrieved from radiological reports, multidisciplinary team meetings, and the patients' case notes. Univariate survival analysis was performed. Results: Between December 2000 and January 2011, 100 patients (63 males, 37 females) had 110 gastroduodenal stenting procedures. Median age was 73 (range 39-89) years. SEMS were inserted transorally (n = 66) or transgastrically (n = 44). Site of obstruction was the stomach (n = 37), duodenum (n = 50), gastric pull-up (n = 10), or gastroenterostomy (n = 13). Seven patients required biliary stents. Technical success was 86.4 %: 83.3 % for transoral insertion, 90.9 % for transgastric insertion. Eleven patients developed complications. Median GOO severity score: 1 pre-stenting, 2 post-stenting (p = 0.0001). Median survival was 54 (range 1-624) days. Post-stenting GOO severity score was predictive of survival (p = 0.0001). Conclusions: The technical success rate for insertion of palliative SEMS is high. Insertional technique can be tailored to the individual depending on the location of the tumor and whether it is possible to access the stomach percutaneously. Patients who have successful stenting and return to eating a soft/normal diet have a statistically significant increase in survival.

  17. Occupational dermatoses in restaurant, catering and fast-food outlets in Singapore.

    Science.gov (United States)

    Teo, Sylvia; Teik-Jin Goon, Anthony; Siang, Lee Hock; Lin, Gan Siok; Koh, David

    2009-10-01

    The restaurant industry is a rapidly growing sector in Singapore and workers in this industry are trained in culinary skills but not on recognition of safety and health hazards and their control measures. Anecdotal clinical evidence has suggested an increased prevalence of occupational dermatoses among restaurant workers. To determine the prevalence and risk factors for contact dermatitis and burns among restaurant, catering and fast-food outlet (FFO) staff. Workers were interviewed and then clinical examination and patch and/or prick tests were conducted in selected individuals. In total, 335 of 457 workers (73% response) were interviewed and 65 (19%) had occupational dermatitis or burns and were examined. Of these, contact dermatitis was the commonest diagnosis, with a 12-month period prevalence of 10% (35 workers) and 3-month period prevalence of 8% (26 workers). All 35 workers had irritant contact dermatitis (ICD) and there were no cases of allergic contact dermatitis. The adjusted prevalence rate ratios of risk factors for ICD were 2.78 (95% CI 1.36-5.72) for frequent hand washing >20 times per day, 3.87 (95% CI 1.89-7.93) for atopy and 2.57 (95% CI 1.21-5.47) for contact with squid. The 3-month period prevalence for burns was 6% (20 workers). Ten workers had other occupational dermatoses such as work-related calluses, paronychia, heat rash and allergic contact urticaria to prawn and lobster. ICD and burns are common occupational skin disorders among restaurant, catering and FFO workers.

  18. Primary duodenal tuberculosis presenting as gastric-outlet obstruction: Its diagnosis

    Directory of Open Access Journals (Sweden)

    Vijai Datta Upadhyaya

    2013-01-01

    Full Text Available Introduction: Gastrointestinal tuberculosis often involves the ileocecal region. Duodenal and gastric tuberculosis found in only 1% of patients suffering from pulmonary tuberculosis with associated HIV infection in non-endemic areas. Duodenal obstruction due to tuberculosis is very rare and needs high index of suspicions for diagnosis. Mostly this entity is suspected on intraoperative findings. In this manuscript we emphasized on ways and means for establishing histopathological diagnosis before starting anti-tubercular treatment in such cases. Method and Material: All patients of suspected gastroduodenal tuberculosis presented with feature of gastric-outlet obstruction managed during Jan 2009 to June 2011 were included in the study. After proper evaluation (routine hematological and biochemical examination, microbiological examination, serological and endoscopic evaluation exploratory laparotomy was done and if there is no mesenteric lymphadenopathy or it is not safe to take biopsy form the diseased duodenum, multiple FNAC were taken from the diseased portion for histopathological and microbiological diagnosis. Result: A total of five patients were treated during this period. The most common presentation was vomiting followed by failure to thrive and weight loss; two patients had abdominal pain. Biopsy of mesenteric lymph node was possible in two cases. FNAC from diseases portion was taken in all cases. FNAC showed granulomas in four cases. Cases where even FNAC finding was non-conclusive on HPE/Microbiology was not subjected to antitubercular drug. Conclusion: Multiple intra-operative FNAC may be taken from the diseased portion of the duodenum to establish the histopathological diagnosis if diagnosis is not established by any other mean.

  19. Evaluating the impact of field-scale management strategies on sediment transport to the watershed outlet.

    Science.gov (United States)

    Sommerlot, Andrew R; Pouyan Nejadhashemi, A; Woznicki, Sean A; Prohaska, Michael D

    2013-10-15

    Non-point source pollution from agricultural lands is a significant contributor of sediment pollution in United States lakes and streams. Therefore, quantifying the impact of individual field management strategies at the watershed-scale provides valuable information to watershed managers and conservation agencies to enhance decision-making. In this study, four methods employing some of the most cited models in field and watershed scale analysis were compared to find a practical yet accurate method for evaluating field management strategies at the watershed outlet. The models used in this study including field-scale model (the Revised Universal Soil Loss Equation 2 - RUSLE2), spatially explicit overland sediment delivery models (SEDMOD), and a watershed-scale model (Soil and Water Assessment Tool - SWAT). These models were used to develop four modeling strategies (methods) for the River Raisin watershed: Method 1) predefined field-scale subbasin and reach layers were used in SWAT model; Method 2) subbasin-scale sediment delivery ratio was employed; Method 3) results obtained from the field-scale RUSLE2 model were incorporated as point source inputs to the SWAT watershed model; and Method 4) a hybrid solution combining analyses from the RUSLE2, SEDMOD, and SWAT models. Method 4 was selected as the most accurate among the studied methods. In addition, the effectiveness of six best management practices (BMPs) in terms of the water quality improvement and associated cost were assessed. Economic analysis was performed using Method 4, and producer requested prices for BMPs were compared with prices defined by the Environmental Quality Incentives Program (EQIP). On a per unit area basis, producers requested higher prices than EQIP in four out of six BMP categories. Meanwhile, the true cost of sediment reduction at the field and watershed scales was greater than EQIP in five of six BMP categories according to producer requested prices. Copyright © 2013 Elsevier Ltd. All

  20. Does bladder outlet obstruction alter the non-neuronal cholinergic system of the human urothelium?

    Science.gov (United States)

    Bschleipfer, Thomas; Weidner, Wolfgang; Kummer, Wolfgang; Lips, Katrin S

    2012-11-27

    Alterations of the bladder sensory system are considered to contribute to detrusor overactivity (DO) when patients suffer from bladder outlet obstruction (BOO). The urothelium is one part of this sensory system and it harbors a non-neuronal cholinergic system (NNCS). We aimed to investigate if BOO causes alterations in the NNCS. Urothelial specimens were collected by endoscopy from six male controls and eight male patients suffering from BOO and DO. The samples were examined by immunofluorescence (IF) and real-time RT-PCR for high-affinity choline transporter-1 (CHT1), choline acetyltransferase (ChAT), vesicular acetylcholine transporter (VAChT), organic cation transporters OCT1-3, muscarinic receptor (mAChR) subtypes M1-M5 and nicotinic receptor (nAChR) subunits α7, α9 and α10. ChAT, VAChT and OCT2 are not present in the male urothelium. Real-time RT-PCR and IF detected all other investigated targets. Rank order of expression was M2≫M3=M5>M4=M1 for mAChR subtypes and α7≫α10>α9 for nAChR subunits. Statistical analysis of RT-PCR results did not detect significant differences between patients and controls. Only IF detected differences between both groups: α9-Immunolabeling was increased in all BOO/DO patients. BOO does not induce considerable alterations of the human urothelial NNCS on mRNA level. Expression of mAChRs, CHT1, OCT1 and OCT3 is not significantly affected by BOO. Thus, transport mechanisms for choline and acetylcholine (ACh) stay unaltered. BOO increases immunolabeling of α9-nAChR but whether this sole finding contributes to the onset of DO seems questionable. Comparing the present results with our previous work, the urothelial NNCS does not differ between men and women. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Balloon dilatation in patients with gastric outlet obstruction related to peptic ulcer disease.

    Science.gov (United States)

    Hamzaoui, Lamine; Bouassida, Mahdi; Ben Mansour, Imed; Medhioub, Mouna; Ezzine, Heykal; Touinsi, Hassen; Azouz, Mohamed M

    2015-01-01

    Gastric outlet obstruction (GOO) is a rare complication of peptic ulcer disease (PUD). The endoscopic balloon dilatation (EBD) associated with medical treatment of Helicobacter pylori is a successful method in the management of pyloric stenosis. The aim of this study was to describe epidemiological, clinical, and endoscopic characteristics of GOO related to PUD and to evaluate the effectiveness, safety, and outcome of EBD. In a retrospective study of patients seen between 1999 and 2009 with symptoms of GOO secondary to PUD, pyloro-bulbar stenosis was confirmed by endoscopic examination. Balloon dilatation was performed when obstruction persisted after treatment with double-dose proton-pump inhibitor (PPI) intravenously for 7-10days. The H. pylori status was assessed with histology, and eradication therapy was prescribed for infection. A total of 45 consecutive patients (38 males, 7 females median age, 51.9years; range, 20-58years) with symptoms of GOO secondary to PUD underwent EBD. Median follow-up time of the 45 patients was 32months (range, 4-126months). The immediate success rate of the procedure was 95.5%. Clinical remission was noted in 84.4% of the patients. Remission without relapse was observed in 55.8%, 30months after the dilatation. Pyloric stenosis relapsed in 15 patients (39.5%) after a median period of 22.9months. The dilatation was complicated in three patients (6.7%, two perforations and one bleeding). A total of 13 patients (29%) underwent surgery. H. pylori was found to be positive in 97.7% of the patients, and was eradicated in 78.4% of them. Smoking and failure of H. pylori eradication were associated with the relapse of the stenosis. EBD is a simple, effective, and safe therapy for the GOO related to PUD, producing short- and long-term remission. Copyright © 2015 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  2. Ice-ocean interaction and calving front morphology at two west Greenland tidewater outlet glaciers

    Science.gov (United States)

    Chauché, N.; Hubbard, A.; Gascard, J.-C.; Box, J. E.; Bates, R.; Koppes, M.; Sole, A.; Christoffersen, P.; Patton, H.

    2014-08-01

    Warm, subtropical-originating Atlantic water (AW) has been identified as a primary driver of mass loss across the marine sectors of the Greenland Ice Sheet (GrIS), yet the specific processes by which this water mass interacts with and erodes the calving front of tidewater glaciers is frequently modelled and much speculated upon but remains largely unobserved. We present a suite of fjord salinity, temperature, turbidity versus depth casts along with glacial runoff estimation from Rink and Store glaciers, two major marine outlets draining the western sector of the GrIS during 2009 and 2010. We characterise the main water bodies present and interpret their interaction with their respective calving fronts. We identify two distinct processes of ice-ocean interaction which have distinct spatial and temporal footprints: (1) homogenous free convective melting which occurs across the calving front where AW is in direct contact with the ice mass, and (2) localised upwelling-driven melt by turbulent subglacial runoff mixing with fjord water which occurs at distinct injection points across the calving front. Throughout the study, AW at 2.8 ± 0.2 °C was consistently observed in contact with both glaciers below 450 m depth, yielding homogenous, free convective submarine melting up to ~200 m depth. Above this bottom layer, multiple interactions are identified, primarily controlled by the rate of subglacial fresh-water discharge which results in localised and discrete upwelling plumes. In the record melt year of 2010, the Store Glacier calving face was dominated by these runoff-driven plumes which led to a highly crenulated frontal geometry characterised by large embayments at the subglacial portals separated by headlands which are dominated by calving. Rink Glacier, which is significantly deeper than Store has a larger proportion of its submerged calving face exposed to AW, which results in a uniform, relatively flat overall frontal geometry.

  3. [Disinfection efficiency for outlet water from biological activated carbon process by different disinfecting modes].

    Science.gov (United States)

    Zhi, Xing-hua; Bai, Xiao-hui; Meng, Ming-qun

    2011-05-01

    Lab-scale tests were designed to treat the leak of bacteria from BAC process. Water samples from outlet of BAC pool in Xujing Waterworks in Shanghai were disinfected by NaClO and NH2Cl disinfectant to compare the disinfection efficiency. Heterotrophic bacteria in disinfected water were cultivated and counted and halo hydrocarbons were detected by GC. To keep the disinfecting efficacy [lg(N0/N)] over 2 under the water temperature of 30 degrees C, NaClO should have an initial concentration more than 1.84 mg/L total chlorine and contact with bacteria for about 30 minutes. As to NH2Cl disinfection, the initial concentration should be more than 2.20 mg/L total chlorine and contacting time should be prolonged to about 90 minutes. The production of CHCl3 ranged from 4.97 to 7.10 microg/L and CCl4 ranged from 0.01 to 0.71 microg/L in NaClO disinfection tests with a initial disinfecting concentration in the range of 1.53-2.42 mg/L total chlorine values. In NH2Cl disinfecting tests, CHCl3 ranged from 4.43 to 5.55 microg/L and CCl4 ranged from 0.01 to 0.64 microg/L when initial disinfecting concentration limited in the range of 2.10-2.86 mg/L total chlorine values. All was below the state drinking water standard. The results showed that the disinfection process can be divided into fast step and slow step. NaCl0 has higher disinfecting efficiency on bacteria than NH2Cl, but neither can reach 100% effectivity. Meanwhile the risk of producing halo hydrocarbon over standard was proved to be negligible.

  4. Numerical prediction and performance experiment in a deep-well centrifugal pump with different impeller outlet width

    Science.gov (United States)

    Shi, Weidong; Zhou, Ling; Lu, Weigang; Pei, Bing; Lang, Tao

    2013-01-01

    The existing research of the deep-well centrifugal pump mainly focuses on reduce the manufacturing cost and improve the pump performance, and how to combine above two aspects together is the most difficult and important topic. In this study, the performances of the deep-well centrifugal pump with four different impeller outlet widths are studied by the numerical, theoretical and experimental methods in this paper. Two stages deep-well centrifugal pump equipped with different impellers are simulated employing the commercial CFD software to solve the Navier-Stokes equations for three-dimensional incompressible steady flow. The sensitivity analyses of the grid size and turbulence model have been performed to improve numerical accuracy. The flow field distributions are acquired and compared under the design operating conditions, including the static pressure, turbulence kinetic energy and velocity. The prototype is manufactured and tested to certify the numerical predicted performance. The numerical results of pump performance are higher than the test results, but their change trends have an acceptable agreement with each other. The performance results indicted that the oversize impeller outlet width leads to poor pump performances and increasing shaft power. Changing the performance of deep-well centrifugal pump by alter impeller outlet width is practicable and convenient, which is worth popularizing in the engineering application. The proposed research enhances the theoretical basis of pump design to improve the performance and reduce the manufacturing cost of deep-well centrifugal pump.

  5. An Unusual Lesser Sac Collection Causing Gastric Outlet Obstruction with Coincidental Occurrence of Leriche’s Syndrome: A Case Report

    Science.gov (United States)

    Walia, Darshanjeet Singh; Kaur, Rishabhpreet

    2016-01-01

    Gastric outlet obstruction in adults is usually caused by pyloric stenosis secondary to peptic ulcer disease or malignancy. However, there are few other causes such as a foreign body and external compression due to pseudocyst pancreas. We present a rare aetiology of a large collection of pus in the lesser sac in our patient causing gastric outlet obstruction. A perforated peptic ulcer was suspected in our patient who had symptoms of sudden onset pain in epigastric region which was referred to back. This was followed by pain in upper abdomen, vomiting, constipation and fever for which patient was being managed conservatively before being referred to us. The CECT didn’t show any leakage of contrast to the lesser sac making the possibility of healed perforation likely as all other causes were ruled out at the time of presentation to our hospital. The CECT scan ruled out other causes of gastric outlet obstruction with normal wall thickness of the stomach and duodenum along with normal looking liver, pancreas and no lymphadenopathy. The liver function tests and serum amylase were within normal limits. Along with this, there was another unrelated rare coincidental finding of aortoiliac occlusive disease termed as Leriche’s syndrome. Ultrasound guided percutaneous drainage was done following which the patient’s obstruction was relieved and patient was referred to the department of vascular surgery for the mangement of aortoiliac occlusive disease. PMID:27190892

  6. Geographic Accessibility Of Food Outlets Not Associated With Body Mass Index Change Among Veterans, 2009-14.

    Science.gov (United States)

    Zenk, Shannon N; Tarlov, Elizabeth; Wing, Coady; Matthews, Stephen A; Jones, Kelly; Tong, Hao; Powell, Lisa M

    2017-08-01

    In recent years, various levels of government in the United States have adopted or discussed subsidies, tax breaks, zoning laws, and other public policies that promote geographic access to healthy food. However, there is little evidence from large-scale longitudinal or quasi-experimental research to suggest that the local mix of food outlets actually affects body mass index (BMI). We used a longitudinal design to examine whether the proximity of food outlets, by type, was associated with BMI changes between 2009 and 2014 among 1.7 million veterans in 382 metropolitan areas. We found no evidence that either absolute or relative geographic accessibility of supermarkets, fast-food restaurants, or mass merchandisers was associated with changes in an individual's BMI over time. While policies that alter only geographic access to food outlets may promote equitable access to healthy food and improve nutrition, our findings suggest they will do little to combat obesity in adults. Project HOPE—The People-to-People Health Foundation, Inc.

  7. Exploring obesogenic food environments in Edmonton, Canada: the association between socioeconomic factors and fast-food outlet access.

    Science.gov (United States)

    Hemphill, Eric; Raine, Kim; Spence, John C; Smoyer-Tomic, Karen E

    2008-01-01

    To explore the relationship between the placement of fast-food outlets and neighborhood-level socioeconomic variables by determining if indicators of lower socioeconomic status were predictive of exposure to fast food. A descriptive analysis of the fast-food environment in a Canadian urban center, using secondary analysis of census data and Geographic Information Systems technology. Edmonton, Alberta, Canada. Neighborhoods were classified as High, Medium, or Low Access based on the number of fast-food opportunities available to them. Neighborhood-level socioeconomic data (income, education, employment, immigration status, and housing tenure) from the 2001 Statistics Canada federal census were obtained. A discriminant function analysis was used to determine if any association existed between neighborhood demographic characteristics and accessibility of fast-food outlets. Significant differences were found between the three levels of fast-food accessibility across the socioeconomic variables, with successively greater percentages of unemployment, low income, and renters in neighborhoods with increasingly greater access to fast-food restaurants. A high score on several of these variables was predictive of greater access to fast-food restaurants. Although a causal inference is not possible, these results suggest that the distribution of fast-food outlets relative to neighborhood-level socioeconomic status requires further attention in the process of explaining the increased rates of obesity observed in relatively deprived populations.

  8. Internal Flow of a High Specific-Speed Diagonal-Flow Fan (Rotor Outlet Flow Fields with Rotating Stall

    Directory of Open Access Journals (Sweden)

    Norimasa Shiomi

    2003-01-01

    Full Text Available We carried out investigations for the purpose of clarifying the rotor outlet flow fields with rotating stall cell in a diagonal-flow fan. The test fan was a high–specific-speed (ns=1620 type of diagonal-flow fan that had 6 rotor blades and 11 stator blades. It has been shown that the number of the stall cell is 1, and its propagating speed is approximately 80% of its rotor speed, although little has been known about the behavior of the stall cell because a flow field with a rotating stall cell is essentially unsteady. In order to capture the behavior of the stall cell at the rotor outlet flow fields, hot-wire surveys were performed using a single-slant hotwire probe. The data obtained by these surveys were processed by means of a double phase-locked averaging technique, which enabled us to capture the flow field with the rotating stall cell in the reference coordinate system fixed to the rotor. As a result, time-dependent ensemble averages of the three-dimensional velocity components at the rotor outlet flow fields were obtained. The behavior of the stall cell was shown for each velocity component, and the flow patterns on the meridional planes were illustrated.

  9. Fractionating power and outlet stream polydispersity in asymmetrical flow field-flow fractionation. Part II: programmed operation.

    Science.gov (United States)

    Williams, P Stephen

    2017-01-01

    Asymmetrical flow field-flow fractionation (As-FlFFF) is a widely used technique for analyzing polydisperse nanoparticle and macromolecular samples. The programmed decay of cross flow rate is often employed. The interdependence of the cross flow rate through the membrane and the fluid flow along the channel length complicates the prediction of elution time and fractionating power. The theory for their calculation is presented. It is also confirmed for examples of exponential decay of cross flow rate with constant channel outlet flow rate that the residual sample polydispersity at the channel outlet is quite well approximated by the reciprocal of four times the fractionating power. Residual polydispersity is of importance when online MALS or DLS detection are used to extract quantitative information on particle size or molecular weight. The theory presented here provides a firm basis for the optimization of programmed flow conditions in As-FlFFF. Graphical abstract Channel outlet polydispersity remains significant following fractionation by As-FlFFF under conditions of programmed decay of cross flow rate.

  10. Improvement of the Efficiency of the Axial-Flow Pump at Part Loads due to Installing Outlet Guide Vanes Mechanism

    Directory of Open Access Journals (Sweden)

    Fan Yang

    2016-01-01

    Full Text Available In order to investigate the influence of adjustable outlet guide vane on the hydraulic performance of axial-flow pump at part loads, the axial-flow pump with 7 different outlet guide vane adjustable angles was simulated based on the RNG k-ε turbulent model and Reynolds time-averaged equations. The Vector graphs of airfoil flow were analyzed in the different operating conditions for different adjustable angles of guide vane. BP-ANN prediction model was established about the effect of adjustable outlet guide vane on the hydraulic performance of axial-flow pump based on the numerical results. The effectiveness of prediction model was verified by theoretical analysis and numerical simulation. The results show that, with the adjustable angle of guide vane increasing along clockwise, the high efficiency area moves to the large flow rate direction; otherwise, that moves to the small flow rate direction. The internal flow field of guide vane is improved by adjusting angle, and the flow separation of tail and guide vane inlet ledge are decreased or eliminated, so that the hydraulic efficiency of pumping system will be improved. The prediction accuracy of BP-ANN model is 1%, which can meet the requirement of practical engineering.

  11. The surgical anatomy of double-outlet right ventricle with concordant atrioventricular connection and noncommitted ventricular septal defect.

    Science.gov (United States)

    Stellin, G; Ho, S Y; Anderson, R H; Zuberbuhler, J R; Siewers, R D

    1991-12-01

    In describing hearts with double-outlet right ventricle, we have had problems with how best to use the term noncommitted as applied to the ventricular septal defect. We reviewed, therefore, 63 hearts with double-outlet right ventricle in the setting of usual atrial arrangement and a concordant atrioventricular connection. From these, 18 hearts with potentially noncommitted defects were identified and studied in detail. The defect was unequivocally remote from the ventricular outflow tracts in 16 of these hearts, being perimembranous with excavation to open into the inlet of the right ventricle in 12, two of these also having straddling of an atrioventricular valve. One heart had a muscular defect situated in the inlet part of the muscular septum, whereas the defect was the ventricular component of an atrioventricular septal defect in the other three. In the remaining two hearts the defect was anatomically juxtaposed to a subarterial outlet. The pathway to the outflow tract, however, was obstructed by leaflets of a straddling valve. Our study shows, therefore, the need to distinguish between anatomic "commitment" of the defect from the problems in terms of commitment that may confront the surgeon in the operating room. Not only does the distance between the interventricular communication and one of the subarterial outflow tract need to be assessed (the anatomic commitment), but also the presence and nature of any intervening extraneous tissues (the surgical commitment) requires assessment.

  12. DEM study of granular discharge rate through a vertical pipe with a bend outlet in small absorber sphere system

    Energy Technology Data Exchange (ETDEWEB)

    Li, Tianjin, E-mail: tjli@tsinghua.edu.cn; Zhang, He; Liu, Malin; Huang, Zhiyong; Bo, Hanliang; Dong, Yujie

    2017-04-01

    Highlights: • The work concerns granular flow in a vertical pipe with a bend. • Discharge rate fluctuation in vertical pipe are mainly from velocity fluctuation. • Steady discharge rate decreases rapidly and saturates with μ{sub s} increasing. • Steady discharge rate W{sub s} still obey the 5/2 power law of pipe internal diameter. • A correlation developed for steady discharge rate for this new geometry. - Abstract: Absorber sphere pneumatic conveying is a special application of pneumatic conveying technique in the pebble bed High Temperature Gas-Cooled Reactor (HTGR or HTR). Granular discharge through a vertical pipe with a bend outlet is one of the control modes to determine solid mass flowrate which is an important parameter for the design of absorber sphere pneumatic conveying. Granular discharge rate through the vertical pipe with a bend outlet in the small absorber sphere system are investigated by discrete element method simulation. The effect of geometry parameters on discharge rate, the discharge rate fluctuation in the vertical pipe, and the effect of friction on steady discharge rate (W{sub s}) are analyzed and discussed. The phenomena of discharge rate fluctuation in the vertical pipe are observed, which are mainly resulted from the evolution of the average downward granular velocity. The steady discharge rate decreases rapidly with sliding friction coefficient increasing from 0.125 to 0.5, and gradually saturates with the friction coefficient further increasing from 0.5 to 1. It is interesting that the linear relation between W{sub s}{sup 2/5} and pipe internal diameter D with zero intercept are found for the vertical pipe discharge with a bend outlet, which is different from the orifice discharge through a hopper or silo with none-zero intercept. A correlation similar to Beverloo’s correlation is developed to predict the steady discharge rate through the vertical pipe with a bend outlet. These results are helpful for the design of sphere

  13. Pemilihan food outlet sebagai faktor risiko berat badan lebih anak usia sekolah dasar di Kecamatan Tegalsari Surabaya

    Directory of Open Access Journals (Sweden)

    Renny Evelyn Hartono

    2016-08-01

    Full Text Available ABSTRACTIntroduction: Overweight and obesity are conditions resulting from an imbalance of calories in the body that occur in a long time and cause more deaths than underweight. One of factors related is food pattern, which also infl uenced the selection of food outlets. Surabaya is an urban area so it has many types and characteristic s of food outlet. Elementary school (4, 5, 6 do not really depend on their parents, so their food consumption and physical activity began to vary. Objectives: To identify the relationship between the selection of food outlets and overweight/obesity status of elementary school in Tegalsari district, Surabaya.Methods: This research used a case-control study design. Samples were 51 children for each group of cases and control and obtained from 11 primary school in the 5 subdistricts in Tegalsari district, Surabaya. Data were obtained by interview, direct observation of food outlets, and interview to select informants about the reasons of selecting food outlets . Quantitative data were processed by bivariate (chi-square and multivariate (binomial regression test. Results: Bivariate test results showed that there were signifi cant relationships between the frequency to the street vendors consumption (OR=4.09, 95% CI:1.60-10.75, frequency of fast food consumption (OR=2.86, 95% CI:1.19-6.94 and snacks (OR=6,05, 95% CI:2.20-17.62, physical activity (OR=3.09, 95% CI:1.28-7.51 and gender (OR=2.70, 95% CI:1.11-6.64 with overweight/obesity status, while frequency of stores (total, supermarket, market, mini-market, frequency of food service place (total, restaurants, fast food restaurants, frequency of vegetable and fruit consumption, and socio-economic status of respondents did not relate signifi cantly. In multivariate analysis, the variables that affected frequency of the street vendors were snack consumption, physical activity, sex and total expenditure. Conclusions: Frequency of the street vendors, fast food consumption

  14. IMPACT OF SERVICE QUALITY ON CUSTOMER SATISFACTION AND LOYALTY: IN THE CONTEXT OF RETAIL OUTLETS IN DB CITY SHOPPING MALL BHOPAL

    National Research Council Canada - National Science Library

    A P Singh; Satendra Thakur

    2012-01-01

      The purpose of the research article to examine the effect of service quality on customer satisfaction and loyalty in the context of retail outlets in DB City shopping mall Bhopal, Five dimension...

  15. Surgical management of functional bladder outlet obstruction in adults with neurogenic bladder dysfunction.

    Science.gov (United States)

    Utomo, Elaine; Groen, Jan; Blok, Bertil F M

    2014-05-24

    The most common type of functional bladder outlet obstruction in patients with neurogenic bladder is detrusor-sphincter dyssynergia (DSD). The lack of co-ordination between the bladder and the external urethral sphincter muscle (EUS) in DSD can result in poor bladder emptying and high bladder pressures, which may eventually lead to progressive renal damage. To assess the effectiveness of different surgical therapies for the treatment of functional bladder outlet obstruction (i.e. DSD) in adults with neurogenic bladder dysfunction. We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, and handsearching of journals and conference proceedings (searched 20 February 2014), and the reference lists of relevant articles. Randomised controlled trials (RCTs) or quasi-RCTs comparing a surgical treatment of DSD in adults suffering from neurogenic bladder dysfunction, with no treatment, placebo, non-surgical treatment, or other surgical treatment, alone or in combination. Two review authors independently assessed trial quality and extracted data. We included five trials (total of 199 participants, average age of 40 years). The neurological diseases causing DSD were traumatic spinal cord injury (SCI), multiple sclerosis (MS), or congenital malformations.One trial compared placement of sphincteric stent prosthesis with sphincterotomy. For urodynamic measurements, results for postvoid residual urine volume (PVR) and cystometric bladder capacity were inconclusive and consistent with benefit of either sphincteric stent prosthesis or sphincterotomy at three, six, 12, and 24 months. Results for maximum detrusor pressure (Pdet.max) were also inconclusive at three, six, and 12 months; however, after two years, the Pdet.max after sphincterotomy was lower than after stent placement (mean difference (MD) -30 cmH2O, 95% confidence interval (CI) 8.99 to

  16. Tremors behind the power outlet - where earthquakes appear on our monthly bill

    Science.gov (United States)

    Baisch, Stefan

    2013-04-01

    (micro earthquakes) increases the hydraulic conductivity. Magnitudes of the induced micro earthquakes are typically below the human detection threshold, but a few exceptionally strong events in the order of ML=3.5 have occurred in EGS reservoirs. In one case, slight material damage was caused, which eventually led to a project stop. Although these induced micro earthquakes are usually generated under well-controlled conditions, the possibility of rare occurrences of felt events in EGS reservoirs remains part of the technology. The same applies for the up-scaling of hydrocarbon production. Tapping unconventional resources requires similar stimulation technologies as used for EGS. Every power production technology has got its prize - we have to decide what currency we are willing to pay and to what extent we are ready to accept the small tremors behind our power outlet.

  17. The changing food outlet distributions and local contextual factors in the United States.

    Science.gov (United States)

    Chen, Hsin-Jen; Wang, Youfa

    2014-01-16

    Little is known about the dynamics of the food outlet distributions associated with local contextual factors in the U.S. This study examines the changes in food stores/services at the 5-digit Zip Code Tabulated Area (ZCTA5) level in the U.S., and assesses contextual factors associated with the changes. Data from 27,878 ZCTA5s in the contiguous United States without an extreme change in the number of 6 types of food stores/services (supermarkets, small-size grocery stores, convenience stores, fresh/specialty food markets, carry-out restaurants, and full-service restaurants) were used. ZCTA5s' contextual factors were from the 2000 Census. Numbers of food stores/services were derived from the Census Business Pattern databases. Linear regression models assessed contextual factors' influences (racial/ethnic compositions, poverty rate, urbanization level, and foreign-born population%) on 1-year changes in food stores/services during 2000-2001, adjusted for population size, total business change, and census regions. Small-size grocery stores and fresh/specialty food markets increased more and convenience stores decreased more in Hispanic-predominant than other areas. Among supermarket-free places, new supermarkets were less likely to be introduced into black-predominant than white-predominant areas (odds ratio (OR) = 0.52, 95% CI = 0.30-0.92). However, among areas without the following type of store at baseline, supermarket (OR = 0.48 (0.33-0.70)), small-size grocery stores (OR = 1.32 (1.08-1.62)), and fresh/specialty food markets (OR = 0.70 (0.53-0.92)) were less likely to be introduced into areas of low foreign-born population than into areas of high foreign-born population. Higher poverty rate was associated with a greater decrease in supermarket, a less decrease in small-size grocery stores, and a less increase in carry-out restaurants (all p for trends <0.001). Urban areas experienced more increases in full-service and carry-out restaurants than

  18. Testosterone Modifies Alterations to Detrusor Muscle after Partial Bladder Outlet Obstruction in Juvenile Mice.

    Science.gov (United States)

    Flum, Andrew S; Firmiss, Paula R; Bowen, Diana K; Kukulka, Natalie; Delos Santos, Grace B; Dettman, Robert W; Gong, Edward M

    2017-01-01

    Lower urinary tract symptoms secondary to posterior urethral valves (PUV) arise in boys during adolescence. The reasons for this have previously been attributed to increased urine output as boys experience increased growth. Additionally, there are few choices for clinicians to effectively treat these complications. We formed the new hypothesis that increased androgen levels at this time of childhood development could play a role at the cellular level in obstructed bladders. To test this hypothesis, we investigated the role of testosterone on bladder detrusor muscle following injury from partial bladder outlet obstruction (PO) in mice. A PO model was surgically created in juvenile male mice. A group of mice were castrated by bilateral orchiectomy at time of obstruction (CPO). Testosterone cypionate was administered to a group of castrated, obstructed mice (CPOT). Bladder function was assessed by voiding stain on paper (VSOP). Bladders were analyzed at 7 and 28 days by weight and histology. Detrusor collagen to smooth muscle ratio (Col/SM) was calculated using Masson's trichrome stain. All obstructed groups had lower max voided volumes (MVV) than sham mice at 1 day. Hormonally intact mice (PO) continued to have lower MVV at 7 and 28 days while CPO mice improved to sham levels at both time points. In accordance, PO mice had higher bladder-to-body weight ratios than CPO and sham mice demonstrating greater bladder hypertrophy. Histologically, Col/SM was lower in sham and CPO mice. When testosterone was restored in CPOT mice, MVV remained low at 7 and 28 days compared to CPO and bladder-to-body weight ratios were also greater than CPO. Histologic changes were also seen in CPOT mice with higher Col/SM than sham and CPO mice. In conclusion, our findings support a role for testosterone in the fibrotic changes that occur after obstruction in male mice. This suggests that while other changes may occur in adolescent boys that cause complication in boys with PUV, the

  19. Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Gabra Michael

    2011-06-01

    Full Text Available Abstract Background In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. Methods The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. The program established a supply of subsidized ACTs, created a price system with a cost recovery plan, developed a plan to distribute the subsidized products to the ADDOs, trained dispensers, and strengthened the adverse drug reactions reporting system. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. This intervention was implemented from 2007-2008. Results During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased after the start of the pilot, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008. District-specific data showed substantial variation among the districts in ACT uptake through ADDOs, ranging from ACTs representing 10% of all antimalarial sales

  20. The Relationship between Alcohol Outlets, HIV Risk Behavior, and HSV-2 Infection among South African Young Women: A Cross-Sectional Study.

    Science.gov (United States)

    Rosenberg, Molly; Pettifor, Audrey; Van Rie, Annelies; Thirumurthy, Harsha; Emch, Michael; Miller, William C; Gómez-Olivé, F Xavier; Twine, Rhian; Hughes, James P; Laeyendecker, Oliver; Selin, Amanda; Kahn, Kathleen

    2015-01-01

    Alcohol consumption has a disinhibiting effect that may make sexual risk behaviors and disease transmission more likely. The characteristics of alcohol-serving outlets (e.g. music, dim lights, lack of condoms) may further encourage risky sexual activity. We hypothesize that frequenting alcohol outlets will be associated with HIV risk. In a sample of 2,533 school-attending young women in rural South Africa, we performed a cross-sectional analysis to examine the association between frequency of alcohol outlet visits in the last six months and four outcomes related to HIV risk: number of sex partners in the last three months, unprotected sex acts in the last three months, transactional sex with most recent partner, and HSV-2 infection. We also tested for interaction by alcohol consumption. Visiting alcohol outlets was associated with having more sex partners [adjusted odds ratio (aOR), one versus zero partners (95% confidence interval (CI)): 1.51 (1.21, 1.88)], more unprotected sex acts [aOR, one versus zero acts (95% CI): 2.28 (1.52, 3.42)], higher levels of transactional sex [aOR (95% CI): 1.63 (1.03, 2.59)], and HSV-2 infection [aOR (95% CI): 1.30 (0.88, 1.91)]. In combination with exposure to alcohol consumption, visits to alcohol outlets were more strongly associated with all four outcomes than with either risk factor alone. Statistical evidence of interaction between alcohol outlet visits and alcohol consumption was observed for all outcomes except transactional sex. Frequenting alcohol outlets was associated with increased sexual risk in rural South African young women, especially when they consumed alcohol. Sexual health interventions targeted at alcohol outlets may effectively reach adolescents at high risk for sexually transmitted infections like HIV and HSV-2. HIV Prevention Trials Network HPTN 068.

  1. Evaluation of medicine retail outlets for sale of typhoid fever vaccine among adults in two urban and rural settings in western Kenya: a proof-of-concept study.

    Science.gov (United States)

    Ho, Julius; Odhiambo, Gladys; Meng'anyi, Lucy W; Musuva, Rosemary M; Mule, Joseph M; Alaly, Zakayo S; Odiere, Maurice R; Mwinzi, Pauline N; Ganley-Leal, Lisa

    2016-09-29

    Private sector medicine outlets are an important provider of health services across the developing world, and are an untapped means of distributing and selling vaccines outside of childhood immunization programs. The present study assessed the viability of medicine outlets (chemists and pharmacies) as potential channels for sale of vaccines. To evaluate the viability of the medicine outlet model, we partnered with nine outlets across urban and rural communities in western Kenya to sell a nurse-administered typhoid vaccine. Purchasers were surveyed to reveal market demographic characteristics, reasons for vaccine purchase, and sources of information about the program. Key informant interviews and focus group discussions defined acceptability, demand, and additional suggestions for improving this mechanism of selling and distributing vaccines. There was a higher than expected demand for the vaccine that resulted in stock-outs. Previous instance of typhoid, desire to prevent disease, affordable price and convenience were cited by most participants as main reasons for purchase of vaccine at the local outlet. The most common source of information on the vaccine sale was word-of-mouth and referral from friends. Longer vaccine sale duration, adequate stocking of vaccines and extended hours of administration in the evening to allow working individuals to buy vaccines were cited by participants as ways for improved participation in the future. This study demonstrated a high demand for vaccines at community medicine outlets. Important insights on how to improve and sustain such a program included extension of distribution time, education of outlet keepers, and minimizing vaccine stockouts. With improved social marketing, infrastructure mapping, education and pricing schemes, medicine outlets could become a sustainable avenue for selling adult vaccines in emerging markets for both routine and pandemic vaccines.

  2. Brief report: Using global positioning system (GPS) enabled cell phones to examine adolescent travel patterns and time in proximity to alcohol outlets.

    Science.gov (United States)

    Byrnes, Hilary F; Miller, Brenda A; Morrison, Christopher N; Wiebe, Douglas J; Remer, Lillian G; Wiehe, Sarah E

    2016-07-01

    As adolescents gain freedom to explore new environments unsupervised, more time in proximity to alcohol outlets may increase risks for alcohol and marijuana use. This pilot study: 1) Describes variations in adolescents' proximity to outlets by time of day and day of the week, 2) Examines variations in outlet proximity by drinking and marijuana use status, and 3) Tests feasibility of obtaining real-time data to study adolescent proximity to outlets. U.S. adolescents (N = 18) aged 16-17 (50% female) carried GPS-enabled smartphones for one week with their locations tracked. The geographic areas where adolescents spend time, activity spaces, were created by connecting GPS points sequentially and adding spatial buffers around routes. Proximity to outlets was greater during after school and evening hours. Drinkers and marijuana users were in proximity to outlets 1½ to 2 times more than non-users. Findings provide information about where adolescents spend time and times of greatest risk, informing prevention efforts. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  3. Fractionating power and outlet stream polydispersity in asymmetrical flow field-flow fractionation. Part I: isocratic operation.

    Science.gov (United States)

    Williams, P Stephen

    2016-05-01

    Asymmetrical flow field-flow fractionation (As-FlFFF) has become the most commonly used of the field-flow fractionation techniques. However, because of the interdependence of the channel flow and the cross flow through the accumulation wall, it is the most difficult of the techniques to optimize, particularly for programmed cross flow operation. For the analysis of polydisperse samples, the optimization should ideally be guided by the predicted fractionating power. Many experimentalists, however, neglect fractionating power and rely on light scattering detection simply to confirm apparent selectivity across the breadth of the eluted peak. The size information returned by the light scattering software is assumed to dispense with any reliance on theory to predict retention, and any departure of theoretical predictions from experimental observations is therefore considered of no importance. Separation depends on efficiency as well as selectivity, however, and efficiency can be a strong function of retention. The fractionation of a polydisperse sample by field-flow fractionation never provides a perfectly separated series of monodisperse fractions at the channel outlet. The outlet stream has some residual polydispersity, and it will be shown in this manuscript that the residual polydispersity is inversely related to the fractionating power. Due to the strong dependence of light scattering intensity and its angular distribution on the size of the scattering species, the outlet polydispersity must be minimized if reliable size data are to be obtained from the light scattering detector signal. It is shown that light scattering detection should be used with careful control of fractionating power to obtain optimized analysis of polydisperse samples. Part I is concerned with isocratic operation of As-FlFFF, and part II with programmed operation.

  4. Gastric Outlet Obstruction After Esophagectomy: Retrospective Analysis of the Effectiveness and Safety of Postoperative Endoscopic Pyloric Dilatation.

    Science.gov (United States)

    Maus, Martin K H; Leers, Jessica; Herbold, Till; Bludau, Marc; Chon, Seung-Hun; Kleinert, Robert; Hescheler, Daniel A; Bollschweiler, Elfriede; Hölscher, Arnulf H; Schäfer, Hartmut; Alakus, Hakan

    2016-10-01

    Delayed gastric emptying after esophagectomy with gastric replacement can pose a significant postoperative problem, often leading to aspiration and pneumonia. The present study analyzes retrospectively the effectiveness of endoscopic pyloric dilatation for post-surgical gastric outlet obstruction. Between March 2006 and March 2010, 403 patients underwent a transthoracic en-bloc esophagectomy and reconstruction with a gastric tube and intrathoracic esophagogastrostomy. In patients with postoperative symptoms of an outlet dysfunction and the confirmation by endoscopy, pyloric dilatations were performed without preference with either 20- or 30-mm balloons. A total of 89 balloon dilatations of the pylorus after esophagectomy were performed in 60 (15.6 %) patients. In 21 (35 %) patients, a second dilatation of the pylorus was performed. 55 (61.8 %) dilatations were performed with a 30-mm balloon and 34 (38.2 %) with a 20-mm balloon. The total redilatation rate for the 30-mm balloon was 20 % (n = 11) and 52.9 % (n = 18) for the 20-mm balloon (p < 0.001). All dilatations were performed without any complications. Pylorus spasm contributes to delayed gastric emptying leading to postoperative complications after esophagectomy. Endoscopic pyloric dilatation after esophagectomy is a safe procedure for treatment of gastric outlet obstruction. The use of a 30-mm balloon has the same safety profile but a 2.5 lower redilatation rate compared to the 20-mm balloon. Thus, the use of 20-mm balloons has been abandoned in our clinic.

  5. Field validation of secondary data sources: a novel measure of representativity applied to a Canadian food outlet database.

    Science.gov (United States)

    Clary, Christelle M; Kestens, Yan

    2013-06-19

    Validation studies of secondary datasets used to characterize neighborhood food businesses generally evaluate how accurately the database represents the true situation on the ground. Depending on the research objectives, the characterization of the business environment may tolerate some inaccuracies (e.g. minor imprecisions in location or errors in business names). Furthermore, if the number of false negatives (FNs) and false positives (FPs) is balanced within a given area, one could argue that the database still provides a "fair" representation of existing resources in this area. Yet, traditional validation measures do not relax matching criteria, and treat FNs and FPs independently. Through the field validation of food businesses found in a Canadian database, this paper proposes alternative criteria for validity. Field validation of the 2010 Enhanced Points of Interest (EPOI) database (DMTI Spatial®) was performed in 2011 in 12 census tracts (CTs) in Montreal, Canada. Some 410 food outlets were extracted from the database and 484 were observed in the field. First, traditional measures of sensitivity and positive predictive value (PPV) accounting for every single mismatch between the field and the database were computed. Second, relaxed measures of sensitivity and PPV that tolerate mismatches in business names or slight imprecisions in location were assessed. A novel measure of representativity that further allows for compensation between FNs and FPs within the same business category and area was proposed. Representativity was computed at CT level as ((TPs +|FPs-FNs|)/(TPs+FNs)), with TPs meaning true positives, and |FPs-FNs| being the absolute value of the difference between the number of FNs and the number of FPs within each outlet category. The EPOI database had a "moderate" capacity to detect an outlet present in the field (sensitivity: 54.5%) or to list only the outlets that actually existed in the field (PPV: 64.4%). Relaxed measures of sensitivity and PPV

  6. Data on metal levels in the inlet and outlet wastewater treatment plant of hospitals in Bushehr province, Iran

    Directory of Open Access Journals (Sweden)

    Fereshte Babaahmadi

    2017-02-01

    Full Text Available In this paper, we measured the levels of metals including Pb, Cr, Cd, Ni, Hg, Fe, and Cu in the inlet and outlet wastewater of hospitals. The samples were taken from wastewater in Bushehr׳s province hospitals, Iran. After the collection of samples, the concentration levels of metals were determined by using graphite furnace absorption spectrometer (AAS method (Varian, SpectrAA 240, Australia. Statistical analysis of the data was carried out using Special Package for Social Sciences (SPSS 16.

  7. Constraining calving front processes on W Greenland outlet glaciers using inertial-corrected laser scanning & swath-bathymetry

    Science.gov (United States)

    Bates, R.; Hubbard, A.; Neale, M.; Woodward, J.; Box, J. E.; Nick, F.

    2010-12-01

    Calving and submarine melt account for the majority of loss from the Antarctic and over 50% of that from the Greenland Ice Sheet. These ice-ocean processes are highly efficient mass-loss mechanisms, providing a rapid link between terrestrial ice (storage) and the oceanic sink (sea level/freshwater flux) which renders the ocean-outlet-ice sheet system potentially highly non-linear. Despite this, the controls on tidewater processes are poorly understood and a process based description of them is lacking from the present generation of coupled ice sheet models. We present details from an innovative study where two survey techniques are integrated to enable the construction of accurate, ~m resolution 3d digital terrain models (DTMs) of the aerial and submarine ice front of calving outlet glaciers. A 2km range terrestrial laser scanner was combined with a 416KHz swath-interferometric system and corrected via an inertial motion unit stabilized by RTK GPS and gyro-compass data. The system was mounted aboard a heavy displacement (20,000kg) yacht in addition to a light displacement (100kg) semi-autonomous boat and used to image the aerial and submarine calving fronts of two large outlet glaciers in W Greenland. Six daily surveys, each 2.5km long were repeated across Lille Glacier during which significant ice flow, melt and calving events were observed and captured from on-ice GPS stations and time-lapse sequences. A curtain of CTD and velocity casts were also conducted to constrain the fresh and oceanic mass and energy fluxes within the fjord. The residual of successive DTMs yield the spatial pattern of frontal change enabling the processes of aerial and submarine calving and melt to be quantified and constrained in unprecedented detail. These observed frontal changes are tentatively related to local dynamic, atmospheric and oceanographic processes that drive them. A partial survey of Store Glacier (~7km calving front & W Greenland 2nd largest outlet after Jakobshavn Isbrae

  8. Chondrosarcoma of right 1st rib presenting as neurogenic thoracic outlet syndrome; A 13th case report in world literature

    Directory of Open Access Journals (Sweden)

    Ravisagar Patel

    2016-07-01

    Full Text Available Thoracic outlet syndrome [TOS] caused by a tumor of the rib is rare and has been reported only 12 times in the literature over the past one and one-half centuries, with the majority of cases due to osteochondroma. We report a case of chondrosarcoma of right 1st rib causing neurogenic TOS that was resected via posterolateral thoracotomy and biopsy confirmed a grade I chondrosarcoma. In the treatment of chondrosarcoma, chemotherapy and radiotherapy are less effective, and appropriate surgery is needed.

  9. Assessing the Validity of On-Premise Alcohol License Data in Six Communities in California: Operating Characteristics and Outlet Densities

    Science.gov (United States)

    Ponicki, William R.; Gruenewald, Paul J.; Remer, Lillian G.; Martin, Scott E.; Treno, Andrew J.

    2014-01-01

    This study evaluated State of California alcohol license records as a measure of businesses selling alcohol for consumption on premise. In 2008, researchers attempted to visit all 799 licensed restaurants, bars, and pubs in six medium-sized cities near San Francisco. Surveys collected detailed business characteristics for a subsample of 151 bars or restaurants that included a separate bar area. Results suggest inaccuracies of official records regarding license locations and types (bar/pub vs. restaurant). Analyses also indicate that establishment characteristics are related to local alcohol outlet densities. Study implications and limitations are discussed. PMID:23905583

  10. Case management of malaria fever in Cambodia: results from national anti-malarial outlet and household surveys

    Directory of Open Access Journals (Sweden)

    Littrell Megan

    2011-10-01

    Full Text Available Abstract Background Continued progress towards global reduction in morbidity and mortality due to malaria requires scale-up of effective case management with artemisinin-combination therapy (ACT. The first case of artemisinin resistance in Plasmodium falciparum was documented in western Cambodia. Spread of artemisinin resistance would threaten recent gains in global malaria control. As such, the anti-malarial market and malaria case management practices in Cambodia have global significance. Methods Nationally-representative household and outlet surveys were conducted in 2009 among areas in Cambodia with malaria risk. An anti-malarial audit was conducted among all public and private outlets with the potential to sell anti-malarials. Indicators on availability, price and relative volumes sold/distributed were calculated across types of anti-malarials and outlets. The household survey collected information about management of recent "malaria fevers." Case management in the public versus private sector, and anti-malarial treatment based on malaria diagnostic testing were examined. Results Most public outlets (85% and nearly half of private pharmacies, clinics and drug stores stock ACT. Oral artemisinin monotherapy was found in pharmacies/clinics (9%, drug stores (14%, mobile providers (4% and grocery stores (2%. Among total anti-malarial volumes sold/distributed nationally, 6% are artemisinin monotherapies and 72% are ACT. Only 45% of people with recent "malaria fever" reportedly receive a diagnostic test, and the most common treatment acquired is a drug cocktail containing no identifiable anti-malarial. A self-reported positive diagnostic test, particularly when received in the public sector, improves likelihood of receiving anti-malarial treatment. Nonetheless, anti-malarial treatment of reportedly positive cases is low among people who seek treatment exclusively in the public (61% and private (42% sectors. Conclusions While data on the anti

  11. Tanddú: Desarrollo de un plan de marketing digital para la creación de un outlet virtual

    OpenAIRE

    Estrada-García, Claudia Marcela

    2015-01-01

    Este trabajo es el resultado del Máster Universitario en Marketing Digital y Comercio Electrónico realizado en la Universidad Internacional de la Rioja en España, en el cual se obtuvieron todos los conocimientos prácticos y teóricos para el desarrollo del plan de marketing digital de Tanddú, un outlet virtual de artículos deportivos en Colombia. Inicialmente se realizó un análisis del entorno basado en la herramienta PEST, la cual sirvió para delimitar el contexto del macroentorno e identi...

  12. Accessibility of fast food outlets is associated with fast food intake. A study in the Capital Region of Denmark

    DEFF Research Database (Denmark)

    Bernsdorf, Kamille Almer; Lau, Cathrine Juel; Andreasen, Anne Helms

    2017-01-01

    Literature suggests that people living in areas with a wealth of unhealthy fast food options may show higher levels of fast food intake. Multilevel logistic regression analyses were applied to examine the association between GIS-located fast food outlets (FFOs) and self-reported fast food intake...... among adults (+ 16 years) in the Capital Region of Denmark (N = 48,305). Accessibility of FFOs was measured both as proximity (distance to nearest FFO) and density (number of FFOs within a 1km network buffer around home). Odds of fast food intake ≥ 1/week increased significantly with increasing FFO...

  13. Damage distribution and remnant life assessment of a super-heater outlet header used for long time

    Energy Technology Data Exchange (ETDEWEB)

    Hiroyuki, Okamura [Science Univ. of Tokyo (Japan); Ryuichi, Ohotani [Kyoto Univ. (Japan); Kazuya, Fujii [Japan Power Engineering and Inspection Corp., Tokyo (Japan); Masashi, Nakashiro; Fumio, Takemasa; Hideo, Umaki; Tomiyasu, Masumura [Ishikawajima-Harima Heavy Industries Co. Ltd., Tokyo (Japan)

    1998-11-01

    This paper presents the results of investigation on evaluating damage distribution to base metals and welded joints in the thickness direction and evaluate damage on ligaments. Thick wall tested sample was the superheater outlet header component long term serviced in high pressure and temperature condition in thermal power plant. The simulate unused steel of component material was made from sample by suitable heat treatment, and the extent of damage was assessed based on a comparison of nondestructive and destructive test results between simulate unused and aged samples. Damage evaluation was also made by FEM structural stress analysis. (orig./MM)

  14. The changing food outlet distributions and local contextual factors in the United States

    Science.gov (United States)

    2014-01-01

    Background Little is known about the dynamics of the food outlet distributions associated with local contextual factors in the U.S. This study examines the changes in food stores/services at the 5-digit Zip Code Tabulated Area (ZCTA5) level in the U.S., and assesses contextual factors associated with the changes. Methods Data from 27,878 ZCTA5s in the contiguous United States without an extreme change in the number of 6 types of food stores/services (supermarkets, small-size grocery stores, convenience stores, fresh/specialty food markets, carry-out restaurants, and full-service restaurants) were used. ZCTA5s’ contextual factors were from the 2000 Census. Numbers of food stores/services were derived from the Census Business Pattern databases. Linear regression models assessed contextual factors’ influences (racial/ethnic compositions, poverty rate, urbanization level, and foreign-born population%) on 1-year changes in food stores/services during 2000–2001, adjusted for population size, total business change, and census regions. Results Small-size grocery stores and fresh/specialty food markets increased more and convenience stores decreased more in Hispanic-predominant than other areas. Among supermarket-free places, new supermarkets were less likely to be introduced into black-predominant than white-predominant areas (odds ratio (OR) = 0.52, 95% CI = 0.30-0.92). However, among areas without the following type of store at baseline, supermarket (OR = 0.48 (0.33-0.70)), small-size grocery stores (OR = 1.32 (1.08-1.62)), and fresh/specialty food markets (OR = 0.70 (0.53-0.92)) were less likely to be introduced into areas of low foreign-born population than into areas of high foreign-born population. Higher poverty rate was associated with a greater decrease in supermarket, a less decrease in small-size grocery stores, and a less increase in carry-out restaurants (all p for trends <0.001). Urban areas experienced more increases in full

  15. Occurrence and seasonal variations of per- and polyfluoroalkyl substances (PFASs) including fluorinated alternatives in rivers, drain outlets and the receiving Bohai Sea of China.

    Science.gov (United States)

    Chen, Hong; Han, Jianbo; Zhang, Can; Cheng, Jiayi; Sun, Ruijun; Wang, Xiaomeng; Han, Gengchen; Yang, Wenchao; He, Xin

    2017-12-01

    A simultaneous sampling campaign was undertaken to study the pollution by 21 per- and polyfluoroalkyl substances (PFASs) in rivers, drain outlets and their receiving Bohai Sea of China. Chlorinated polyfluoroalkyl ether sulfonic acids (Cl-PFESAs) are being used as fluorinated alternatives and they were included in this study. In comparison with other regions and countries, high concentrations of ∑21PFASs in seawater samples from the Bohai Sea, ranging from 5.03 to 41 700 ng/L (median: 64.8 ng/L), were observed. The spatial distribution of PFAS levels in this sea area was in the ranking of Laizhou Bay > Liaodong Bay > Bohai Bay > other sea areas. By comparing the levels and composition profiles of PFASs in the seawater and their sources (rivers and drain outlets), it was concluded that rivers and drain outlets are the primary sources of PFAS contamination to the Bohai Sea. These PFAS levels varied seasonally among the rivers and drain outlets, but statistically significant changes were not observed. Levels of 6:2 and 8:2 Cl-PFESAs in rivers, drain outlets and receiving sea were firstly reported in the present study. Relatively high concentrations of 6:2 Cl-PFESA were found in drain outlets, ranging from below method limits of quantification (MLQ) to 7600 ng/L, but 8:2 Cl-PFAES detection was infrequent and all median concentration below MLQ. Mass discharges to the sea of 6:2 Cl-PFESA from rivers and drain outlets to the sea were estimated to be 37 and 17 kg/y, respectively. Copyright © 2017. Published by Elsevier Ltd.

  16. OPERABILITY RATE OF DISTAL GASTRIC CANCER AND THE EFFECT OF GASTRIC OUTLET OBSTRUCTION IN THE OPERABILITY RATE AND POSTOPERATIVE OUTCOME- A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Rajesh T. R

    2017-10-01

    Full Text Available BACKGROUND Stomach cancer is the fourth most common malignancy in the world. 1 Except in countries where screening for stomach cancer is prevalent, most of the distal stomach tumours are diagnosed at advanced stage. Gastric outlet obstruction is usually believed to be a sign of locally-advanced disease. Complete surgical removal of the disease (R0 is the only potentially curative treatment for resectable gastric cancer. The aim of the study is to finda The operability rate of gastric cancer in our institution and the incidence of Gastric Outlet Obstruction (GOO in patients undergoing gastrectomy for distal gastric cancer. b To compare the postoperative outcome in patients with gastric outlet obstruction and those without gastric outlet obstruction. c To see if the histology of the tumour has any role in the development of GOO. MATERIALS AND METHODS This is a retrospective study. The study includes patients who were admitted with carcinoma stomach and underwent operative or nonoperative treatment in our institution during 2013 to 2015. RESULTS Overall operability rate was 45.8%. Operable patients in the GOO group were 47%. Operability in the no outlet obstruction group were 45%. Data shows a slightly increased predilection for GOO in diffuse and mixed type of tumours (statistically not significant. Intestinal tumours had significant rate of anaemia compared to diffuse tumours (p <0.005. Overall mortality was 6.7%. Mortality is higher in the GOO group (8.8%. CONCLUSION (a. Operability rate of distal gastric cancer in our institution is 45.8%. (b. Incidence of gastric outlet obstruction in patients undergoing gastrectomy is 38.2%. (c. Presence of gastric outlet obstruction does not influence operability rate (47% vs. 45%. (d. Morbidity and mortality after distal radical gastrectomy is comparable in both groups. (e. Both intestinal and diffuse histology have equal incidence of GOO. (f. Chronic blood loss and incidence of anaemia is more in

  17. Numerical Research on Hydraulically Generated Vibration and Noise of a Centrifugal Pump Volute with Impeller Outlet Width Variation

    Directory of Open Access Journals (Sweden)

    Houlin Liu

    2014-01-01

    Full Text Available The impeller outlet width of centrifugal pumps is of significant importance for numbers of effects. In the paper, these effects including the performance, pressure pulsations, hydraulically generated vibration, and noise level are investigated. For the purpose, two approaches were used to predict the vibration and sound radiation of the volute under fluid excitation force. One approach is the combined CFD/FEM analysis for structure vibration, and then the structure response obtained from the FEM analysis is treated as the boundary condition for BEM analysis for sound radiation. The other is the combined CFD/FEM/BEM coupling method. Before the numerical methods were used, the simulation results were validated by the vibration acceleration of the monitoring points on the volute. The vibration and noise were analyzed and compared at three flow conditions. The analysis of the results shows that the influences of the sound pressure of centrifugal pumps on the structure appear insignificant. The relative outlet width b2* at nq(SI = 26.7 in this paper should be less than 0.06, based on an overall consideration of the pump characteristics, pressure pulsations, vibration and noise level.

  18. Neighbourhood deprivation and outlet density for tobacco, alcohol and fast food: first hints of obesogenic and addictive environments in Germany.

    Science.gov (United States)

    Schneider, Sven; Gruber, Johannes

    2013-07-01

    The current discussion regarding ‘place effects on health’ is increasingly focusing on the characteristics of a specific physical environment. Our study investigated whether socially deprived residential areas are more likely than affluent neighbourhoods to provide access to addictive substances and fast food. In this ecological study the total number of tobacco, alcohol and fastfood outlets was recorded and visualized using a geographic information system. Area affluence was measured through the percentage of parents with children of kindergarten or school age with joint annual taxable income ,h12 272. Eighteen social areas in Cologne, Germany. All social areas in four districts in Cologne, Germany, with a total of 92 000 inhabitants, were analysed. In the investigation area, 339 tobacco, 353 alcohol and sixty-seven fastfood outlets were identified. As area affluence declined the availability of the following potentially health damaging sources increased: cigarettes (Kendall’s tau50?433; P50?012), alcohol (Kendall’s tau50?341, P50?049) and fast food (Kendall’s tau50?473; P50?009). The availability of addictive substances and fast food can be seen to have a contextual influence on an individual’s lifestyle and can, in the form of physical exposure to obesogenic and addictive environments, contribute to a culmination of health risks.

  19. Availability of weight-loss supplements: Results of an audit of retail outlets in a southeastern city.

    Science.gov (United States)

    Sharpe, Patricia A; Granner, Michelle L; Conway, Joan M; Ainsworth, Barbara E; Dobre, Mirela

    2006-12-01

    The sale of nonprescription weight-loss products accounts for millions of dollars spent by Americans trying to lose weight, yet there is little evidence for effectiveness and there are multiple safety concerns. The purpose of this study was to determine what products, and ingredients within products, were available at retail outlets in a metropolitan area. A purposive sampling strategy identified 73 retail outlets. An audit form was used to collect information from product labels. The audit identified 402 products containing 4,053 separate ingredients. The mean number of ingredients per product was 9.9+/-8.96 (range = 1 to 96). A database search was conducted regarding evidence for effectiveness, safety precautions, and side effects for the 10 ingredients that appeared most often across products. Modest evidence of effectiveness exists for green tea (Camellia sinensis), chromium picolinate, and ma huang (Ephedra major). For the remaining seven (ginger root [Zingiber officinale], guarana [Paullinia cupana], hydroxycitric acid [Garcinia cambogia], white willow [Salix alba], Siberian ginseng [Eleutherococcus senticosus], cayenne [Capsicum annuum], and bitter orange/zhi shi [Citrus aurantium]), inadequate or negative evidence exists. Although precautions and contraindications were found for all 10 ingredients, the strongest concerns in the literature appear for ma huang, bitter orange, and guarana. Our audit revealed numerous weight-loss products available to consumers, yet there is little evidence to support the effectiveness of the top 10 ingredients identified and many potential adverse reactions; therefore, food and nutrition professionals should discuss dietary supplement use with their clients.

  20. Correlation of high flow nasal cannula outlet area with gas clearance and pressure in adult upper airway replicas.

    Science.gov (United States)

    Moore, Charles P; Katz, Ira M; Caillibotte, Georges; Finlay, Warren H; Martin, Andrew R

    2017-11-11

    Primary benefits of high flow nasal cannula therapy include washout of carbon dioxide rich exhaled gas and increased airway pressures during tidal breathing. This work reports on the influence of high flow nasal cannula outlet area on upper airways gas clearance and tracheal pressures using measurements in five realistic adult nose-throat airway replicas. Two commercial high flow nasal cannulas and one generic nasal cannula of varying size were compared. 100% oxygen was supplied via cannulas at flow rates ranging from 30 to 90l/min to replicas originally filled with air, and oxygen concentrations at the larynx and trachea were compared over time. Additionally, and separately, replicas were connected to a mechanical lung simulator to simulate tidal breathing while undergoing high flow nasal cannula therapy, with tracheal pressure-time waveforms recorded. Faster gas clearance corresponded with higher flow rates (Pflow rates, tracheal positive end expiratory pressures increase was greater with the smallest cannula (∆PPEEP=785SD(185) Pa) compared to the largest cannula (∆PPEEP=380SD(120)Pa). Regression analysis indicates that positive end expiratory pressure is proportional to the square of flow velocities exiting the cannula and nares (R2=0.906). Since increased pressure and clearance rate have been associated with improved clinical outcomes in previous studies, our results suggest that smaller cannula outlet area may be preferable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Glacier dynamics over the last quarter of a century at Helheim, Kangerdlugssuaq and 14 other major Greenland outlet glaciers

    Directory of Open Access Journals (Sweden)

    S. L. Bevan

    2012-09-01

    Full Text Available The Greenland ice sheet is experiencing increasing rates of mass loss, the majority of which results from changes in discharge from tidewater glaciers. Both atmospheric and ocean drivers have been implicated in these dynamic changes, but understanding the nature of the response has been hampered by the lack of measurements of glacier flow rates predating the recent period of warming. Here, using Landsat-5 data from 1985 onwards, we extend back in time the record of surface velocities and ice-front position for 16 of Greenland's fastest-flowing tidewater glaciers, and compare these to more recent data from Landsat-7 and satellite-borne synthetic-aperture radar. Climate re-analysis data and sea surface temperatures from 1982 show that since 1995 most of Greenland and its surrounding oceans have experienced significant overall warming, and a switch to a warming trend. During the period from 1985 to 1995 when Greenland and the surrounding oceans were not warming, major tidewater outlet glaciers around Greenland, including Kangerdlugssuaq and Helheim, were dynamically stable. Since the mid-1990s, glacier discharge has consistently been both greater and more variable. Together, these observations support the hypothesis that recent dynamic change is a rapid response to climate forcing. Both air and ocean temperatures in this region are predicted to continue to warm, and will therefore likely drive further change in outlet glacier discharge.

  2. A new method for measurement of subcoracoid outlet and its relationship to rotator cuff pathology at MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Porter, N.A.; Singh, J.; Tins, B.J.; Lalam, R.K.; Tyrrell, P.N.M.; Cassar-Pullicino, V.N. [Robert Jones and Agnes Hunt Orthopaedic Hospital, Department of Radiology, Oswestry, Shropshire (United Kingdom)

    2015-09-15

    Orthopaedic surgical studies have shown that variations in the vertical distance between the tip of the coracoid process and the supra-glenoid tubercle alter the shape of the subcoracoid outlet. Our objective was to measure the vertical distance between the coracoid tip and the supra-glenoid tubercle (CTGT) on MR and to assess whether this showed better correlation with rotator cuff pathology compared with the axial coraco-humeral distance. A retrospective review was performed of 100 consecutive shoulder MR arthrograms. Vertical distance between the coracoid tip and the supraglenoid tubercle was measured in the sagittal oblique plane. Separate assessment was then made of tendon pathology of the subscapularis, supraspinatus and long head of biceps tendons. Axial coraco-humeral distance was then measured. Correlation between tendon abnormalities and the two measurements was then made. Of the 100 cases, 42 had subscapularis tendon lesions, 21 had lesions of the long head of biceps and 53 had supraspinatus tendon lesions. Mean vertical distance from the coracoid tip to supraglenoid tubercle was greater in those with lesions of any of these tendons and was statistically significant for the supraspinatus group (P = 0.005). Reduced axial coraco-humeral distance was also seen in patients with tendinopathy, although with less statistically significant difference (p = 0.059). Our results support orthopaedic studies that have shown that the vertical distance between the coracoid tip and the supraglenoid tubercle increases the incidence and risk of rotator cuff disease by altering the shape of the subcoracoid outlet. (orig.)

  3. A Review of Thoracic Outlet Syndrome and the Possible Role of Botulinum Toxin in the Treatment of This Syndrome

    Directory of Open Access Journals (Sweden)

    Andrew Travlos

    2012-11-01

    Full Text Available The objective of this paper is to discuss the classification, diagnosis, pathophysiology and management of Thoracic outlet syndrome (TOS. Thoracic outlet syndrome (TOS is a complex entity that is characterized by different neurovascular signs and symptoms involving the upper limb. TOS is defined as upper extremity symptoms due to compression of the neurovascular bundle in the area of the neck just above the first rib. Compression is thought to occur at one or more of the three anatomical compartments: the interscalene triangle, the costoclavicular space and the retropectoralis minor spaces. The clinical presentation can include both neurogenic and vascular symptoms. TOS can be difficult to diagnose because there is no standardized objective test that can be used and the clinician must rely on history and several positive findings on physical exam. The medial antebrachial cutaneous nerve conduction may be a sensitive way to detect pathology in the lower trunks of the brachial plexus which is promising for future research. Treatment options continue to be conservative and surgical. However, for those who have failed physical therapy there is research to suggest that botulinum toxin may help with symptom relief. However, given that there has been conflicting evidence, further research is required using randomized controlled trials.

  4. Differences in liquor prices between control state-operated and license-state retail outlets in the United States.

    Science.gov (United States)

    Siegel, Michael; DeJong, William; Albers, Alison B; Naimi, Timothy S; Jernigan, David H

    2013-02-01

    This study aims to compare the average price of liquor in the United States between retail alcohol outlets in states that have a monopoly ('control' states) with those that do not ('licence' states). A cross-sectional study of brand-specific alcohol prices in the United States. We determined the average prices in February 2012 of 74 brands of liquor among the 13 control states that maintain a monopoly on liquor sales at the retail level and among a sample of 50 license-state liquor stores, using their online-available prices. We calculated average prices for 74 brands of liquor by control versus license state. We used a random-effects regression model to estimate differences between control and license state prices-overall and by alcoholic beverage type. We also compared prices between the 13 control states. The overall mean price for the 74 brands was $27.79 in the license states [95% confidence interval (CI): $25.26-30.32] and $29.82 in the control states (95% CI: $26.98-32.66). Based on the random-effects linear regression model, the average liquor price was approximately $2 lower (6.9% lower) in license states. In the United States monopoly of alcohol retail outlets appears to be associated with slightly higher liquor prices. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  5. Differences in liquor prices between control state-operated and license-state retail outlets in the U.S.

    Science.gov (United States)

    Siegel, Michael; DeJong, William; Albers, Alison B.; Naimi, Timothy S.; Jernigan, David H.

    2012-01-01

    Aims This study aims to compare the average price of liquor in the United States between retail alcohol outlets in states that have a monopoly ('control' states) with those that do not ('licence' states). Design A cross-sectional study of brand-specific alcohol prices in the United States. Setting We determined the average prices in February 2012 of 74 brands of liquor among the 13 control states that maintain a monopoly on liquor sales at the retail level and among a sample of 50 license-state liquor stores, using their online-available prices. Measurements We calculated average prices for 74 brands of liquor by control vs. license state. We used a random effects regression model to estimate differences between control and license state prices – overall and by alcoholic beverage type. We also compared prices between the 13 control states. Findings The overall mean price for the 74 brands was $27.79 in the license states (95% confidence interval [CI], $25.26–$30.32) and $29.82 in the control states (95% CI, $26.98–$32.66). Based on the random effects linear regression model, the average liquor price was approximately two dollars lower (6.9% lower) in license states. Conclusions In the United States monopoly of alcohol retail outlets appears to be associated with slightly higher liquor prices. PMID:22934914

  6. Personal values, marketing attitudes and nutrition trust are associated with patronage of convenience food outlets in the Asia-Pacific region: a cross-sectional study.

    Science.gov (United States)

    De Jong, Breanna; Worsley, Anthony; Wang, Wei Chun; Sarmugam, Rani; Pham, Quynh; Februhartanty, Judhiastuty; Ridley, Stacey

    2017-02-16

    An online cross-sectional survey examined the relationships between the demographic characteristics, personal values, trust in sources of nutrition information and the use of convenience food outlets among middle-class household food providers in the Asia-Pacific region. The survey was administered to 3945 household food providers in Melbourne, Singapore, Shanghai, Vietnam and Indonesia in late 2013. Information about demographics, personal values, trust in sources of nutrition information and use of convenience food outlets was elicited. Exploratory factor analysis, two-step clustering and logistic regression were employed. The analyses found that the use of convenience food outlets was positively related to hedonist values and trust in food industry sources of nutrition information. However, lesser use of convenience food outlets and trust in health sources of nutrition information was associated with traditional (community-oriented) values. Further replication and extension of these findings would be useful. However, they suggest that improvements in the quality of foods sold in convenience food outlets combined with stronger regulation of food marketing and long-term food education are required.

  7. Antenatal and postnatal sonographic imaging findings of a single ventricle presenting as double outlet right ventricle with rudimentary left ventricle and single atrium

    Directory of Open Access Journals (Sweden)

    Donboklang Lynser

    2015-11-01

    Full Text Available Congenital heart disease is a major cause of morbidity and mortality. Single ventricle is a rare finding and usually of left ventricular morphology. We present here interesting antenatal and postnatal echocardiographic findings of a baby having a rare single ventricle of right ventricular morphology with double outlet. Antenatally we saw a large ventricular septal defect indistinguishable from a single ventricle with left to right ventricular ratio of 1:1. Postnatally we saw a single ventricle having the outlets for both the main pulmonary artery and aortic root. The left ventricle is collapse with a rudimentary morphology possibly due to changes in hemodynamics after birth and absent of outlet from it.

  8. Research of Dust Field Optimization Distribution Based on Parameters Change of Air Duct Outlet in Fully Mechanized Excavation Face of Coal Mine

    Science.gov (United States)

    Gong, Xiao-Yan; Xia, Zhi-Xin; Wu, Yue; Mo, Jin-Ming; Zhang, Xin-Yi

    2017-12-01

    Aiming at the problem of dust accumulation and pollution risk rising sharply in fully mechanized excavation face, which caused by the unreasonable air duct outlet airflow under the long distance driving, this paper proposes a new idea to optimize the distribution of dust by changing the angle, caliber and the front and rear distance of air duct outlet. Taking the fully mechanized excavation face of Ningtiaota coal mine which located in Shaanxi province as the research object, the numerical simulation scheme of dust field was established, the safety hazard of the distribution of original dust field was simulated and analyzed, the numerical simulation and optimization analysis of the dust distribution by changing the angle, caliber and the front and rear distance of air duct outlet was carried out, and the adjustment scheme of the optimized dust distribution was obtained, which provides a theoretical basis for reducing the probability of dust explosion and the degree of pollution.

  9. Numerical analysis on inlet and outlet sections of a test fuel assembly for a Supercritical Water Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Kiss, Attila, E-mail: kissa@reak.bme.hu; Vágó, Tamás; Aszódi, Attila

    2015-12-15

    Graphical abstract: - Highlights: • SCWR-FQT, first facility works with nuclear fuel cooled by SCW, was analysed. • The inlet and outlet section of the test fuel assembly was investigated by CFD. • Two thermohydraulic problems were revealed, described and analysed. • To solve them design changes were proposed and proven by further analysis. - Abstract: The Supercritical Water Reactor (SCWR) is one of the six reactor concepts being investigated under the framework of the Generation IV International Forum (GIF). One of the major challenges in the development of a SCWR is to develop materials for the fuel and core structures that will be sufficiently corrosion-resistant to withstand supercritical water conditions. Previously, core, reactor and plant design concept of the European High Performance Light Water Reactor (HPLWR) have been worked out in substantial detail. As the next step, it has been proposed to carry out a fuel qualification test of a small scale fuel assembly in a research reactor under typical prototype conditions. Therefore design and licensing of an experimental facility for the fuel qualification test, including the small scale fuel assembly with four fuel rods, the required coolant loop with supercritical water and safety and auxiliary systems, is the scope of the project “Supercritical Water Reactor—Fuel Qualification Test” (SCWR-FQT). This project is a collaborative project co-funded by the European Commission, which takes advantage of a Chinese—European collaboration. As a sub-task of the SCWR-FQT project, the geometry of inlet and outlet sections of the fuel assembly has to be investigated and optimized according to thermohydraulic considerations such as expected stable and uniform inflow pattern and uniform outflow temperature field conditions. To accomplish this task three dimensional CFD analysis has been performed. During the analysis two main problems were identified. On the one hand, generation of a huge eddy was

  10. Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Minzi OM

    2013-01-01

    Full Text Available OM Minzi,1 VS Manyilizu21Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Logistics System Strengthening Unit, John Snow Inc, Dar es Salaam, TanzaniaBackground: Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs, in Tanzania.Methodology: This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.Results: As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004. The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg

  11. A stratified random survey of the proportion of poor quality oral artesunate sold at medicine outlets in the Lao PDR - implications for therapeutic failure and drug resistance.

    Science.gov (United States)

    Sengaloundeth, Sivong; Green, Michael D; Fernández, Facundo M; Manolin, Ot; Phommavong, Khamlieng; Insixiengmay, Vongsavanh; Hampton, Christina Y; Nyadong, Leonard; Mildenhall, Dallas C; Hostetler, Dana; Khounsaknalath, Lamphet; Vongsack, Latsamy; Phompida, Samlane; Vanisaveth, Viengxay; Syhakhang, Lamphone; Newton, Paul N

    2009-07-28

    Counterfeit oral artesunate has been a major public health problem in mainland SE Asia, impeding malaria control. A countrywide stratified random survey was performed to determine the availability and quality of oral artesunate in pharmacies and outlets (shops selling medicines) in the Lao PDR (Laos). In 2003, 'mystery' shoppers were asked to buy artesunate tablets from 180 outlets in 12 of the 18 Lao provinces. Outlets were selected using stratified random sampling by investigators not involved in sampling. Samples were analysed for packaging characteristics, by the Fast Red Dye test, high-performance liquid chromatography (HPLC), mass spectrometry (MS), X-ray diffractometry and pollen analysis. Of 180 outlets sampled, 25 (13.9%) sold oral artesunate. Outlets selling artesunate were more commonly found in the more malarious southern Laos. Of the 25 outlets, 22 (88%; 95%CI 68-97%) sold counterfeit artesunate, as defined by packaging and chemistry. No artesunate was detected in the counterfeits by any of the chemical analysis techniques and analysis of the packaging demonstrated seven different counterfeit types. There was complete agreement between the Fast Red dye test, HPLC and MS analysis. A wide variety of wrong active ingredients were found by MS. Of great concern, 4/27 (14.8%) fakes contained detectable amounts of artemisinin (0.26-115.7 mg/tablet). This random survey confirms results from previous convenience surveys that counterfeit artesunate is a severe public health problem. The presence of artemisinin in counterfeits may encourage malaria resistance to artemisinin derivatives. With increasing accessibility of artemisinin-derivative combination therapy (ACT) in Laos, the removal of artesunate monotherapy from pharmacies may be an effective intervention.

  12. A stratified random survey of the proportion of poor quality oral artesunate sold at medicine outlets in the Lao PDR – implications for therapeutic failure and drug resistance

    Science.gov (United States)

    Sengaloundeth, Sivong; Green, Michael D; Fernández, Facundo M; Manolin, Ot; Phommavong, Khamlieng; Insixiengmay, Vongsavanh; Hampton, Christina Y; Nyadong, Leonard; Mildenhall, Dallas C; Hostetler, Dana; Khounsaknalath, Lamphet; Vongsack, Latsamy; Phompida, Samlane; Vanisaveth, Viengxay; Syhakhang, Lamphone; Newton, Paul N

    2009-01-01

    Background Counterfeit oral artesunate has been a major public health problem in mainland SE Asia, impeding malaria control. A countrywide stratified random survey was performed to determine the availability and quality of oral artesunate in pharmacies and outlets (shops selling medicines) in the Lao PDR (Laos). Methods In 2003, 'mystery' shoppers were asked to buy artesunate tablets from 180 outlets in 12 of the 18 Lao provinces. Outlets were selected using stratified random sampling by investigators not involved in sampling. Samples were analysed for packaging characteristics, by the Fast Red Dye test, high-performance liquid chromatography (HPLC), mass spectrometry (MS), X-ray diffractometry and pollen analysis. Results Of 180 outlets sampled, 25 (13.9%) sold oral artesunate. Outlets selling artesunate were more commonly found in the more malarious southern Laos. Of the 25 outlets, 22 (88%; 95%CI 68–97%) sold counterfeit artesunate, as defined by packaging and chemistry. No artesunate was detected in the counterfeits by any of the chemical analysis techniques and analysis of the packaging demonstrated seven different counterfeit types. There was complete agreement between the Fast Red dye test, HPLC and MS analysis. A wide variety of wrong active ingredients were found by MS. Of great concern, 4/27 (14.8%) fakes contained detectable amounts of artemisinin (0.26–115.7 mg/tablet). Conclusion This random survey confirms results from previous convenience surveys that counterfeit artesunate is a severe public health problem. The presence of artemisinin in counterfeits may encourage malaria resistance to artemisinin derivatives. With increasing accessibility of artemisinin-derivative combination therapy (ACT) in Laos, the removal of artesunate monotherapy from pharmacies may be an effective intervention. PMID:19638225

  13. Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries

    Directory of Open Access Journals (Sweden)

    O'Connell Kathryn A

    2011-10-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC, Madagascar, Nigeria, Uganda and Zambia. Methods Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. Results 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets as compared to first-line quality-assured ACT ( Conclusions These standardized, nationally representative results demonstrate the typically low availability, low market share and high prices of ACT, in the private sector where most anti-malarials are accessed, with some exceptions. The results confirm that there is substantial room to improve availability and affordability of ACT treatment in the surveyed countries. The data will also be useful for monitoring the impact of interventions such as the Affordable Medicines Facility for malaria.

  14. Mathematical modeling of the stress-strain state of the outlet guide vane made of various materials

    Science.gov (United States)

    Grinev, M. A.; Anoshkin, A. N.; Pisarev, P. V.; Zuiko, V. Yu.; Shipunov, G. S.

    2016-11-01

    The present work is devoted to the detailed stress-strain analysis of the composite outlet guide vane (OGV) for aircraft engines with a special focus on areas with twisted layers where the initiation of high interlaminar stresses is most expected. Various polymer composite materials and reinforcing schemes are researched. The technological scheme of laying-out of anisotropic plies and the fastening method are taken into account in the model. The numerical simulation is carried out by the finite element method (FEM) with the ANSYS Workbench software. It is shown that interlaminar shear stresses are most dangerous. It is found that balanced carbon fiber reinforced plastic (CFRP) with the [0°/±45°] reinforcing scheme allows us to provide the double strength margin under working loads for the developed OGV.

  15. Increased Mass Loss and Asynchronous Behavior of Marine-Terminating Outlet Glaciers at Upernavik Isstrøm, NW Greenland

    DEFF Research Database (Denmark)

    Larsen, Signe Hillerup; Khan, Shfaqat Abbas; Ahlstrøm, Andreas Peter

    2016-01-01

    on UI glaciers is found to be related to increased surface melt. Our investigations suggest that three out of the four main glaciers in the UI are likely to be in unstable positions and may have the potential to rapidly thin and accelerate and increase their contribution to sea level in the future.......In order to model and predict future behavior of marine terminating glaciers, it is essential to understand the different factors that control a glaciers response to climate change. Here we present a detailed study of the asynchronous changes in dynamic behavior of four adjacent marine......-terminating glaciers at Upernavik Isstrøm (UI), Northwest Greenland, between 1992 and 2013. Velocities were stable for all outlets at UI between 1992 and 2005. The northernmost glacier started to accelerate and thin in 2006 and continued to do so into 2011 after which time the velocities stabilized. The second most...

  16. Catheter traction and gastric outlet obstruction: a repeated complication of using a Foley catheter for gastrostomy tube replacement.

    Science.gov (United States)

    Fonseca, Jorge; Nunes, Gonçalo; Patita, Marta; Barosa, Rita; Santos, Carla Adriana

    2017-03-30

    Percutaneous endoscopic gastrostomy (PEG) is a safe procedure and major morbidity is unusual. However, the number of PEG fed patients is increasing all over the world and complications may become more and more frequent. We describe a 73 years old woman with persistent vomit after replacement of the standard PEG tube with a Foley catheter. An upper GI endoscopy showed the catheter pulled into the duodenum causing gastric outlet obstruction. It was removed and replaced by a suitable standard PEG tube, allowing PEG feeding to be resumed. Previous reports pointed the risk of this complication, almost always associated with insertion of a Foley-type catheter. Replacement of PEG tubes should be performed by experienced teams using standard PEG tubes and the use of Foley-type catheters for this purpose should be banned from routine practice.

  17. The personal and general hygiene practices of food handlers in the delicatessen sections of retail outlets in South Africa.

    Science.gov (United States)

    van Tonder, Izanne; Lues, Jan F R; Theron, Maria M

    2007-11-01

    This paper presents data on personal- and general-hygiene knowledge and practices among food handlers in the delicatessens of a major retail group in the Western Cape in South Africa. Food handlers were interviewed by means of a structured questionnaire. Although the majority of food handlers adhered to basic hygiene principles, there is definitely a need for proper and continuous training in personal and general hygiene, not only for food handlers, but also for management. The study reported here is of importance particularly in view of new local regulations governing the application of the hazard analysis and critical control point (HACCP) system. Management is responsible for the implementation of this system, and where supervision is not adequate, the manager of the outlet should intervene to ensure that staff conform to the requirements.

  18. [Reoperation for double-outlet right ventricle (SDL type) following the Rastelli procedure: report of a case].

    Science.gov (United States)

    Hachiro, Y; Takagi, N; Koyanagi, T; Sato, S; Morikawa, M; Abe, T

    2003-09-01

    The relationship of the conduit to the sternum is crucial in the Rastelli operation. Right-sided conduits are more greatly affected by sternal compression than left, since the position of the right ventricular infundibulum is more anterior. A 37-year-old woman developed right ventricular outflow tract obstruction, left ventricular outflow tract obstruction, and aortic valve regurgitation secondary to infective endocarditis 15 years after Rastelli repair for double-outlet right ventricle (SDL). We enlarged the ventricular septal defect, performed intraventricular rerouting and aortic valve replacement, and reconstructed the valved conduit using a Carpentier-Edwards conduit. The old conduit was densely adherent to the sternum. Subaortic stenosis was caused by a narrow fibromuscular ridge associated with a bulge of the underlying septal muscle. The patient's recovery was uneventful. She is alive and well without any complaints 1 year after surgery.

  19. Outcomes After Severe Distal Tibia, Ankle, and/or Foot Trauma: Comparison of Limb Salvage Versus Transtibial Amputation (OUTLET).

    Science.gov (United States)

    Bosse, Michael J; Teague, David; Reider, Lisa; Gary, Joshua L; Morshed, Saam; Seymour, Rachel B; Toledano, James; Cannada, Lisa K; Steverson, Barbara; Scharfstein, Daniel O; Luly, Jason; MacKenzie, Ellen J

    2017-04-01

    Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries. This study aims to build upon the previous work of the Lower Extremity Assessment Project by identifying the injury and patient characteristics that help define a subgroup of salvage patients who will have better outcomes had they undergone a transtibial amputation.

  20. Accessibility of fast food outlets is associated with fast food intake. A study in the Capital Region of Denmark.

    Science.gov (United States)

    Bernsdorf, Kamille Almer; Lau, Cathrine Juel; Andreasen, Anne Helms; Toft, Ulla; Lykke, Maja; Glümer, Charlotte

    2017-11-01

    Literature suggests that people living in areas with a wealth of unhealthy fast food options may show higher levels of fast food intake. Multilevel logistic regression analyses were applied to examine the association between GIS-located fast food outlets (FFOs) and self-reported fast food intake among adults (+ 16 years) in the Capital Region of Denmark (N = 48,305). Accessibility of FFOs was measured both as proximity (distance to nearest FFO) and density (number of FFOs within a 1km network buffer around home). Odds of fast food intake ≥ 1/week increased significantly with increasing FFO density and decreased significantly with increasing distance to the nearest FFO for distances ≤ 4km. For long distances (>4km), odds increased with increasing distance, although this applied only for car owners. Results suggest that Danish health promotion strategies need to consider the contribution of the built environment to unhealthy eating. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The radiologic relationship of the shoulder girdle to the thorax as an aid in diagnosing neurogenic thoracic outlet syndrome.

    Science.gov (United States)

    Cho, Young Jae; Lee, Hyuk Jin; Gong, Hyun Sik; Rhee, Seung Hwan; Park, Sang Jae; Baek, Goo Hyun

    2012-06-01

    Neurogenic thoracic outlet syndrome (NTOS) is produced by compression of the brachial plexus in the thoracic outlet. The lower position of the shoulder girdle relative to the upper thorax may be related to NTOS. We investigated this hypothesis using plain cervical radiographs. We conducted this case-control study using plain cervical anteroposterior and lateral radiographs in 63 NTOS patients and 126 carpal tunnel syndrome patients who were matched for age and sex. To estimate the position of the shoulder girdle relative to the upper thorax, we analyzed the level of the clavicle using 2 parameters: the number of vertebrae visible in a lateral radiograph and the number of vertebrae above the line connecting both sternal ends of the clavicles in an anteroposterior radiograph. The number of vertebrae visible in a lateral radiograph was the parameter for the level of the lateral part of the clavicle relative to the upper thorax, whereas we used the number of vertebrae above the line connecting both sternal ends of the clavicles in an anteroposterior radiograph to determine the level of the medial part of the clavicle. Both parameters were greater in the NTOS group than in the control group, which suggests that the level of the shoulder girdle was lower in the NTOS group than in the control group. In addition, the risk of NTOS was increased in patients with lower shoulder girdle position. The lower placement of the shoulder girdle relative to the upper thorax was related to NTOS. Physicians may be able to estimate the position of the shoulder girdle using plain cervical radiographs when NTOS is clinically suspected. Diagnostic IV. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Automated Ground-based Time-lapse Camera Monitoring of West Greenland ice sheet outlet Glaciers: Challenges and Solutions

    Science.gov (United States)

    Ahn, Y.; Box, J. E.; Balog, J.; Lewinter, A.

    2008-12-01

    Monitoring Greenland outlet glaciers using remotely sensed data has drawn a great attention in earth science communities for decades and time series analysis of sensory data has provided important variability information of glacier flow by detecting speed and thickness changes, tracking features and acquiring model input. Thanks to advancements of commercial digital camera technology and increased solid state storage, we activated automatic ground-based time-lapse camera stations with high spatial/temporal resolution in west Greenland outlet and collected one-hour interval data continuous for more than one year at some but not all sites. We believe that important information of ice dynamics are contained in these data and that terrestrial mono-/stereo-photogrammetry can provide theoretical/practical fundamentals in data processing along with digital image processing techniques. Time-lapse images over periods in west Greenland indicate various phenomenon. Problematic is rain, snow, fog, shadows, freezing of water on camera enclosure window, image over-exposure, camera motion, sensor platform drift, and fox chewing of instrument cables, and the pecking of plastic window by ravens. Other problems include: feature identification, camera orientation, image registration, feature matching in image pairs, and feature tracking. Another obstacle is that non-metric digital camera contains large distortion to be compensated for precise photogrammetric use. Further, a massive number of images need to be processed in a way that is sufficiently computationally efficient. We meet these challenges by 1) identifying problems in possible photogrammetric processes, 2) categorizing them based on feasibility, and 3) clarifying limitation and alternatives, while emphasizing displacement computation and analyzing regional/temporal variability. We experiment with mono and stereo photogrammetric techniques in the aide of automatic correlation matching for efficiently handling the enormous

  3. Presence of faecal coliforms and selected heavy metals in ice cubes from food outlets in Taman Universiti, Johor Bahru, Malaysia.

    Science.gov (United States)

    Mahat, N A; Meor Ahmad, Z; Abdul Wahab, R

    2015-09-01

    Consumption of iced beverages is common in Malaysia although specific research focusing on its safety parameters such as presence of faecal coliforms and heavy metal elements remains scarce. A study conducted in Kelantan indicated that faecal coliforms were detected in the majority of the ice cube samples analyzed, largely attributable to improper handling. Hence, it was found pertinent to conduct similar study in other parts of the country such as Johor Bahru if the similar pattern prevailed. Therefore, this present cross sectional study which randomly sampled ice cubes from 30 permanent food outlets in Taman Universiti, Johor Bahru for detecting contamination by faecal coliforms and selected heavy metal elements (lead, copper, manganese and zinc) acquires significance. Faecal coliforms were detected in 11 (36.67%) of the samples, ranging between 1 CFU/100 mL to > 50 CFU/100 mL; two of the samples were grossly contaminated (>50 CFU/100 mL). Interestingly, while positive detection of lead was observed in 29 of the 30 ice cube samples (mean: 0.511±0.105 ppm; range: 0.489-0.674 ppm), copper, manganese and zinc were not detected. In addition, analysis on commercially bottled mineral water as well as in tap water samples did not detect such contaminations. Therefore, it appears that (1) contamination of faecal coliforms in ice cubes in food outlets in Malaysia may not be sporadic in pattern but rather prevalent and (2) the source of water used for manufacturing the ice cubes that contained significant amount of lead would suggest that (3) it was neither originated from the treated tap water supply nor bottled mineral water or (4) perhaps contaminated during manufacturing process. Further studies exploring the source of water used for manufacturing these ice cubes as well as the handling process among food operators deserve consideration.

  4. Media Outlet and Consumer Reactions to Promotional Activities of the Choose Health LA Restaurants Program in Los Angeles County.

    Science.gov (United States)

    Gase, Lauren N; Montes, Christine; Robles, Brenda; Tyree, Rachel; Kuo, Tony

    2016-01-01

    This study sought to assess promotional activities undertaken to raise public awareness of the Choose Health LA Restaurants program in Los Angeles County, an environmental change strategy that recognizes restaurants for offering reduced-size and healthier menu options. We used multiple methods to assess public awareness of and reactions to the promotional activities, including an assessment of the reach of core promotional activities, a content analysis of earned media, and an Internet panel survey. The study was conducted in Los Angeles County, home to more than 10 million residents. An online survey firm recruited participants for an Internet panel survey; to facilitate generalization of results to the county's population, statistical weights were applied to analyses of the survey data. Promotional activities to raise awareness of the program included community engagement, in-store promotion, and a media campaign. Outcomes included media impressions, the number of people who reported seeing the Choose Health LA Restaurants logo, and a description of the themes present in earned media. Collectively, paid media outlets reported 335 587 229 total impressions. The Internet panel survey showed that 12% of people reported seeing the program logo. Common themes in earned media included the Choose Health LA Restaurants program aims to provide restaurant patrons with more choices, represents a new opportunity for restaurants and public health to work together, will benefit participating restaurants, and will positively impact health. Promotional activities for the Choose Health LA Restaurants program achieved modest reach and positive reactions from media outlets and consumers. The program strategy and lessons learned can help inform present and future efforts to combine environmental and individually focused strategies that target key influences of consumer food selection.

  5. Can geodata be used to determine the distribution of fast food outlets in relation to the prevalence and severity of asthma? A novel methodology.

    Science.gov (United States)

    Sheth, A; Asher, M I; Ellwood, P; Ellwood, E

    2016-01-01

    Can the distribution of fast food outlets be obtained and effectively used to identify if there is a relationship between the placement of these and the prevalence and severity of asthma, rhinoconjunctivitis and eczema (ARE) in children and adolescents? Fast food restaurant location data was obtained for seven countries. Data from the International Study of Asthma and Allergies in Childhood (ISAAC) was used from 53 centres in the same seven countries. Each ISAAC centre provided a detailed map of the study area. The location of restaurants and ISAAC centres were overlaid using the ArcMap software, and the number of restaurants within each ISAAC centre counted. Bivariate regression analysis was used to compare outlet density with ARE prevalence and severity. The results from the analyses showed a positive (non-significant) trend on a regression plot between outlet density and ARE severity. This project has shown that it is practical to systematically obtain and map fast food outlets and compare their distribution worldwide with the prevalence and severity of diseases, in this case ARE. The devised methodology has proven to be an efficient way to obtain restaurant distribution data in a form that is manageable and suitable to compare with area based disease prevalences. This project has shown that a larger scale investigation is both feasible and warranted. Copyright © 2015 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  6. A national study of the association between neighbourhood access to fast-food outlets and the diet and weight of local residents.

    Science.gov (United States)

    Pearce, Jamie; Hiscock, Rosemary; Blakely, Tony; Witten, Karen

    2009-03-01

    Differential locational access to fast-food retailing between neighbourhoods of varying socioeconomic status has been suggested as a contextual explanation for the social distribution of diet-related mortality and morbidity. This New Zealand study examines whether neighbourhood access to fast-food outlets is associated with individual diet-related health outcomes. Travel distances to the closest fast-food outlet (multinational and locally operated) were calculated for all neighbourhoods and appended to a national health survey. Residents in neighbourhoods with the furthest access to a multinational fast-food outlet were more likely to eat the recommended intake of vegetables but also be overweight. There was no association with fruit consumption. Access to locally operated fast-food outlets was not associated with the consumption of the recommended fruit and vegetables or being overweight. Better neighbourhood access to fast-food retailing is unlikely to be a key contextual driver for inequalities in diet-related health outcomes in New Zealand.

  7. Simulation of the effects of Devils Lake outlet alternatives on future lake levels and water quality in the Sheyenne River and Red River of the North

    Science.gov (United States)

    Vecchia, Aldo V.

    2011-01-01

    Since 1992, Devils Lake in northeastern North Dakota has risen nearly 30 feet, destroying hundreds of homes, inundating thousands of acres of productive farmland, and costing more than $1 billion for road raises, levee construction, and other flood mitigation measures. In 2011, the lake level is expected to rise at least another 2 feet above the historical record set in 2010 (1,452.0 feet above the National Geodetic Vertical Datum of 1929), cresting less than 4 feet from the lake's natural spill elevation to the Sheyenne River (1,458.0 feet). In an effort to slow the rising lake and reduce the chance of an uncontrolled spill, the State of North Dakota is considering options to expand a previously constructed outlet from the west end of Devils Lake or construct a second outlet from East Devils Lake. Future outlet discharges from Devils Lake, when combined with downstream receiving waters, need to be in compliance with applicable Clean Water Act requirements. This study was completed by the U.S. Geological Survey, in cooperation with the North Dakota Department of Health Division of Water Quality, to evaluate the various outlet alternatives with respect to their effect on downstream water quality and their ability to control future lake levels.

  8. Neighborhood Characteristics, Alcohol Outlet Density, and Alcohol-Related Calls-for-Service: A Spatiotemporal Analysis in a Wet Drinking Country

    Directory of Open Access Journals (Sweden)

    Miriam Marco

    2017-11-01

    Full Text Available Alcohol outlets have been associated with different social problems, such as crime, violence, intimate partner violence, and child maltreatment. The spatial analysis of neighborhood availability of alcohol outlets is key for better understanding of these influences. Most studies on the spatial distribution of alcohol outlets in the community have been conducted in U.S. cities, but few studies have assessed this spatial distribution in other countries where the drinking culture may differ. The aim of this study was to analyze the spatiotemporal distribution of alcohol outlets in the city of Valencia, Spain, and its relationship with neighborhood-level characteristics, as well as to examine the influence of alcohol outlet density on alcohol-related police calls-for-service. Spain is characterized by having a “wet” drinking culture and greater social acceptance of drinking compared to the U.S. Data on alcohol outlets between 2010–2015 in three categories (off-premise, restaurants and cafes, and bars were used for the analysis. We used the 552 census block groups allocated within the city as neighborhood unit. Data were analyzed using Bayesian spatiotemporal regression models. Results showed different associations between alcohol outlets categories and neighborhood variables: off-premise density was higher in areas with lower economic status, higher immigrant concentration, and lower residential instability; restaurant and cafe density was higher in areas with higher spatially-lagged economic status, and bar density was higher in areas with higher economic status and higher spatially-lagged economic status. Furthermore, restaurant and cafe density was negatively associated with alcohol-related police calls-for-service, while bar density was positively associated with alcohol-related calls-for-service. These results can be used to inform preventive strategies for alcohol-related problems at the neighborhood-level in Spain or other countries

  9. Tobacco retail outlet advertising practices and proximity to schools, parks and public housing affect Synar underage sales violations in Washington, DC.

    Science.gov (United States)

    Kirchner, Thomas R; Villanti, Andrea C; Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Ganz, Ollie; Conway, Kevin P; Vallone, Donna M; Abrams, David B

    2015-03-01

    To examine the cross-sectional association between illicit sales of tobacco to minors, Washington DC tobacco outlet advertising practices, retail store type, the demographic make-up of the area surrounding each outlet, and the proximity of each outlet to high schools, recreational parks and public housing. Seven hundred and fifty tobacco outlets in the DC area, n=347 of which were randomly selected for inspection by the Synar Inspection Program in 2009-2010. The presence of tobacco advertisements on the interior and exterior of each outlet, and illicit tobacco sales to Synar Inspection Program youth volunteers. The presence of tobacco advertisements on the exterior of gas stations was much greater than on other retail store types (OR=6.68; 95% CI 4.05 to 11.01), as was the absence of any advertisements at bars or restaurants that sold tobacco (OR=0.33; 95% CI 0.22 to 0.52). Exterior tobacco advertisements were also more likely in predominantly African-American areas of the city (OR=3.11; 95% CI 2.28 to 4.25), and particularly likely on storefronts located closer to parks (OR=1.87; 95% CI 1.06 to 3.28). Illicit sales to minors were more common at gas stations (OR=3.01; 95% CI 1.5 to 6.3), outlets that displayed exterior tobacco advertisements closer to parks (OR=3.36; 95% CI 1.38 to 8.21), and outlets located closer to high schools in majority African-American block groups (OR=1.29; 95% CI 1.07 to 1.58). Findings demonstrate that while illicit tobacco sales to minors are occurring at acceptably low rates by Synar standards, illicit sales vary considerably by retail store type, advertising approach and proximity to high schools, parks and African-American residential areas. Future work may help inform regulatory efforts to reduce youth access at the neighbourhood, city, state and national levels. 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.

  10. Combination of intravesical prostatic protrusion and resistive index is useful to predict bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.

    Science.gov (United States)

    Suzuki, Takahisa; Otsuka, Atsushi; Ozono, Seiichiro

    2016-11-01

    To examine which parameters obtained from transrectal ultrasonography are accurate predictors of urodynamically-confirmed bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. The records of 350 patients with complaints of lower urinary tract symptoms suggestive of benign prostatic hyperplasia were reviewed. Baseline parameters were international prostate symptom score, quality of life score, postvoid residual urine volume, prostate-specific antigen, and data obtained from uroflowmetry and transrectal ultrasonography. Urodynamic studies were carried out to determine bladder outlet obstruction. Receiver operator characteristic curves were generated to compare the accuracy of the different parameters, and the area under the curve of each parameter was calculated. Bladder outlet obstruction index positively correlated with intravesical prostatic protrusion, total prostate volume, transition zone volume, transition zone index, resistive index and prostate-specific antigen. Further, resistive index was only a significant independent variable with intravesical prostatic protrusion. Intravesical prostatic protrusion had the highest area under the curve of 0.790 among all variables, and its cut-off value was 10 mm. The positive predictive value of intravesical prostatic protrusion was 76.2%. In addition, the positive predictive value of the combined parameters intravesical prostatic protrusion and resistive index increased to 83.8%. Intravesical prostatic protrusion and resistive index are useful parameters for predicting bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. In clinical practice, the combination of intravesical prostatic protrusion and resistive index on ultrasound can be diagnostic of bladder outlet obstruction. © 2016 The Japanese Urological Association.

  11. Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

    Directory of Open Access Journals (Sweden)

    Li Zhang

    2015-01-01

    Full Text Available Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5-17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe (moderate and severe carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

  12. Has Tanzania embraced the green leaf? Results from outlet and household surveys before and after implementation of the Affordable Medicines Facility-malaria.

    Directory of Open Access Journals (Sweden)

    Rebecca Thomson

    Full Text Available The Affordable Medicines Facility-malaria (AMFm is primarily an artemisinin combination therapy (ACT subsidy, aimed at increasing availability, affordability, market share and use of quality-assured ACTs (QAACTs. Mainland Tanzania was one of eight national scale programmes where AMFm was introduced in 2010. Here we present findings from outlet and household surveys before and after AMFm implementation to evaluate its impact from both the supply and demand side.Outlet surveys were conducted in 49 randomly selected wards throughout mainland Tanzania in 2010 and 2011, and data on outlet characteristics and stocking patterns were collected from outlets stocking antimalarials. Household surveys were conducted in 240 randomly selected enumeration areas in three regions in 2010 and 2012. Questions about treatment seeking for fever and drugs obtained were asked of individuals reporting fever in the previous two weeks.The availability of QAACTs increased from 25.5% to 69.5% among all outlet types, with the greatest increase among pharmacies and drug stores, together termed specialised drug sellers (SDSs, where the median QAACT price fell from $5.63 to $0.94. The market share of QAACTs increased from 26.2% to 42.2%, again with the greatest increase in SDSs. Household survey results showed a shift in treatment seeking away from the public sector towards SDSs. Overall, there was no change in the proportion of people with fever obtaining an antimalarial or ACT from baseline to endline. However, when broken down by treatment source, ACT use increased significantly among clients visiting SDSs.Unchanged ACT use overall, despite increases in QAACT availability, affordability and market share in the private sector, reflected a shift in treatment seeking towards private providers. The reasons for this shift are unclear, but likely reflect both persistent stockouts in public facilities, and the increased availability of subsidised ACTs in the private sector.

  13. The geologic, geomorphic, and hydrologic context underlying options for long-term management of the Spirit Lake outlet near Mount St. Helens, Washington

    Science.gov (United States)

    Grant, Gordon E.; Major, Jon J.; Lewis, Sarah L.

    2017-01-01

    The 1980 eruption of Mount St. Helens produced a massive landslide and consequent pyroclastic currents, deposits of which blocked the outlet to Spirit Lake. Without an outlet, the lake began to rise, threatening a breaching of the blockage and release of a massive volume of water. To mitigate the hazard posed by the rising lake and provide an outlet, in 1984–1985 the U.S. Army Corps of Engineers bored a 2.6-km (8,500-ft) long tunnel through a bedrock ridge on the western edge of the lake. Locally, the tunnel crosses weak rock along faults, and external pressures in these weak zones have caused rock heave and support failures, which have necessitated periodic major repairs. During its more than 30-year lifetime, the tunnel has maintained the level of Spirit Lake at a safe elevation. The lake approaches its maximum safe operating level only when the tunnel closes for repair. The most recent major repair in early 2016 highlights the need for a reliable outlet that does not require repeated and expensive interventions and extended closures. The U.S. Forest Service, U.S. Army Corps of Engineers, and U.S. Geological Survey developed, reviewed, and analyzed an array of options for a long-term plan to remove the threat of catastrophic failure of the tunnel. In this report, we (1) provide background on natural hazards that can affect existing and alternative infrastructure; (2) evaluate the potential for tunnel failure and consequent breaching of the blockage posed by the current tunnel infrastructure; (3) evaluate potential consequences to downstream communities and infrastructure in the event of a catastrophic breaching of the blockage; (4) evaluate potential risks associated with alternative lake outlets; and (5) identify data and knowledge gaps that need to be addressed to fully evaluate options available to management.

  14. Contamination of hospital tap water: the survival and persistence of Pseudomonas aeruginosa on conventional and 'antimicrobial' outlet fittings.

    Science.gov (United States)

    Hutchins, C F; Moore, G; Thompson, K-A; Webb, J; Walker, J T

    2017-10-01

    Pseudomonas aeruginosa infections have been linked to contaminated hospital taps, highlighting the potential for tap outlet fittings (OF) to harbour biofilm. P. aeruginosa may be transferred to OFs via contaminated cleaning cloths. Suggested interventions include flushing regimens and alternative OF designs. To investigate the transfer of P. aeruginosa from a contaminated cleaning cloth to conventional and 'antimicrobial/antibiofilm' OFs and to determine whether this contamination persists and/or leads to contamination of tap water. Microfibre cloths contaminated with P. aeruginosa (108 cfu/mL) were used to wipe four different types of OF [one of conventional design (OF-A) and three marketed as 'antimicrobial' and/or 'antibiofilm' (OF- B, -C and -D)]. OFs were inserted into an experimental water distribution system for up to 24 h. Survival was assessed by culture. Single and multiple water samples were collected and cultured for P. aeruginosa. The median number of P. aeruginosa transferred from cloth to OF was 5.7 × 105 cfu (OF-A), 1.9 × 106 cfu (OF-B), 1.4 × 105 cfu (OF-C) and 2.9 × 106 cfu (OF-D). Numbers declined on all OFs during the 24 h period with log reductions ranging from 3.5 (OF-C) to 5.2 (OF-B; P > 0.05). All water samples delivered immediately after OF contamination contained P. aeruginosa at ≥10 cfu per 100 mL. Contamination of water delivered from OF-A persisted despite continued flushing. Water delivered from OF-B did not contain P. aeruginosa beyond the first flush. Contaminated cleaning cloths may transfer P. aeruginosa to OFs, leading to contamination of tap water. Although not removing the potential for contamination, 'antimicrobial/antibiofilm' OFs may prevent P. aeruginosa from continually contaminating water delivered from the outlet. Copyright © 2017 The Healthcare Infection Society. All rights reserved.

  15. Analysis of Influence of Goaf Sealing from Tailgate On the Methane Concentration at the Outlet from the Longwall

    Science.gov (United States)

    Tutak, Magdalena; Brodny, Jaroslaw

    2017-12-01

    One of the most common and most dangerous gas hazards in underground coal mine is methane hazard. Formation of dangerous, explosive concentrations of methane occurs the most often in the region of crossing of longwall with the ventilation gallery. Particularly it applies to longwalls ventilated in „U from bounds” system. Outflow of gases from the goaf to the tailgate takes place through the boundary surfaces of this sidewalk with goaf. Main cause of this process is a phenomenon of air filtration through the goaf with caving. This filtration is a result of migration of the part of ventilation air stream supplied to the longwall. This air is released into the goaf on the entire longwall length; however, its greater amount gets to the goaf with caving space at the crossing of maingate with exploitation longwall. Albeit, the biggest outflow of air mixture and gases from the goaf occurs in top gate in upper corner of the longwall. This is a result of pressure difference in this region. This phenomenon causes that to the space of heading besides the air also other gases present in the goaf, mainly methane, are released. Methane is an explosive gas. Most often boundaries of explosive mixtures of methane, air and inert gases are described by the so-called Coward triangle explosion. Within the limits of the occurrence of the concentration of explosive methane explosion initials may be endogenous fire, blasting or sparks arising from friction of moving lumps of rock. Therefore, in order to decrease its concertation in this region, by limiting its outflow from the goaf with caving different actions are taken. One of such action is sealing of goaf from top gate side. Analysis of impact of sealing of these goaf on the methane concentration at the outlet of longwall is main aim of studies researches. Model of tested region, together with boundary conditions (including parameters of flowing air and the methane content) was developed on the base of real data from one of the

  16. Availability of illicit tobacco in small retail outlets before and after the implementation of Australian plain packaging legislation.

    Science.gov (United States)

    Scollo, Michelle; Bayly, Megan; Wakefield, Melanie

    2015-03-01

    We aimed to assess change in the availability of illicit tobacco in small mixed business retail outlets following the December 2012 introduction of plain packaging in Australia. 303 small retail outlets were visited in June and September 2012 (baseline months), and in December 2012 and February, April and July 2013. Fieldworkers requested a particular low-cost brand of cigarettes and then pressed the retailer for an 'even cheaper' brand. The cheapest pack of cigarettes offered was purchased and later examined to assess any divergence from prescribed Australian packaging regulations. The price paid was compared with tax liability and recommended retail price for the particular brand and pack size. In a sub-set of 179 stores, fieldworkers then asked the retailer about availability of unbranded (chop-chop) tobacco. Thirteen (2.2%) of 598 packs purchased pre-plain packaging were either non-compliant with Australian health warnings and/or suspiciously priced. Four packs (1.3%) of 297 met either or both criteria in the December implementation month, and five (0.6%) of 878 did so in the three collection months following implementation. Chop-chop was offered upon enquiry on 0.6% (n=2) of 338 occasions prior to implementation, 0.6% (n=1) of 170 occasions in the December 2012 implementation month, and 0.6% (n=3) of 514 occasions postimplementation. The likelihood of a 'positive' response (either an offer to sell or information about where unbranded tobacco may be purchased) did not differ across preimplementation, during-implementation and postimplementation waves. Overall, packs judged likely to be illicit were sold in response to requests for cheapest available packs on fewer than one percent of occasions. Offers to sell unbranded tobacco were rare. No change in availability of illicit tobacco was observed following implementation of plain packaging. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  17. Design and testing of swept and leaned outlet guide vanes to reduce stator-strut-splitter aerodynamic flow interactions

    Energy Technology Data Exchange (ETDEWEB)

    Wadia, A.R.; Szucs, P.N. [GE Aircraft Engines, Cincinnati, OH (United States); Gundy-Burlet, K.L. [NASA Ames Research Center, Moffet Field, CA (United States)

    1999-07-01

    Large circumferentially varying pressure levels produced by aerodynamic flow interactions between downstream stators and struts present a potential noise and stability margin liability in a compression component. These interactions are presently controlled by tailoring the camber and/or stagger angles of vanes neighboring the fan frame struts. This paper reports on the design and testing of a unique set of swept and leaned fan outlet guide vanes (OGVs) that do not require this local tailoring even though the OGVs are closely coupled with the fan frame struts and splitter to reduce engine length. The swept and leaned OGVs not only reduce core-duct diffusion, but they also reduce the potential flow interaction between the stator and the strut relative to that produced by conventional radial OGVs. First, the design of the outlet guide vanes using a single blade row three-dimensional viscous flow analysis is outlined. Next, a two-dimensional potential flow analysis was used for the coupled OGV-frame system to obtain a circumferentially nonuniform stator stagger angle distribution to reduce the upstream static pressure disturbance further. Recognizing the limitations of the two-dimensional potential flow analysis for this highly three-dimensional set of leaned OGVs, as a final evaluation of the OGV-strut system design, a full three-dimensional viscous analysis of a periodic circumferential sector of the OGVs, including the fan frame struts and splitter, was performed. The computer model was derived from a NASA-developed code used in simulating the flow field for external aerodynamic applications with complex geometries. The tree-dimensional coupled OGV-frame analysis included the uniformly staggered OGV configuration and the variably staggered OGV configuration determined by the two-dimensional potential flow analysis. Contrary to the two-dimensional calculations, the tree-dimensional analysis revealed significant flow problems with the variable staggered OGV

  18. Geospatial Associations Between Tobacco Retail Outlets and Current Use of Cigarettes and e-Cigarettes among Youths in Texas.

    Science.gov (United States)

    Pérez, Adriana; Chien, Lung-Chang; Harrell, Melissa B; Pasch, Keryn E; Obinwa, Udoka C; Perry, Cheryl L

    2017-10-01

    To identify the geospatial association between the presence of tobacco retail outlets (TRO) around schools' neighborhoods, and current use of cigarettes and e-cigarettes among adolescents in four counties in Texas. Students in grades 6, 8 and 10th were surveyed in their schools in 2014-2015. The schools' addresses was geocoded to determine the presence of at least one TRO within half a mile of the school. Two outcomes were considered: past 30-day use of (a) cigarettes and (b) e-cigarettes. Bayesian structured additive regression models and Kriging methods were used to estimate the geospatial associations between the presence of TRO and use in three counties: Dallas/Tarrant, Harris, and Travis. We observed a geospatial association between the presence of TRO around the schools and current use of cigarettes in the eastern area of Dallas County and in the southeastern area of Harris County. Also, a geospatial association between the presence of TRO around the schools and current use of e-cigarettes was observed in the entire Tarrant County and in the northeastern area of Harris County. There were geospatial associations between the presence of TRO around some schools and cigarette/e-cigarette use among students, but this association was not consistent across all the counties. More research is needed to determine why some areas are at higher risk for this association.

  19. Effects of Gravity and Inlet/Outlet Location on a Two-Phase Cocurrent Imbibition in Porous Media

    Directory of Open Access Journals (Sweden)

    M. F. El-Amin

    2011-01-01

    Full Text Available We introduce 2D numerical investigations of the problem of gravity and inlet/outlet location effects of water-oil two-phase cocurrent imbibition in a porous medium. Three different cases of side-, top-, and bottom-inlet location are considered. Two-dimensional computations are carried out using the finite element method. Intensive comparisons are done between considering and neglecting gravity effect on water saturation, pressures of water and oil as well as water velocity. Results are introduced either in curves or as 2D visualization graphs. The results indicate that the buoyancy effects due to gravity force take place depending on inlet location. So, the buoyancy force in the momentum equations of the co-current imbibition model cannot be neglected as done by several previous studies. Also, we note that the 2D zero gravity model has a uniform flow and may be represented as 1D flow unlike the 2D nonzero gravity model showing a nonuniform flow.

  20. Small-area variations in overweight and obesity in an urban area of Nigeria: The role of fast food outlets

    Directory of Open Access Journals (Sweden)

    Osayomi Tolulope

    2017-12-01

    Full Text Available Overweight and obesity are two related health issues of epidemic proportions. In Nigeria, these health conditions have been emerging only recently. The extant literature shows inter-city variations in the prevalence of overweight and obesity in Nigeria. However, they say little about intra-city variations of these health problems in Nigerian urban centres. Thus, the focus of the study was to determine the small-area variations in the prevalence of overweight and obesity in an urban area of Nigeria and its association with socio-economic, environmental, dietary and lifestyle risk factors. With the aid of a questionnaire, information on the demographic, socio-economic, lifestyle, household and neighbourhood characteristics of respondents was obtained from respondents. Overweight and obesity were computed based on the self-reported height and weight of respondents, using the Body Mass Index (BMI formula. A simple linear regression model was estimated to determine the individual and collective effects of risk factors. Findings showed that there were noticeable spatial variations in the prevalence of overweight and obesity which result from the varying contextual and compositional characteristics among the political wards of the Ibadan North LGA. Physical proximity to fast food outlets was the only significant factor driving the spatial pattern of obesity (b = 0.645; R2 = 0.416. The paper suggests that government and health officials should formulate area-specific obesity prevention and control plans to curb this growing epidemic in Nigeria.

  1. Access to food outlets and children's nutritional intake in urban China: a difference-in-difference analysis

    Directory of Open Access Journals (Sweden)

    Wang Rui

    2012-06-01

    Full Text Available Abstract Background In recent years supermarkets and fast food restaurants have been replacing those “wet markets” of independent vendors as the major food sources in urban China. Yet how these food outlets relate to children’s nutritional intake remains largely unexplored. Method Using a longitudinal survey of households and communities in China, this study examines the effect of the urban built food environment (density of wet markets, density of supermarkets, and density of fast food restaurants on children’s nutritional intake (daily caloric intake, daily carbohydrate intake, daily protein intake, and daily fat intake. Children aged 6–18 (n = 185 living in cities were followed from 2004 to 2006, and difference-in-difference models are used to address the potential issue of omitted variable bias. Results Results suggest that the density of wet markets, rather than that of supermarkets, positively predicts children’s four dimensions of nutritional intake. In the caloric intake model and the fat intake model, the positive effect of neighborhood wet market density on children’s nutritional intake is stronger with children from households of lower income. Conclusion With their cheaper prices and/or fresher food supply, wet markets are likely to contribute a substantial amount of nutritional intake for children living nearby, especially those in households with lower socioeconomic status. For health officials and urban planners, this study signals a sign of warning as wet markets are disappearing from urban China’s food environment.

  2. Bilateral coracoclavicular joints as a rare cause of bilateral thoracic outlet syndrome and shoulder pain treated successfully by conservative means.

    Science.gov (United States)

    Singh, V K; Singh, P K; Balakrishnan, S K

    2009-06-01

    The coracoclavicular joint (CCJ) is a rare anomalous joint. Symptomatic CCJ, being an exceptional rarity, makes it difficult to formulate a standard set of practice or guidelines. We report a 50-year-old Indian man, a machine operator by profession, who experienced bilateral shoulder pain and arm paraesthesia for two years, and was diagnosed with bilateral CCJ. The symptoms gradually increased, affecting his daily activities. Dynamic magnetic resonance imaging revealed the compression of the brachial plexus in extreme shoulder abduction. After a thorough search of the literature, we retrieved four similar cases, all of them treated with individualised protocols. None of the cases was bilateral. The lack of clear evidence in any particular direction and the patient's medical condition prompted us to give a conservative trial, before embarking on more invasive methods. He showed rapid response to the conservative treatment with remission of all symptoms. To the best of our knowledge, this is the first reported case of bilateral symptomatic CCJ with bilateral thoracic outlet syndrome, that was managed conservatively.

  3. The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002-09.

    Science.gov (United States)

    Zhao, Jinhui; Stockwell, Tim; Martin, Gina; Macdonald, Scott; Vallance, Kate; Treno, Andrew; Ponicki, William R; Tu, Andrew; Buxton, Jane

    2013-06-01

    To investigate relationships between periodic increases in minimum alcohol prices, changing densities of liquor stores and alcohol-attributable (AA) deaths in British Columbia, Canada. Cross-section (16 geographic areas) versus time-series (32 annual quarters) panel analyses were conducted with AA deaths as dependent variables and price, outlet densities and socio-demographic characteristics as independent variables. Populations of 16 Health Service Delivery Areas in British Columbia, Canada. Age-sex-standardized rates of acute, chronic and wholly AA mortality; population densities of restaurants, bars, government and private liquor stores; minimum prices of alcohol in dollars per standard drink. A 10% increase in average minimum price for all alcoholic beverages was associated with a 31.72% [95% confidence interval (CI): ± 25.73%, P price increases for wholly but not for acute or chronic AA deaths. Significant reductions in chronic and total AA deaths were detected between 2 and 3 years after minimum price increases. Significant but inconsistent lagged associations were detected for acute AA deaths. A 10% increase in private liquor stores was associated with a 2.45% (95% CI: ± 2.39%, P price of alcohol in British Columbia, Canada, between 2002 and 2009 were associated with immediate and delayed decreases in alcohol-attributable mortality. By contrast, increases in the density of private liquor stores were associated with increases in alcohol-attributable mortality. © 2013 The Authors, Addiction © 2013 Society for the Study of Addiction.

  4. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions.

    Science.gov (United States)

    Stockwell, Tim; Zhao, Jinhui; Martin, Gina; Macdonald, Scott; Vallance, Kate; Treno, Andrew; Ponicki, William; Tu, Andrew; Buxton, Jane

    2013-11-01

    We investigated whether periodic increases in minimum alcohol prices were associated with reduced alcohol-attributable hospital admissions in British Columbia. The longitudinal panel study (2002-2009) incorporated minimum alcohol prices, density of alcohol outlets, and age- and gender-standardized rates of acute, chronic, and 100% alcohol-attributable admissions. We applied mixed-method regression models to data from 89 geographic areas of British Columbia across 32 time periods, adjusting for spatial and temporal autocorrelation, moving average effects, season, and a range of economic and social variables. A 10% increase in the average minimum price of all alcoholic beverages was associated with an 8.95% decrease in acute alcohol-attributable admissions and a 9.22% reduction in chronic alcohol-attributable admissions 2 years later. A Can$ 0.10 increase in average minimum price would prevent 166 acute admissions in the 1st year and 275 chronic admissions 2 years later. We also estimated significant, though smaller, adverse impacts of increased private liquor store density on hospital admission rates for all types of alcohol-attributable admissions. Significant health benefits were observed when minimum alcohol prices in British Columbia were increased. By contrast, adverse health outcomes were associated with an expansion of private liquor stores.

  5. Minimum Alcohol Prices and Outlet Densities in British Columbia, Canada: Estimated Impacts on Alcohol-Attributable Hospital Admissions

    Science.gov (United States)

    Zhao, Jinhui; Martin, Gina; Macdonald, Scott; Vallance, Kate; Treno, Andrew; Ponicki, William; Tu, Andrew; Buxton, Jane

    2013-01-01

    Objectives. We investigated whether periodic increases in minimum alcohol prices were associated with reduced alcohol-attributable hospital admissions in British Columbia. Methods. The longitudinal panel study (2002–2009) incorporated minimum alcohol prices, density of alcohol outlets, and age- and gender-standardized rates of acute, chronic, and 100% alcohol-attributable admissions. We applied mixed-method regression models to data from 89 geographic areas of British Columbia across 32 time periods, adjusting for spatial and temporal autocorrelation, moving average effects, season, and a range of economic and social variables. Results. A 10% increase in the average minimum price of all alcoholic beverages was associated with an 8.95% decrease in acute alcohol-attributable admissions and a 9.22% reduction in chronic alcohol-attributable admissions 2 years later. A Can$ 0.10 increase in average minimum price would prevent 166 acute admissions in the 1st year and 275 chronic admissions 2 years later. We also estimated significant, though smaller, adverse impacts of increased private liquor store density on hospital admission rates for all types of alcohol-attributable admissions. Conclusions. Significant health benefits were observed when minimum alcohol prices in British Columbia were increased. By contrast, adverse health outcomes were associated with an expansion of private liquor stores. PMID:23597383

  6. A Prospective Evaluation of Duplex Ultrasound for Thoracic Outlet Syndrome in High-Performance Musicians Playing Bowed String Musicians

    Directory of Open Access Journals (Sweden)

    Garret Adam

    2018-01-01

    Full Text Available Thoracic outlet syndrome (TOS is a neurovascular condition involving the upper extremity, which is known to occur in individuals who perform chronic repetitive upper extremity activities. We prospectively evaluate the incidence of TOS in high-performance musicians who played bowed string musicians. Sixty-four high-performance string instrument musicians from orchestras and professional musical bands were included in the study. Fifty-two healthy volunteers formed an age-matched control group. Bilateral upper extremity duplex scanning for subclavian vessel compression was performed in all subjects. Provocative maneuvers including Elevated Arm Stress Test (EAST and Upper Limb Tension Test (ULTT were performed. Abnormal ultrasound finding is defined by greater than 50% subclavian vessel compression with arm abduction, diminished venous waveforms, or arterial photoplethysmography (PPG tracing with arm abduction. Bowed string instruments performed by musicians in our study included violin (41%, viola (33%, and cello (27%. Positive EAST or ULTT test in the musician group and control group were 44%, and 3%, respectively (p = 0.03. Abnormal ultrasound scan with vascular compression was detected in 69% of musicians, in contrast to 15% of control subjects (p = 0.03. TOS is a common phenomenon among high-performance bowed string instrumentalists. Musicians who perform bowed string instruments should be aware of this condition and its associated musculoskeletal symptoms.

  7. Effects of gravity and inlet/outlet location on a two-phase cocurrent imbibition in porous media

    KAUST Repository

    El-Amin, Mohamed

    2011-01-01

    We introduce 2D numerical investigations of the problem of gravity and inlet/outlet location effects of water-oil two-phase cocurrent imbibition in a porous medium. Three different cases of side-, top-, and bottom-inlet location are considered. Two-dimensional computations are carried out using the finite element method. Intensive comparisons are done between considering and neglecting gravity effect on water saturation, pressures of water and oil as well as water velocity. Results are introduced either in curves or as 2D visualization graphs. The results indicate that the buoyancy effects due to gravity force take place depending on inlet location. So, the buoyancy force in the momentum equations of the co-current imbibition model cannot be neglected as done by several previous studies. Also, we note that the 2D zero gravity model has a uniform flow and may be represented as 1D flow unlike the 2D nonzero gravity model showing a nonuniform flow. Copyright 2011 M. F. El-Amin and Shuyu Sun.

  8. Dorsal Scapular Artery Variations and Relationship to the Brachial Plexus, and a Related Thoracic Outlet Syndrome Case.

    Science.gov (United States)

    Verenna, Anne-Marie A; Alexandru, Daniela; Karimi, Afshin; Brown, Justin M; Bove, Geoffrey M; Daly, Frank J; Pastore, Anthony M; Pearson, Helen E; Barbe, Mary F

    2016-01-01

    Rationale Knowledge of the relationship of the dorsal scapular artery (DSA) with the brachial plexus is limited. Objective We report a case of a variant DSA path, and revisit DSA origins and under-investigated relationship with the plexus in cadavers. Methods The DSA was examined in a male patient and 106 cadavers. Results In the case, we observed an unusual DSA compressing the lower plexus trunk, that resulted in intermittent radiating pain and paresthesia. In the cadavers, the DSA originated most commonly from the subclavian artery (71%), with 35% from the thyrocervical trunk. Nine sides of eight cadavers (seven females) had two DSA branches per side, with one branch from each origin. The most typical DSA path was a subclavian artery origin before passing between upper and middle brachial plexus trunks (40% of DSAs), versus between middle and lower trunks (23%), or inferior (4%) or superior to the plexus (1%). Following a thyrocervical trunk origin, the DSA passed most frequently superior to the plexus (23%), versus between middle and lower trunks (6%) or upper and middle trunks (4%). Bilateral symmetry in origin and path through the brachial plexus was observed in 13 of 35 females (37%) and 6 of 17 males (35%), with the most common bilateral finding of a subclavian artery origin and a path between upper and middle trunks (17%). Conclusion Variability in the relationship between DSA and trunks of the brachial plexus has surgical and clinical implications, such as diagnosis of thoracic outlet syndrome.

  9. Interval Type-2 Fuzzy Model Based on Inverse Controller Design for the Outlet Temperature Control System of Ethylene Cracking Furnace

    Directory of Open Access Journals (Sweden)

    Taoyan Zhao

    2017-09-01

    Full Text Available Multivariable coupling, nonlinear and large time delays exist in the coil outlet temperature (COT control system of the ethylene cracking furnace, which make it hard to achieve accurate control over the COT of the furnace in actual production. To solve these problems, an inverse controller based on an interval type-2 fuzzy model control strategy is introduced. In this paper, the proposed control scheme is divided into two parts: one is the approach structure part of the interval type-2 fuzzy model (IT2-FM, which is utilized to approach the process output. The other is the interval type-2 fuzzy model inverse controller (IT2-FMIC part, which is utilized to control the output process to achieve the target value. In addition, on the cyber-physical system platform, the actual industrial data are used to test and obtain the mathematical model of the COT control system of the ethylene cracking furnace. Finally, the proposed inverse controller based on the IT2-FM control scheme has been implemented on the COT control system of the ethylene cracking furnace, and the simulation results show that the proposed method is feasible.

  10. Bromate and trace metal levels in bread loaves from outlets within Ile-Ife Metropolis, Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    J.A.O. Oyekunle

    2014-01-01

    Full Text Available Bread loaves randomly sampled from nine outlets and bakeries within Ile-Ife were analysed to determine their safety levels for human consumption with respect to bromate and trace metal contents. Bromate determination was carried out via spectrophotometric method while trace metals in the digested bread samples were profiled using Flame Atomic Absorption Spectrophotometer. Bromate levels in the analyzed bread samples ranged from 2.051 ± 0.011 μg/g to 66.224 ± 0.014 μg/g while the trace metal levels were of the order: 0.03–0.10 μg/g Co = 0.03–0.10 μg/g Pb < 0.23–0.46 μg/g Cu < 2.23–6.63 μg/g Zn < 25.83–75.53 μg/g Mn. This study revealed that many bread bakers around Ile-Ife had not fully complied with the bromate-free rule stipulated by NAFDAC contrary to the “bromate free” inscribed on the labels of the bread. The bread samples contained both essential and toxic trace metals to levels that could threaten the health of consumers over prolonged regular consumption.

  11. Highly temporally resolved response to seasonal surface melt of the Zachariae and 79N outlet glaciers in northeast Greenland

    Science.gov (United States)

    Rathmann, N. M.; Hvidberg, C. S.; Solgaard, A. M.; Grinsted, A.; Gudmundsson, G. H.; Langen, P. L.; Nielsen, K. P.; Kusk, A.

    2017-10-01

    The seasonal response to surface melting of the Northeast Greenland Ice Stream outlets, Zachariae and 79N, is investigated using new highly temporally resolved surface velocity maps for 2016 combined with numerical modeling. The seasonal speedup at 79N of 0.15 km/yr is suggested to be driven by a decrease in effective basal pressure induced by surface melting, whereas for Zachariae its 0.11 km/yr seasonal speedup correlates equally well with the breakup of its large ice mélange. We investigate the influence 76 km long floating tongue at 79N, finding it provides little resistance and that most of it could be lost without impacting the dynamics of the area. Furthermore, we show that reducing the slipperiness along the tongue-wall interfaces produces a velocity change spatially inconsistent with the observed seasonal speedup. Finally, we find that subglacial sticky spots such as bedrock bumps play a negligible role in the large-scale response to a seasonally enhanced basal slipperiness of the region.

  12. Highly temporally resolved response to seasonal surface melt of the Zachariae and 79N outlet glaciers in Northeast Greenland

    DEFF Research Database (Denmark)

    Rathmann, N. M.; Hvidberg, C. S.; Solgaard, A. M.

    2017-01-01

    The seasonal response to surface melting of the Northeast Greenland Ice Stream outlets, Zachariae and 79N, is investigated using new highly temporally resolved surface velocity maps for 2016 combined with numerical modelling. The seasonal speed-up at 79N of 0.15km/yr is suggested to be driven...... by a decrease in effective basal pressure induced by surface melting, whereas for Zachariae its 0.11km/yr seasonal speed-up correlates equally well with the break-up of its large ice mélange. We investigate the influence 76km long floating tongue at 79N, finding it provides little resistance and that most...... of it could be lost without impacting the dynamics of the area. Furthermore, we show that reducing the slipperiness along the tongue–wall interfaces produces a velocity change spatially inconsistent with the observed seasonal speed-up. Finally, we find that subglacial sticky spots such as bedrock bumps play...

  13. Electrophysiological and mechanical activity of the upper gastrointestinal tract after duodenoplasty or segmental resection of benign gastric outlet stenosis.

    Science.gov (United States)

    Peiper, C; Titkova, S M; Polivoda, M; Anurov, M; Arlt, G; Ottinger, A P; Schumpelick, V

    2000-03-01

    In an animal experimental study we examined the postoperative recovery of the motility of the upper gastrointestinal tract after operative treatment of a benign gastric outlet obstruction. At 45 Days after induction, a duodenal stenosis was resected in six dogs, and resolved by Finney's duodenoplasty in another six dogs. Fourteen days after segmental resection, the gastric emptying was faster [half evacuation time (T1/2) for semisolid food = 44.4 +/- 16.8 min] than following duodenoplasty [T1/2 = 56.8 +/- 25.3). Here motor migrating complexes (MMCs) started in the antrum and could be traced down to the jejunum. After segmental resection we recognized MMC only distal to the anastomosis. The duration of the whole MMC cycle (69.0 +/- 18.6 min) as well as of the single phases was significantly shorter in the resection group than after duodenoplasty (108.0 +/- 15.1 min). At 28 days after operation the differences in the electromyographic findings were smaller (82.0 +/- 15.1 min vs. 111.4 +/- 11.2 min), but still significant. Obviously humoral transmitters and the extrinsic neural system lead to good propagation of the MMC across the anastomosis, even before the intramural pathways are reestablished. Concerning the fast recovery of the motility of the upper gastrointestinal tract, duodenoplasty is superior to segmental duodenal resection.

  14. Large-scale machine learning of media outlets for understanding public reactions to nation-wide viral infection outbreaks.

    Science.gov (United States)

    Choi, Sungwoon; Lee, Jangho; Kang, Min-Gyu; Min, Hyeyoung; Chang, Yoon-Seok; Yoon, Sungroh

    2017-10-01

    From May to July 2015, there was a nation-wide outbreak of Middle East respiratory syndrome (MERS) in Korea. MERS is caused by MERS-CoV, an enveloped, positive-sense, single-stranded RNA virus belonging to the family Coronaviridae. Despite expert opinions that the danger of MERS might be exaggerated, there was an overreaction by the public according to the Korean mass media, which led to a noticeable reduction in social and economic activities during the outbreak. To explain this phenomenon, we presumed that machine learning-based analysis of media outlets would be helpful and collected a number of Korean mass media articles and short-text comments produced during the 10-week outbreak. To process and analyze the collected data (over 86 million words in total) effectively, we created a methodology composed of machine-learning and information-theoretic approaches. Our proposal included techniques for extracting emotions from emoticons and Internet slang, which allowed us to significantly (approximately 73%) increase the number of emotion-bearing texts needed for robust sentiment analysis of social media. As a result, we discovered a plausible explanation for the public overreaction to MERS in terms of the interplay between the disease, mass media, and public emotions. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Reconstruction of maximum LIA extent and 20th century volume loss of maritime outlet glaciers, SE - Iceland

    Science.gov (United States)

    Gudmundsson, Snaevarr; Björnsson, Helgi

    2017-04-01

    Kvískerjajöklar outlet glaciers cover the upper eastern flanks of Öræfajökull stratovolcano, Southeast Iceland. These maritime temperate glaciers have recessed dramatically since their maximum Little Ice Age (LIAmax) extent, from an area of 10 km2, to 6.4 km2 in 2010, i. e. 37%, an annual average recession rate of 0.03 km2/yr. We estmate the volume loss by subtraction of glacier surface maps. The LIAmax surface map was constructed from geomorphological in-field evidences of the former glacier margins, supported by 1904 topographical maps, aerial photos and maps of 1945, a LiDAR high resolution elevation model from 2010-2011 and various historical documents. The lower part of the LIAmax glacier was reconstructed by a simple ice flow modeling (Glacier Reconstruction Tool (GlaRe) in ArcGIS, by Pellitero et al. (2016). We estimate the volume loss from the 1890 LIAmax to 2010 as 0.47 km3 water equivalent (w.e.) This correspond to an annual average recession of 0.004 km3 w.e. or specific mass loss of 0.5 m/yr.

  16. Seasonal variability of the circulation system in a West Greenland tidewater outlet glacier fjord, Godthåbsfjord (64°N)

    DEFF Research Database (Denmark)

    Mortensen, John; Bendtsen, Jørgen; Lennert, Kunuk

    2014-01-01

    circulation phases are identified during the period, and they are related to exchange processes with coastal waters, tidal mixing, and melt processes on the Greenland Ice Sheet. During early summer, warm intermediate water is transported toward the glacier at an average velocity of about 7 cm s−1. In late...... due to melting of the ice sheet. However, very few observational studies describe the seasonal dynamics of fjord circulation. Here we present the first continuous current measurements (April–November) from a deep mooring deployed in a west Greenland tidewater outlet glacier fjord. Four distinct......Many tidewater outlet glacier fjords surround the coast of Greenland, and their dynamics and circulation are of great importance for understanding the heat transport toward glaciers from the ice sheet. Thus, fjord circulation is a critical aspect for assessing the threat of global sea level rise...

  17. Mean energy of ions at outlet of a type Ecr plasma source; Energia promedio de los iones a la salida de una fuente de plasma tipo ECR

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez T, C.; Gonzalez D, J. [Departamento de Fisica, ININ, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    1998-07-01

    In this work it is described the calculations to mean energy of the ions in the extraction zone of a type Ecr plasma source considering the presence of a metallic substrate. This zone is characterized by the existence of a divergent magnetic field. It is showed that mean energy is function as the distance between the outlet and substrate as the value of the external magnetic field. (Author)

  18. Acoustic Telemetry Evaluation of Juvenile Salmonid Passage and Survival at John Day Dam with Emphasis on the Prototype Surface Flow Outlet, 2008

    Energy Technology Data Exchange (ETDEWEB)

    Weiland, Mark A.; Ploskey, Gene R.; Hughes, James S.; Deng, Zhiqun; Fu, Tao; Monter, Tyrell J.; Johnson, Gary E.; Khan, Fenton; Wilberding, Matthew C.; Cushing, Aaron W.; Zimmerman, Shon A.; Faber, Derrek M.; Durham, Robin E.; Townsend, Richard L.; Skalski, John R.; Kim, Jina; Fischer, Eric S.; Meyer, Matthew M.

    2009-12-01

    The main purpose of the study was to evaluate the performance of Top Spill Weirs installed at two spillbays at John Day Dam and evaluate the effectiveness of these surface flow outlets at attracting juvenile salmon away from the powerhouse and reducing turbine passage. The Juvenile Salmonid Acoustic Telemetry System (JSATS) was used to estimate survival of juvenile salmonids passing the dam and also for calculating performance metrics used to evaluate the efficiency and effectiveness of the dam at passing juvenile salmonids.

  19. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Jorge FONSECA

    2015-03-01

    Full Text Available Background Stent palliation is the gold standard for gastric/duodenal cancer outlet obstruction. When stenting is impossible, feeding may be achieved through a gastrojejunostomy (PEG-J, but displacement of jejunal tube is frequent due to manipulation for feeding and drainage. Gastric outlet obstruction results on increased gastroesophageal reflux or extra-tube leakage. In order to reduce the jejunostomy tube manipulation and the gastric residuum, we created a second gastrostomy (PEG dedicated to gastric drainage, reducing the PEG-J handling. Objective Our aim was evaluating of the usefulness of an added second gastrostomy in a PEG-J patient, for: 1. controlling symptomatic reflux and extra-tube leakage; 2. preventing jejunal tube dislocation. Methods We retrospectively evaluated patients were stent palliation of gastric/duodenal cancer outlet obstruction was not achieved, who were referred and underwent PEG-J. We selected four of these patients who needed a second PEG dedicated to gastric drainage, which was performed a few centimetres apart from the gastrojejunostomy. In order to achieve an efficient gastric drainage and provide the maximum comfort to the patient, the drainage PEG tube could be linked to an ileostomy bag. Results The four PEG-J cancer patients with longer survival developed symptoms associated with an important gastric residuum. After the drainage gastrostomy, symptoms subsided or vanished and there were no jejunal tube dislocations. Conclusions When stenting is not possible in patients with gastric/duodenal outlet obstruction due to cancer growing, feeding PEG-J plus drainage PEG may be an alternative, allowing duodenal/jejunal feeding and gastric drainage with minimal manipulation of the jejunal tube.

  20. Association between proximity to and coverage of traditional fast-food restaurants and non-traditional fast-food outlets and fast-food consumption among rural adults

    OpenAIRE

    Horel Scott A; Dean Wesley R; Johnson Cassandra M; Sharkey Joseph R

    2011-01-01

    Abstract Objective The objective of this study is to examine the relationship between residential exposure to fast-food entrées, using two measures of potential spatial access: proximity (distance to the nearest location) and coverage (number of different locations), and weekly consumption of fast-food meals. Methods Traditional fast-food restaurants and non-traditional fast-food outlets, such as convenience stores, supermarkets, and grocery stores, from the 2006 Brazos Valley Food Environmen...

  1. Associations between major chain fast-food outlet availability and change in body mass index: a longitudinal observational study of women from Victoria, Australia.

    Science.gov (United States)

    Lamb, Karen E; Thornton, Lukar E; Olstad, Dana Lee; Cerin, Ester; Ball, Kylie

    2017-10-16

    The residential neighbourhood fast-food environment has the potential to lead to increased levels of obesity by providing opportunities for residents to consume energy-dense products. This longitudinal study aimed to examine whether change in body mass index (BMI) differed dependent on major chain fast-food outlet availability among women residing in disadvantaged neighbourhoods. Eighty disadvantaged neighbourhoods in Victoria, Australia. Sample of 882 women aged 18-46 years at baseline (wave I: 2007/2008) who remained at the same residential location at all three waves (wave II: 2010/2011; wave III: 2012/2013) of the Resilience for Eating and Activity Despite Inequality study. BMI based on self-reported height and weight at each wave. There was no evidence of an interaction between time and the number of major chain fast-food outlets within 2 (p=0.88), 3 (p=0.66) or 5 km (p=0.24) in the multilevel models of BMI. Furthermore, there was no evidence of an interaction between time and change in availability at any distance and BMI. Change in BMI was not found to differ by residential major chain fast-food outlet availability among Victorian women residing in disadvantaged neighbourhoods. It may be that exposure to fast-food outlets around other locations regularly visited influence change in BMI. Future research needs to consider what environments are the key sources for accessing and consuming fast food and how these relate to BMI and obesity risk. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Next Generation Nuclear Plant Project Technology Development Roadmaps: The Technical Path Forward for 750–800°C Reactor Outlet Temperature

    Energy Technology Data Exchange (ETDEWEB)

    John Collins

    2009-08-01

    This document presents the NGNP Critical PASSCs and defines their technical maturation path through Technology Development Roadmaps (TDRMs) and their associated Technology Readiness Levels (TRLs). As the critical PASSCs advance through increasing levels of technical maturity, project risk is reduced and the likelihood of within-budget and on-schedule completion is enhanced. The current supplier-generated TRLs and TDRMs for a 750–800°C reactor outlet temperature (ROT) specific to each supplier are collected in Appendix A.

  3. Thermo-expandable prostatic stents for bladder outlet obstruction in the frail and elderly population: An underutilized procedure?

    Directory of Open Access Journals (Sweden)

    Kapil Sethi

    2017-11-01

    Full Text Available Purpose: To report our outcomes with the use of a thermo-expandable metallic intraprostatic stent (Memokath for patients with bladder outlet obstruction (BOO secondary to prostatic obstruction, and to assess it is a feasible option for many frail and elderly men unsuitable for surgery. Materials and Methods: We reviewed patients who underwent insertion of a Memokath stent for BOO over 17 years (January 1999 to December 2015 at one regional center over a long follow-up period (median, 7 years. Patients were selected if they had obstructive urinary symptoms or urinary retention with an indwelling catheter in situ, and were ineligible for transurethral resection of the prostate (TURP under general or spinal anesthesia. Primary outcomes assessed were the improvement in urinary symptoms and voiding parameters, as well as the ability to void spontaneously if catheterized, along with complications. Results: One hundred forty-four patients who presented with BOO or urinary retention had a Memokath stent inserted. Ninety patients (62.5% had a successful stent insertion with a significant difference between the median preoperative (550 mL and postoperative residual volume (80 mL, p<0.0001. Nearly two-thirds of men (64% returned to unassisted voiding with no increased risk of complications over time. Fifty-four patients (37.5% experienced stent failure. Main complications requiring stent removal or repositioning were migration, occlusion, refractory urinary retention and irritative voiding symptoms. Conclusions: In elderly and frail men with BOO deemed unsuitable to undergo TURP, prostatic stent is a safe and practical alternative to long-term catheterization.

  4. Accurate delineation of the grounding line from kinematic GPS measurements. Application to an outlet glacier in East Antarctica

    Science.gov (United States)

    Le Meur, E.; Sacchettini, M.; Durand, G.; Drouet, A.; Rignot, E. J.; Mouginot, J.; Young, D. A.; Blankenship, D.; Greenbaum, J.

    2011-12-01

    Polar ice sheets have a huge potential in terms of sea level rise. Recent measurements show clear evidence of a generalized speeding up of outlet glaciers in Greenland and West Antarctica and the question whether similar behaviors are to be expected in East Antarctica is all the more crucial as this latter represents the largest ice reservoir. Moreover, many glaciers in the Wilkes-Terre Adélie sector are in a supposedly unstable configuration due to a landward downsloping bedrock. As a consequence, the Astrolabe Glacier (Terre Adélie land) was selected as a test zone for extensive field surveys like surface and bedrock heights, surface velocities, mass balance measurements. Among those, the exact position of the grounding line is fundamental as it represents a strong transition in the flow regime when the basal drag of the grounded ice reduces to virtually zero when this latter starts to float over the ocean. We here propose a method based on GPS measurements along various profiles in order to identify the presence or not of tidal movements of the ice surface indicating floating ice. The amplitude of the tides of the order of a meter requires accurate data only possible with the differential GPS method. Processing of these GPS data along selected profiles allows us to propose a position for the grounding line (hydrostatic one) which we then compare to that obtained from remote techniques (Landsat-7, ICESat, differential satellite synthetic-aperture radar interferometry). The exact position of the grounding line as well as the exact surface height along a radar transect across the glacier (giving the underlying bedrock topography) is also used to infer a mean density for the whole ice column by applying the hydrostatic criterion and a firn depth correction.

  5. A-TOS SYMPTOMS AND MOBILITY: A CASE STUDY ON UNCOMPLICATED ARTERIAL THORACIC OUTLET SYNDROME INVOLVING CONSERVATIVE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Vengata Subramani Manoharan

    2016-10-01

    Full Text Available Background: Thoracic outlet syndrome (TOS is a complex condition characterised by a group of conditions that compress on the neurovascular bundle that enter and leaves the thoracic inlet, interscalene triangle, costoclavicular space and above the pectoris minor that occur above the clavicle. 1-2% is associated with arterial obstruction among the other type of TOS. Symptoms usually annoy extremely by movement of cervical spine and head or by raising upper limb. The main aim of this case report is to reduce the gap in evidence based research and to describe the process and outcomes of conservative management. Methods: As there is no specific test for TOS, the patient was initially assessed with Adson and Roos test. All these test were positive along with MR angiogram and Doppler to confirm A-TOS. Physiotherapy intervention of 6 weeks with following procedure such as massage, warm up, passive stretching, active stretching, hand grip strengthening and cool down. Pain was assessed using VAS scale, strength was assessed using hand dynamometer. Patient was also taught to palpate her own pulse (radial before intervention. Result: After 6 weeks of intervention patients pain intensity according to the VAS scale was 3, and pulse grade was 3+ that shows pain and pulse in the hand and wrist area were improved significantly. Patients hand grip strength is slightly improved compared to pre intervention using TuKey’s multiple comparison test and it is statistically significant in p<0.001, p<0.01 and p<0.05 respectively. Our results have convinced us that particular approach to the treatment of A-TOS. Conclusion: We concluded that the massage, stretching and hap grip strengthening will improve patient’s condition in Arterial TOS. We also suggested that future research should also focus on arterial TOS due to bony abnormalities and patient’s with arterial luminal defect.

  6. Obtaining Fruit and Vegetables for the Lowest Prices: Pricing Survey of Different Outlets and Geographical Analysis of Competition Effects

    Science.gov (United States)

    Pearson, Amber L.; Winter, Pieta R.; McBreen, Ben; Stewart, Georgia; Roets, Rianda; Nutsford, Daniel; Bowie, Christopher; Donnellan, Niamh; Wilson, Nick

    2014-01-01

    Aims Inadequate fruit and vegetable (F&V) consumption is an important dietary risk factor for disease internationally. High F&V prices can be a barrier to dietary intake and so to improve understanding of this topic we surveyed prices and potential competition between F&V outlet types. Methods Over a three week early autumn period in 2013, prices were collected bi-weekly for 18 commonly purchased F&Vs from farmers' markets (FM) selling local produce (n = 3), other F&V markets (OFVM) (n = 5), supermarkets that neighbored markets (n = 8), and more distant supermarkets (n = 8), (in urban Wellington and Christchurch areas of New Zealand). Prices from an online supermarket were also collected. Results A total of 3120 prices were collected. Most F&Vs (13/18) were significantly cheaper at OFVMs than supermarkets. Over half of the F&Vs (10/18) were significantly cheaper at nearby compared to distant supermarkets, providing evidence of a moderate ‘halo effect’ in price reductions in supermarkets that neighbored markets. Weekend (vs midweek) prices were also significantly cheaper at nearby (vs distant) supermarkets, supporting evidence for a ‘halo effect’. Ideal weekly ‘food basket’ prices for a two adult, two child family were: OFVMs (NZ$76), online supermarket ($113), nearby supermarkets ($124), distant supermarkets ($127), and FMs ($138). This represents a savings of $49 per week (US$26) by using OFVMs relative to (non-online) supermarkets. Similarly, a shift from non-online supermarkets to the online supermarket would generate a $13 saving. Conclusions In these locations general markets appear to be providing some substantially lower prices for fruit and vegetables than supermarkets. They also appear to be depressing prices in neighboring supermarkets. These results, when supplemented by other needed research, may help inform the case for interventions to improve access to fruit and vegetables, particularly for low-income populations. PMID

  7. Obtaining fruit and vegetables for the lowest prices: pricing survey of different outlets and geographical analysis of competition effects.

    Science.gov (United States)

    Pearson, Amber L; Winter, Pieta R; McBreen, Ben; Stewart, Georgia; Roets, Rianda; Nutsford, Daniel; Bowie, Christopher; Donnellan, Niamh; Wilson, Nick

    2014-01-01

    Inadequate fruit and vegetable (F&V) consumption is an important dietary risk factor for disease internationally. High F&V prices can be a barrier to dietary intake and so to improve understanding of this topic we surveyed prices and potential competition between F&V outlet types. Over a three week early autumn period in 2013, prices were collected bi-weekly for 18 commonly purchased F&Vs from farmers' markets (FM) selling local produce (n = 3), other F&V markets (OFVM) (n = 5), supermarkets that neighbored markets (n = 8), and more distant supermarkets (n = 8), (in urban Wellington and Christchurch areas of New Zealand). Prices from an online supermarket were also collected. A total of 3120 prices were collected. Most F&Vs (13/18) were significantly cheaper at OFVMs than supermarkets. Over half of the F&Vs (10/18) were significantly cheaper at nearby compared to distant supermarkets, providing evidence of a moderate 'halo effect' in price reductions in supermarkets that neighbored markets. Weekend (vs midweek) prices were also significantly cheaper at nearby (vs distant) supermarkets, supporting evidence for a 'halo effect'. Ideal weekly 'food basket' prices for a two adult, two child family were: OFVMs (NZ$76), online supermarket ($113), nearby supermarkets ($124), distant supermarkets ($127), and FMs ($138). This represents a savings of $49 per week (US$26) by using OFVMs relative to (non-online) supermarkets. Similarly, a shift from non-online supermarkets to the online supermarket would generate a $13 saving. In these locations general markets appear to be providing some substantially lower prices for fruit and vegetables than supermarkets. They also appear to be depressing prices in neighboring supermarkets. These results, when supplemented by other needed research, may help inform the case for interventions to improve access to fruit and vegetables, particularly for low-income populations.

  8. Changes in Greenland Outlet Glacier Systems Synchronous With Increasing Summer Sea Surface Temperatures Over the Past Decade

    Science.gov (United States)

    Fahnestock, M.; Milliman, T.; Truffer, M.; Joughin, I.; Motyka, R.; Amundson, J.

    2007-12-01

    Analysis of satellite-derived (AVHRR and MODIS) sea surface temperature (SST) time series around Greenland show large-scale patterns of increase that are synchronous with changes in glacier termini and flow speed. In particular, the warming of summer SST in the last half of the 1990s is observed in the south of Greenland and in Disko Bay, coincident with the patterns of glacier acceleration (Rignot and Kanagaratnam. Science 2006) and, in Disko Bay, with the initial changes observed in the configuration and flow of Jakobshavns Isbrae (Joughin et al., Nature, 2004, and Luckman and Murray, GRL, 2005). The warming is observed to spread to the north along both coasts of Greenland, and be particularly pronounced on the NW coast during the first half of the present decade, also matching the patterns of glacier acceleration reported by Rignot and Kanagaratnam and others. Local reports from Disko Bay, and sea ice extent maps from satellite imagery, indicate that winter freezing of the coastal ocean has shown a dramatic decrease over the interval of change, and open water is much more common. Local changes in SST appear to coincide with changes in outlet glacier systems on a nearly annual basis, suggesting that the connection between ocean and inland ice is quite responsive to changes, whether warming or cooling. In a number of areas, maximum summer sea surface temperatures, as measured by satellite thermal IR data, have increased by four degrees C over the last 15 years, representing a significant change in the melting potential of near surface waters.

  9. Absence of Bladder Outlet Obstruction Is an Independent Risk Factor for Prostate Cancer in Men Undergoing Prostate Biopsy

    Science.gov (United States)

    Cormio, Luigi; Lucarelli, Giuseppe; Selvaggio, Oscar; Di Fino, Giuseppe; Mancini, Vito; Massenio, Paolo; Troiano, Francesco; Sanguedolce, Francesca; Bufo, Pantaleo; Carrieri, Giuseppe

    2016-01-01

    Abstract The purpose of this study was to investigate the relationship between bladder outlet obstruction (BOO) and the risk of being diagnosed with prostate cancer (PCa). Study population consisted of 2673 patients scheduled for the first prostate biopsy (PBx). All patients underwent uroflowmetry before PBx; those with a peak flow rate (PFR) <10 mL/s were considered to have BOO. The incidence of PCa was 41.3% (1104/2673) in the overall population and 34.1% (659/1905) in patients with serum prostate-specific antigen (PSA) ≤ 10 ng/mL. Univariate and multivariate logistic regression analyses showed that patients with BOO had a significantly (P < 0.0001) lower risk than those without BOO of being diagnosed with PCa (33.1% vs 66.9% in the overall population; 30% vs 70% in patients with PSA ≤ 10 ng/mL). As the presence of BOO was significantly correlated to a large prostate volume, another independent predictor of PBx outcome, we tested whether these parameters could be used to identify, in the subset of patients with PSA≤10 ng/mL, those who could potentially be spared from a PBx. If we would have not biopsied patients with BOO and prostate volume ≥60 mL, 14.5% of biopsies could have been avoided while missing only 6% of tumors. Only 10% of the tumors that would have been missed were high-risk cancers. In conclusion, in men undergoing PBx, the absence of BOO, as determined by a PFR ≥10 mL/s, is an independent risk factor for PCa. Our study provides ground for this simple, noninvasive, objective parameter being used, alone or in combination with prostate volume, in the decision-making process of men potentially facing a PBx. PMID:26886598

  10. Obtaining fruit and vegetables for the lowest prices: pricing survey of different outlets and geographical analysis of competition effects.

    Directory of Open Access Journals (Sweden)

    Amber L Pearson

    Full Text Available AIMS: Inadequate fruit and vegetable (F&V consumption is an important dietary risk factor for disease internationally. High F&V prices can be a barrier to dietary intake and so to improve understanding of this topic we surveyed prices and potential competition between F&V outlet types. METHODS: Over a three week early autumn period in 2013, prices were collected bi-weekly for 18 commonly purchased F&Vs from farmers' markets (FM selling local produce (n = 3, other F&V markets (OFVM (n = 5, supermarkets that neighbored markets (n = 8, and more distant supermarkets (n = 8, (in urban Wellington and Christchurch areas of New Zealand. Prices from an online supermarket were also collected. RESULTS: A total of 3120 prices were collected. Most F&Vs (13/18 were significantly cheaper at OFVMs than supermarkets. Over half of the F&Vs (10/18 were significantly cheaper at nearby compared to distant supermarkets, providing evidence of a moderate 'halo effect' in price reductions in supermarkets that neighbored markets. Weekend (vs midweek prices were also significantly cheaper at nearby (vs distant supermarkets, supporting evidence for a 'halo effect'. Ideal weekly 'food basket' prices for a two adult, two child family were: OFVMs (NZ$76, online supermarket ($113, nearby supermarkets ($124, distant supermarkets ($127, and FMs ($138. This represents a savings of $49 per week (US$26 by using OFVMs relative to (non-online supermarkets. Similarly, a shift from non-online supermarkets to the online supermarket would generate a $13 saving. CONCLUSIONS: In these locations general markets appear to be providing some substantially lower prices for fruit and vegetables than supermarkets. They also appear to be depressing prices in neighboring supermarkets. These results, when supplemented by other needed research, may help inform the case for interventions to improve access to fruit and vegetables, particularly for low-income populations.

  11. Urodynamic pattern distribution among aged male patients with lower urinary tract symptoms suggestive of bladder outlet obstruction.

    Science.gov (United States)

    Xu, Danfeng; Cui, Xingang; Qu, Chuangyu; Yin, Lei; Wang, Cunzhou; Chen, Jie

    2014-03-01

    To develop a urodynamic study (UDS) pattern system for aged male patients who complained of non-neurogenic lower urinary tract symptoms (LUTS) to create a reference guideline for their diagnosis and treatment by a retrospective analysis. A retrospective analysis of UDS data was carried out in 1984 male patients neurologically intact with symptoms suggestive of bladder outlet obstruction (BOO) aged older than 45 years (2002-2013). On the basis of their UDS characteristic findings, the patients were classified into 1 of 7 subgroups: equivocal or mild BOO with sphincter synergia with or without idiopathic detrusor overactivity (pattern A); equivocal or mild BOO with idiopathic sphincter overactivity (B); classic BOO with sphincter synergia (C) or overactivity (D); BOO with only detrusor low compliance (E); BOO with both detrusor underactivity and low compliance (F); and equivocal BOO with detrusor underactivity (G). The follow-up data were reviewed and analyzed thereafter. The feasibility and rationality of this system were confirmed. The distribution of 7 patterns (pattern, case number, %) was A 158, 8%; B 59, 3%; C 1059, 53.3%; D 277, 14%; E 120, 6%; F 93, 4.7%; and G 218, 11%. A-G numbers in pattern C, D, and E were 103.1-141.4, higher than other patterns (P <.001), and functional pressure lengths of pattern C and D were 7.0-7.2 cm, longer than other patterns (P <.001). A practical UDS pattern system for aged male patients with lower urinary tract symptoms suggestive of BOO was constructed, which can be used to optimize the diagnosis and treatment of these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The influence of using heat storage with PCM on inlet and outlet temperatures in substation in DHS

    Science.gov (United States)

    Nogaj, Kinga; Turski, Michał; Sekret, Robert

    2017-11-01

    The main objective of this article is to indicate the direction of development of new generation heating systems that use phase change materials, and the important criteria needed when choosing a phase change material. The work contains a detailed classification of materials using the latent heat of organic and inorganic PCM. This references the technical possibilities of existing heat storage technologies. A specific objective was adopted to determine the effect of using heat storage with PCM on inlet and outlet temperatures in substation in district heating systems. The scope of the study included determining the parameters of the heat distribution network as a function of an outdoor air temperature within the range of -20°C to + 12°C. The object of analysis was chosen to be the heating system parameters: supply 120°C and return 60°C. It is located on the surface of 160km2, and supplies heat to 240,000 residents. The total length of the district heating network is 170 km. Based on the study, it was found that the most advantageous material that accumulates heat depends on the return temperature in the heating network. For the above analyzed case, the return temperature was in the range of 46°C to 57°C. The analysis showed that the most preferred materials using heat of phase change, have possible applications in heating networks and received a return temperature including salt hydrates, such as MgSO4·7H2O and Na2S2O3·5H2. The introduction of stored heat for the district heating system with the phase change material in the form of salt hydrates, allows the return temperature in the district heating to remain at temperatures compatible with the adopted regulatory table for temperatures outside the standard heating season.

  13. 'McDonalds and KFC, it's never going to happen': the challenges of working with food outlets to tackle the obesogenic environment.

    Science.gov (United States)

    Hanratty, Barbara; Milton, Beth; Ashton, Matthew; Whitehead, Margaret

    2012-12-01

    Food outlets may make an important contribution to an obesogenic environment. This study investigated barriers and facilitators to public health work with food outlets in disadvantaged areas. In-depth qualitative interviews with 36 directors, managers and public health service delivery staff in a coterminous primary care trust and local authority in northwest England. Data were analysed using the constant comparative method. Three interventions were available to engage with businesses; awards for premises that welcomed breastfeeding mothers or offered healthy menu options and local authority planning powers. Sensitivity to the potential conflict between activities that generate profit and those that promote health, led to compromises, such as awards for cafés that offer only one healthy option on an otherwise unhealthy menu. An absence of existing relationships with businesses and limited time were powerful disincentives to action, leading to greater engagement with public rather than private sector organizations. Hiring staff with commercial experience and incentives for businesses were identified as useful strategies, but seldom used. Encouraging food outlets to contribute to tackling the obesogenic environment is a major challenge for local public health teams that requires supportive national policies. Commitment to engage with the local public health service should be part of any national voluntary agreements with industry.

  14. Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets: A Nationwide 6-Year Follow-Up Study of 944,487 Children.

    Science.gov (United States)

    Hamano, Tsuyoshi; Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

    2017-01-01

    The aim of this 6-year follow-up study was to examine whether neighbourhood accessibility to fast-food outlets was associated with diagnosed childhood obesity, after adjustment for neighbourhood- and individual-level socio-demographic factors. This 6-year follow-up study comprised 484,677 boys and 459,810 girls aged 0-14 years in Sweden. The follow-up period ran from January 1, 2005, until hospitalisation/out-patient treatment for obesity, death, emigration or the end of the study period on December 31, 2010. Multilevel logistic regression models (individual-level factors at the first level and neighbourhood-level factors at the second level) were used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). We identified 6,968 obesity cases (3,878 boys and 3,090 girls) during the follow-up period. Higher odds of childhood obesity for those living in neighbourhoods with accessibility to fast-food outlets was observed (OR = 1.14, 95% CI = 1.07-1.22) that remained significant after adjustments (OR = 1.06, 95% CI = 1.00-1.13). This prospective nationwide study showed that the neighbourhood accessibility to fast-food outlets was independently associated with increased odds of diagnosed childhood obesity. This finding implicates that residential environments should be considered when developing health promotion programmes. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  15. Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets: A Nationwide 6-Year Follow-Up Study of 944,487 Children

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Hamano

    2017-11-01

    Full Text Available Objectives: The aim of this 6-year follow-up study was to examine whether neighbourhood accessibility to fast-food outlets was associated with diagnosed childhood obesity, after adjustment for neighbourhood- and individual-level socio-demographic factors. Methods: This 6-year follow-up study comprised 484,677 boys and 459,810 girls aged 0-14 years in Sweden. The follow-up period ran from January 1, 2005, until hospitalisation/out-patient treatment for obesity, death, emigration or the end of the study period on December 31, 2010. Multilevel logistic regression models (individual-level factors at the first level and neighbourhood-level factors at the second level were used to calculate odds ratios (ORs with 95% confidence intervals (95% CIs. Results: We identified 6,968 obesity cases (3,878 boys and 3,090 girls during the follow-up period. Higher odds of childhood obesity for those living in neighbourhoods with accessibility to fast-food outlets was observed (OR = 1.14, 95% CI = 1.07-1.22 that remained significant after adjustments (OR = 1.06, 95% CI = 1.00-1.13. Conclusions: This prospective nationwide study showed that the neighbourhood accessibility to fast-food outlets was independently associated with increased odds of diagnosed childhood obesity. This finding implicates that residential environments should be considered when developing health promotion programmes.

  16. Rural people who inject drugs: A cross-sectional survey addressing the dimensions of access to secondary needle and syringe program outlets.

    Science.gov (United States)

    Fisher, Karin; Smith, Tony; Nairn, Karen; Anderson, Donna

    2017-04-01

    To better understand issues related to access to injecting equipment for people who inject drugs (PWID) in a rural area of New South Wales (NSW), Australia. Cross-sectional face-to-face survey using convenience and snowball sampling. Six regional and rural population centres in Northern NSW, within the Hunter New England Local Health District. The sample included 190 PWID who had accessed a needle and syringe program outlet within 4 weeks of the survey. Data include demographic information, preferred location for accessing injecting equipment, reasons for that preference, whether they obtained enough equipment, travelling distance to an NSP and self-reported hepatitis C virus status. Sixty percent self-identified as Aboriginal people. The median age of respondents was 32 years and 60% were men. A significantly larger proportion (P equipment at a community health facility (62.6%), as opposed to other secondary outlets, where they gained enough equipment (67.4%). Just over 80% said they were tested for HCV in the past year, with about 37% told they had tested positive. There are complex dimensions affecting how rural PWID access secondary NSP outlets. Although access is similarly limited as other rural health services because of the nature of injecting drug use and sensitivities existing in rural communities, there is potential for application of unique access models, such as, promoting secondary distribution networks. © 2016 National Rural Health Alliance Inc.

  17. The availability and accessibility of nutrition information in fast food outlets in five states post-menu labelling legislation in New South Wales.

    Science.gov (United States)

    Wellard, Lyndal; Havill, Michelle; Hughes, Clare; Watson, Wendy L; Chapman, Kathy

    2015-12-01

    1) Explore the availability and accessibility of fast food energy and nutrient information post-NSW menu labelling legislation in states with and without menu labelling legislation. 2) Determine whether availability and accessibility differed compared with pre-menu labelling legislation in NSW. We visited 210 outlets of the five largest fast food chains in five Australian states to observe the availability and accessibility of energy and nutrient information. Results were compared with 197 outlets surveyed pre-menu labelling. Most outlets (95%) provided energy values, half provided nutrient values and 3% provided information for all menu items. The total amount of information available increased post-NSW menu labelling implementation (473 versus 178 pre-implementation, pFast food chains surveyed had voluntarily introduced menu labelling nationally. However, more nutrient information was available in-store in 2010, showing that fast food chains are able to provide comprehensive nutrition information, yet they have stopped doing so. Menu labelling legislation should compel fast food chains to provide accessible nutrition information including nutrient values in addition to energy for all menu items in-store. Additionally, public education campaigns are needed to ensure customers can use menu labelling. © 2015 Public Health Association of Australia.

  18. Thoracic Outlet Syndrome

    Science.gov (United States)

    ... TOS, including rotator cuff injuries, cervical disc disorders, fibromyalgia, multiple sclerosis, complex regional pain syndrome, and tumors ... TOS, including rotator cuff injuries, cervical disc disorders, fibromyalgia, multiple sclerosis, complex regional pain syndrome, and tumors ...

  19. Bladder outlet obstruction

    Science.gov (United States)

    ... Names BOO; Lower urinary tract obstruction; Prostatism; Urinary retention - BOO Images Kidney anatomy Female urinary tract Male ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  20. Associations between Food Outlets around Schools and BMI among Primary Students in England: A Cross-Classified Multi-Level Analysis.

    Directory of Open Access Journals (Sweden)

    Julianne Williams

    Full Text Available Researchers and policy-makers are interested in the influence that food retailing around schools may have on child obesity risk. Most previous research comes from North America, uses data aggregated at the school-level and focuses on associations between fast food outlets and school obesity rates. This study examines associations between food retailing and BMI among a large sample of primary school students in Berkshire, England. By controlling for individual, school and home characteristics and stratifying results across the primary school years, we aimed to identify if the food environment around schools had an effect on BMI, independent of socio-economic variables.We measured the densities of fast food outlets and food stores found within schoolchildren's home and school environments using Geographic Information Systems (GIS and data from local councils. We linked these data to measures from the 2010/11 National Child Measurement Programme and used a cross-classified multi-level approach to examine associations between food retailing and BMI z-scores. Analyses were stratified among Reception (aged 4-5 and Year 6 (aged 10-11 students to measure associations across the primary school years.Our multilevel model had three levels to account for individual (n = 16,956, home neighbourhood (n = 664 and school (n = 268 factors. After controlling for confounders, there were no significant associations between retailing near schools and student BMI, but significant positive associations between fast food outlets in home neighbourhood and BMI z-scores. Year 6 students living in areas with the highest density of fast food outlets had an average BMI z-score that was 0.12 (95% CI: 0.04, 0.20 higher than those living in areas with none.We found little evidence to suggest that food retailing around schools influences student BMI. There is some evidence to suggest that fast food outlet densities in a child's home neighbourhood may have an effect on BMI

  1. Associations between Food Outlets around Schools and BMI among Primary Students in England: A Cross-Classified Multi-Level Analysis.

    Science.gov (United States)

    Williams, Julianne; Scarborough, Peter; Townsend, Nick; Matthews, Anne; Burgoine, Thomas; Mumtaz, Lorraine; Rayner, Mike

    2015-01-01

    Researchers and policy-makers are interested in the influence that food retailing around schools may have on child obesity risk. Most previous research comes from North America, uses data aggregated at the school-level and focuses on associations between fast food outlets and school obesity rates. This study examines associations between food retailing and BMI among a large sample of primary school students in Berkshire, England. By controlling for individual, school and home characteristics and stratifying results across the primary school years, we aimed to identify if the food environment around schools had an effect on BMI, independent of socio-economic variables. We measured the densities of fast food outlets and food stores found within schoolchildren's home and school environments using Geographic Information Systems (GIS) and data from local councils. We linked these data to measures from the 2010/11 National Child Measurement Programme and used a cross-classified multi-level approach to examine associations between food retailing and BMI z-scores. Analyses were stratified among Reception (aged 4-5) and Year 6 (aged 10-11) students to measure associations across the primary school years. Our multilevel model had three levels to account for individual (n = 16,956), home neighbourhood (n = 664) and school (n = 268) factors. After controlling for confounders, there were no significant associations between retailing near schools and student BMI, but significant positive associations between fast food outlets in home neighbourhood and BMI z-scores. Year 6 students living in areas with the highest density of fast food outlets had an average BMI z-score that was 0.12 (95% CI: 0.04, 0.20) higher than those living in areas with none. We found little evidence to suggest that food retailing around schools influences student BMI. There is some evidence to suggest that fast food outlet densities in a child's home neighbourhood may have an effect on BMI, particularly

  2. Clients’ expectations from and satisfaction with medicine retail outlets in Gondar town, northwestern Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Workye M

    2015-01-01

    Full Text Available Mulualem Workye,1 Sewunet Admasu,2 Tamrat Abura,1 Yared Belete,1 Yonas Getaye,2 Fitsum Sebsibe Teni,1 Abdrrahman Shemsu Surur31Pharmaceutics and Social Pharmacy Unit, 2Clinical Pharmacy Unit, 3Pharmaceutical Chemistry Unit, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Regional State, EthiopiaPurpose: The aim of this study was to assess clients' level of expectation from and satisfaction with medicine retail outlets (MROs in Gondar town, northwestern Ethiopia.Patients and methods: An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the MROs during the study period were included in the study. Data were collected using structured questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1–5 through face-to-face interviews.Results: Out of the total 424 interview encounters, 422 (99.5% response rate questionnaires were included in the analysis, of which 61.1% were of males. The overall mean expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the respondents was 3.02. More than three-quarters (76.8% of the respondents expected medicines in affordable prices from MROs, but nearly half (44.8% were not satisfied with it. Much more than half (58.5% of the respondents were dissatisfied with the comfort and convenience of private counseling area. Also, nearly half (47.6% of the respondents claimed that pharmacy professionals did not provide information regarding the storage condition of medications. There was statistically significant difference in overall expectation (t=2.707, P=0.007 and satisfaction (t=2.260, P=0.024 with the setting and services of MROs between respondents who claimed to know the difference between a pharmacy and a drug store and those who claimed they did not

  3. EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction.

    Science.gov (United States)

    Chen, Yen-I; Itoi, Takao; Baron, Todd H; Nieto, Jose; Haito-Chavez, Yamile; Grimm, Ian S; Ismail, Amr; Ngamruenphong, Saowanee; Bukhari, Majidah; Hajiyeva, Gulara; Alawad, Ahmad S; Kumbhari, Vivek; Khashab, Mouen A

    2017-07-01

    Endoscopic enteral stenting (ES) in malignant gastric outlet obstruction (GOO) is limited by high rates of stent obstruction. EUS-guided gastroenterostomy (EUS-GE) is a novel procedure that potentially offers sustained patency without tumor ingrowth/overgrowth. The aim of this study is to compare EUS-GE with ES in terms of (1) symptom recurrence and need for re-intervention, (2) technical success (proper stent positioning as determined via endoscopy and fluoroscopy), (3) clinical success (ability to tolerate oral intake without vomiting), and (4) procedure-related adverse events (AEs). Multicenter retrospective study of all consecutive patients who underwent either EUS-GE at four centers between 2013 and 2015 or ES at one center between 2008 and 2010. A total of 82 patients (mean age 66-years ± 13.5 and 40.2% female) were identified: 30 in EUS-GE and 52 in ES. Technical and clinical success was not significantly different: 86.7% EUS-GE versus 94.2% ES (p = 0.2) and 83.3% EUS-GE versus 67.3% ES (p = 0.12), respectively. Symptom recurrence and need for re-intervention, however, was significantly lower in the EUS-GE group (4.0 vs. 28.6%, (p = 0.015). Post-procedure mean length of hospitalization was comparable at 11.3 days ± 6.6 for EUS-GE versus 9.5 days ± 8.3 for ES (p = 0.3). Rates and severity of AEs (as per the ASGE lexicon) were also similar (16.7 vs. 11.5%, p = 0.5). On multivariable analysis, ES was independently associated with need for re-intervention (OR 12.8, p = 0.027). EUS-GE may be ideal for malignant GOO with comparable effectiveness and safety to ES while being associated with fewer symptom recurrence and requirements for re-intervention.

  4. Work Capacity of the Bladder During Voiding: A Novel Method to Evaluate Bladder Contractile Function and Bladder Outlet Obstruction

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    Ning Liu

    2015-01-01

    Full Text Available Background: Work in voiding (WIV of the bladder may be used to evaluate bladder status throughout urination rather than at a single time point. Few studies, however, have assessed WIV owing to the complexity of its calculations. We have developed a method of calculating work capacity of the bladder while voiding and analyzed the associations of bladder work parameters with bladder contractile function and bladder outlet obstruction (BOO. Methods: The study retrospectively evaluated 160 men and 23 women, aged >40 years and with a detrusor pressure at maximal flow rate (P det Q max of ≥40 cmH 2 O in men, who underwent urodynamic testing. The bladder power integration method was used to calculate WIV; WIV per second (WIV/t and WIV per liter of urine voided (WIV/v were also calculated. In men, the relationships between these work capacity parameters and P det Q max and Abrams-Griffiths (AG number were determined using linear-by-linear association tests, and relationships between work capacity parameters and BOO grade were investigated using Spearman′s association test. Results: The mean WIV was 1.15 ± 0.78 J and 1.30 ± 0.88 J, mean WIV/t was 22.95 ± 14.45 mW and 23.78 ± 17.02 mW, and mean WIV/v was 5.59 ± 2.32 J/L and 2.83 ± 1.87 J/L in men and women, respectively. In men, WIV/v showed significant positive associations with P det Q max (r = 0.845, P = 0.000, AG number (r = 0.814, P = 0.000, and Schafer class (r = 0.726, P = 0.000. Conversely, WIV and WIV/t showed no associations with P det Q max or AG number. In patients with BOO (Schafer class > II, WIV/v correlated positively with increasing BOO grade. Conclusions: WIV can be calculated from simple urodynamic parameters using the bladder power integration method. WIV/v may be a marker of BOO grade, and the bladder contractile function can be evaluated by WIV and WIV/t.

  5. Effectiveness of laparoscopic stomach-partitioning gastrojejunostomy for patients with gastric outlet obstruction caused by advanced gastric cancer.

    Science.gov (United States)

    Tanaka, Tsuyoshi; Suda, Koichi; Satoh, Seiji; Kawamura, Yuichiro; Inaba, Kazuki; Ishida, Yoshinori; Uyama, Ichiro

    2017-01-01

    Distal advanced gastric cancer (AGC) occasionally causes gastric outlet obstruction (GOO). We developed a laparoscopic stomach-partitioning gastrojejunostomy (LSPGJ) to restore the ability of food intake. This was a retrospective study performed at a single institution. Of consecutive 78 patients with GOO caused by AGC between 2006 and 2012, 43 patients who underwent LSPGJ were enrolled. The procedure was performed in an antiperistaltic Billroth II fashion, and the afferent loop was elevated and fixed along the staple line of the proximal partitioned stomach. Then, patients for whom R0 resection was planned received chemotherapy prior to laparoscopic gastrectomy. The primary end point was food intake at the time of discharge, which was evaluated using the GOO scoring system (GOOSS). Short- and long-term outcomes were assessed as secondary end points. Overall survival was estimated and compared between the groups who received neoadjuvant chemotherapy followed by surgery (NAC group), definitive chemotherapy followed by curative resection (Conversion group), and best supportive care (BSC group). The median operative time was 92 min, blood loss did not exceed 30 g in any patient, and postoperative complications (Clavien-Dindo grade ≥2) were only seen in four patients (9.3 %). The median time to food intake was 3 days, and GOOSS scores were significantly improved in 41 patients (95.3 %). Chemotherapy was administered to 38 patients (88.4 %), of whom 11 later underwent radical resection, and 4 of 11 patients underwent conversion surgery following definitive chemotherapy. Median survival times were significantly superior in the NAC (n = 7; 46.8 months) and Conversion (n = 4; 35.9 months) groups than in the BSC group (n = 26; 12.2 months); however, the difference was not significant between the Conversion and NAC groups. LSPGJ is a feasible and safe minimally invasive induction surgery for patients with GOO from surgical and oncological perspectives.

  6. Private sector opportunities and threats to achieving malaria elimination in the Greater Mekong Subregion: results from malaria outlet surveys in Cambodia, the Lao PDR, Myanmar, and Thailand.

    Science.gov (United States)

    Phok, Sochea; Phanalasy, Saysana; Thein, Si Thu; Likhitsup, Asawin

    2017-05-02

    The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current coverage of private sector engagement and support through ACTwatch outlet surveys implemented in 2015 and 2016. Over 76,168 outlets were screened, and approximately 6500 interviews were conducted (Cambodia, N = 1303; the Lao People's Democratic Republic (PDR), N = 724; Myanmar, N = 4395; and Thailand, N = 74). There was diversity in the types of private sector outlets providing malaria treatment across countries, and the extent to which they were authorized to test and treat for malaria differed. Among outlets stocking at least one anti-malarial, public sector availability of the first-line treatment for uncomplicated Plasmodium falciparum or Plasmodium vivax malaria was >75%. In the anti-malarial stocking private sector, first-line treatment availability was variable (Cambodia, 70.9%; the Lao PDR, 40.8%; Myanmar P. falciparum = 42.7%, P. vivax = 19.6%; Thailand P. falciparum = 19.6%, P. vivax = 73.3%), as was availability of second-line treatment (the Lao PDR, 74.9%; Thailand, 39.1%; Myanmar, 19.8%; and Cambodia, 0.7%). Treatment not in the National Treatment Guidelines (NTGs) was most common in Myanmar (35.8%) and Cambodia (34.0%), and was typically stocked by the informal sector. The majority of anti-malarials distributed in Cambodia and Myanmar were first-line P. falciparum or P. vivax treatments (90.3% and 77.1%, respectively), however, 8.8% of the market share in Cambodia was treatment not in the NTGs (namely chloroquine) and 17.6% in Myanmar (namely oral artemisinin monotherapy). In the Lao PDR, approximately 9 in 10 anti-malarials distributed in the private sector were second-line treatments-typically locally manufactured chloroquine. In Cambodia, 90% of anti-malarials were distributed through outlets that had confirmatory testing

  7. Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries.

    Science.gov (United States)

    O'Connell, Kathryn A; Gatakaa, Hellen; Poyer, Stephen; Njogu, Julius; Evance, Illah; Munroe, Erik; Solomon, Tsione; Goodman, Catherine; Hanson, Kara; Zinsou, Cyprien; Akulayi, Louis; Raharinjatovo, Jacky; Arogundade, Ekundayo; Buyungo, Peter; Mpasela, Felton; Adjibabi, Chérifatou Bello; Agbango, Jean Angbalu; Ramarosandratana, Benjamin Fanomezana; Coker, Babajide; Rubahika, Denis; Hamainza, Busiku; Chapman, Steven; Shewchuk, Tanya; Chavasse, Desmond

    2011-10-31

    Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia. Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were distributed

  8. Are Retail Outlets Complying with National Legislation to Protect Children from Exposure to Tobacco Displays at Point of Sale? Results from the First Compliance Study in the UK

    Science.gov (United States)

    Eadie, Douglas; Stead, Martine; MacKintosh, Anne Marie; Murray, Susan; Best, Catherine; Pearce, Jamie; Tisch, Catherine; van der Sluijs, Winfried; Amos, Amanda; MacGregor, Andy; Haw, Sally

    2016-01-01

    Background From April 6th 2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS) to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction. Materials and Methods A discreet observational audit was conducted 7–14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83) selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively. Results Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%). Most shops also displayed at least one generic tobacco message (88%). Conclusions Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people’s awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should

  9. Are Retail Outlets Complying with National Legislation to Protect Children from Exposure to Tobacco Displays at Point of Sale? Results from the First Compliance Study in the UK.

    Science.gov (United States)

    Eadie, Douglas; Stead, Martine; MacKintosh, Anne Marie; Murray, Susan; Best, Catherine; Pearce, Jamie; Tisch, Catherine; van der Sluijs, Winfried; Amos, Amanda; MacGregor, Andy; Haw, Sally

    2016-01-01

    From April 6th 2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS) to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction. A discreet observational audit was conducted 7-14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83) selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively. Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%). Most shops also displayed at least one generic tobacco message (88%). Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people's awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should pay particular attention to regulations regarding the use

  10. Reaching the hard-to-reach: a probability sampling method for assessing prevalence of driving under the influence after drinking in alcohol outlets.

    Directory of Open Access Journals (Sweden)

    Raquel De Boni

    Full Text Available Drinking alcoholic beverages in places such as bars and clubs may be associated with harmful consequences such as violence and impaired driving. However, methods for obtaining probabilistic samples of drivers who drink at these places remain a challenge--since there is no a priori information on this mobile population--and must be continually improved. This paper describes the procedures adopted in the selection of a population-based sample of drivers who drank at alcohol selling outlets in Porto Alegre, Brazil, which we used to estimate the prevalence of intention to drive under the influence of alcohol. The sampling strategy comprises a stratified three-stage cluster sampling: 1 census enumeration areas (CEA were stratified by alcohol outlets (AO density and sampled with probability proportional to the number of AOs in each CEA; 2 combinations of outlets and shifts (COS were stratified by prevalence of alcohol-related traffic crashes and sampled with probability proportional to their squared duration in hours; and, 3 drivers who drank at the selected COS were stratified by their intention to drive and sampled using inverse sampling. Sample weights were calibrated using a post-stratification estimator. 3,118 individuals were approached and 683 drivers interviewed, leading to an estimate that 56.3% (SE = 3,5% of the drivers intended to drive after drinking in less than one hour after the interview. Prevalence was also estimated by sex and broad age groups. The combined use of stratification and inverse sampling enabled a good trade-off between resource and time allocation, while preserving the ability to generalize the findings. The current strategy can be viewed as a step forward in the efforts to improve surveys and estimation for hard-to-reach, mobile populations.

  11. Are Retail Outlets Complying with National Legislation to Protect Children from Exposure to Tobacco Displays at Point of Sale? Results from the First Compliance Study in the UK.

    Directory of Open Access Journals (Sweden)

    Douglas Eadie

    Full Text Available From April 6th 2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction.A discreet observational audit was conducted 7-14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83 selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively.Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%. Most shops also displayed at least one generic tobacco message (88%.Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people's awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should pay particular attention to regulations

  12. Reaching the hard-to-reach: a probability sampling method for assessing prevalence of driving under the influence after drinking in alcohol outlets.

    Science.gov (United States)

    De Boni, Raquel; do Nascimento Silva, Pedro Luis; Bastos, Francisco Inácio; Pechansky, Flavio; de Vasconcellos, Mauricio Teixeira Leite

    2012-01-01

    Drinking alcoholic beverages in places such as bars and clubs may be associated with harmful consequences such as violence and impaired driving. However, methods for obtaining probabilistic samples of drivers who drink at these places remain a challenge--since there is no a priori information on this mobile population--and must be continually improved. This paper describes the procedures adopted in the selection of a population-based sample of drivers who drank at alcohol selling outlets in Porto Alegre, Brazil, which we used to estimate the prevalence of intention to drive under the influence of alcohol. The sampling strategy comprises a stratified three-stage cluster sampling: 1) census enumeration areas (CEA) were stratified by alcohol outlets (AO) density and sampled with probability proportional to the number of AOs in each CEA; 2) combinations of outlets and shifts (COS) were stratified by prevalence of alcohol-related traffic crashes and sampled with probability proportional to their squared duration in hours; and, 3) drivers who drank at the selected COS were stratified by their intention to drive and sampled using inverse sampling. Sample weights were calibrated using a post-stratification estimator. 3,118 individuals were approached and 683 drivers interviewed, leading to an estimate that 56.3% (SE = 3,5%) of the drivers intended to drive after drinking in less than one hour after the interview. Prevalence was also estimated by sex and broad age groups. The combined use of stratification and inverse sampling enabled a good trade-off between resource and time allocation, while preserving the ability to generalize the findings. The current strategy can be viewed as a step forward in the efforts to improve surveys and estimation for hard-to-reach, mobile populations.

  13. [Thoracic outlet syndrome: A case of scalene muscle hypertrophy in long-term follow-up of diagnosis of cervical discopathy].

    Science.gov (United States)

    Yürük, Damla; Özgencil, Güngör Enver; Yılmaz, Ahmet; Kocaoğlu, Merve Hayriye; Bilgin, Sırrı Sinan; Aşık, İbrahim

    2016-07-01

    Described in this article is diagnosis and treatment of mixed type of thoracic outlet syndrome (TOS) resulting from scalene muscle hypertrophy. Many diseases should be considered in the differential diagnosis to definitively diagnose this syndrome, and it is necessary to ask about activities of daily life, in addition to adding provocative tests to physical examination and examining electrophysiological and imaging results. Once diagnosed, even if complaints decrease with conservative treatment, surgery may be required. However, in patients diagnosed late, despite decrease in complaints after surgery, neurological deficit may remain.

  14. Sulforaphane Ameliorates Bladder Dysfunction through Activation of the Nrf2-ARE Pathway in a Rat Model of Partial Bladder Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Chong Liu

    2016-01-01

    Full Text Available Purpose. We evaluated the effect of sulforaphane (SFN treatment on the function and changes of expression of Nrf2-ARE pathway in the bladder of rats with bladder outlet obstruction (BOO. Materials and Methods. A total of 18 male Sprague-Dawley rats at age of 8 weeks were divided into 3 groups (6 of each: the sham operated group, the BOO group, and the BOO+SFN group. We examined histological alterations and the changes of oxidative stress markers and the protein expression of the Nrf2-ARE pathway. Results. We found that SFN treatment could prolong micturition interval and increase bladder capacity and bladder compliance. However, the peak voiding pressure was lower than BOO group. SFN treatment can ameliorate the increase of collagen fibers induced by obstruction. SFN treatment also increased the activity of SOD, GSH-Px, and CAT compared to the other groups. The level of bladder cell apoptosis was decreased in BOO rats with SFN treatment. Moreover, SFN could reduce the ratio of Bax/Bcl-2 expression. Furthermore, SFN could activate the Nrf2 expression with elevation of its target antioxidant proteins. Conclusions. The sulforaphane-mediated decrease of oxidative stress and activation of the Nrf2-ARE pathway may ameliorate bladder dysfunction caused by bladder outlet obstruction.

  15. The effect and contribution of wind generated rotation on outlet temperature and heat gain of LS-2 parabolic trough solar collector

    Directory of Open Access Journals (Sweden)

    Sadaghiyani Omid Karimi

    2013-01-01

    Full Text Available The Monte Carlo ray tracing method is applied and coupled with finite volume numerical methods to study effect of rotation on outlet temperature and heat gain of LS-2 parabolic trough concentrator (PTC. Based on effect of sunshape, curve of mirror and use of MCRT, heat flux distribution around of inner wall of evacuated tube is calculated. After calculation of heat flux, the geometry of LS-2 Luz collector is created and finite volume method is applied to simulate. The obtained results are compared with Dudley et al test results for irrotational cases to validate these numerical solving models. Consider that, for rotational models ,the solving method separately with K.S. Ball's results. In this work, according to the structure of mentioned collector, we use plug as a flow restriction. In the rotational case studies, the inner wall rotates with different angular speeds. We compare results of rotational collector with irrotational. Also for these two main states, the location of plug changed then outlet temperature and heat gain of collector are studied. The results show that rotation have positive role on heat transfer processing and the rotational plug in bottom half of tube have better effectual than upper half of tube. Also the contribution of rotation is calculated in the all of case studies. Working fluid of these study is one of the oil derivatives namely Syltherm-800. The power of wind can be used to rotate tube of collector.

  16. Relationships between past and present pesticide applications and pollution at a watershed outlet: The case of a horticultural catchment in Martinique, French West Indies.

    Science.gov (United States)

    Mottes, Charles; Lesueur Jannoyer, Magalie; Le Bail, Marianne; Guéné, Mathilde; Carles, Céline; Malézieux, Eric

    2017-10-01

    The understanding of factors affecting pesticide transfers to catchment outlet is still at a very early stage in tropical context, and especially on tropical volcanic context. We performed on-farm pesticide use surveys during 87 weeks and monitored pesticides in water weekly during 67 weeks at the outlet of a small catchment in Martinique. We identified three types of pollution. First, we showed long-term chronic pollution by chlordecone, diuron and metolachlor resulting from horticultural practices applied 5-20 years ago (quantification frequency higher than 80%). Second, we showed peak pollution. High amounts of propiconazole and fosthiazate applied at low frequencies caused river pollution peaks for weeks following a single application. Low amounts of diquat and diazinon applied at low frequencies also caused pollution peaks. The high amounts of glyphosate applied at high frequency resulted into pollution peaks by glyphosate and aminomethylphosphonic acid (AMPA) in 6 and 20% of the weeks. Any intensification of their uses will result in higher pollution levels. Third, relatively low amounts of glufosinate-ammonium, difenoconazol, spinosad and metaldehyde were applied at high frequencies. Unexpectedly, such pesticides remained barely detected (pollution of shallow aquifers alimenting surface water. We prove that to avoid the past errors and decrease the risk of long-term pollution of water resources, it is urgent to reduce or stop the use of pesticides with leaching potential by changing agricultural practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Successful treatment with a combination of endoscopic injection and irrigation with coca cola for gastric bezoar-induced gastric outlet obstruction.

    Science.gov (United States)

    Lin, Chen-Sheng; Tung, Chun-Fang; Peng, Yen-Chun; Chow, Wei-Keung; Chang, Chi-Sen; Hu, Wei-Hsiung

    2008-01-01

    We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f.) as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

  18. Successful Treatment with a Combination of Endoscopic Injection and Irrigation with Coca Cola for Gastric Bezoar-induced Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Chen-Sheng Lin

    2008-01-01

    Full Text Available We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f. as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

  19. The effectiveness of otis urethrotomy combined with six weeks urethral dilations until 40 Fr in the treatment of bladder outlet obstruction in women: a prospective study.

    Science.gov (United States)

    Grivas, Nikolaos; Tsimaris, Ioannis; Makatsori, Aikaterini; Hastazeris, Konstantinos; Kafarakis, Vasillios; Stavropoulos, Nikolaos E

    2014-01-04

    To evaluate the effectiveness of Otis urethrotomy combined with six weekly urethral dilations until 40 French (Fr) in the treatment of women with urodynamic diagnosis of bladder outlet obstruction (BOO). Women diagnosed with lower urinary tract symptoms underwent urodynamic evaluation. Severity of symptoms and quality of life were assessed with international prostate symptom score (IPSS) and quality of life (QoL) questionnaires. Bladder outlet obstruction was defined as the presence of two or more of the following: maximum flow rate (Qmax) 50 cmH2O and urethral resistance factor (URF) greater than 0.2. Ten out of 25 women diagnosed with BOO met the criteria. All women underwent Otis urethrotomy to 40 F and six-week urethral dilations until 40 F. After six months all patients underwent free uroflowmetry. Moreover post voiding residual (PVR), IPSS-QoL were recorded. Six months post-operatively there was a significant improvement in all parameters: IPSS = 13.5 vs. 22.5 (P = .001), QoL = 3 vs. 5 (P = .001), voided volume = 312 mL vs. 216 mL (P = .055), Qmax = 27.5 mL/s vs. 12 mL/s (P = .001), and PVR = 27.5 mL vs. 170 mL (P = .005). Five women had close follow up during an average of 82 months. They maintained improved QoL (P women with evidence of BOO not related to detrusor sphincter dyssynergia or obvious functional and anatomical pathology.

  20. Changes in microbial contamination levels of porcine carcasses and fresh pork in slaughterhouses, processing lines, retail outlets, and local markets by commercial distribution.

    Science.gov (United States)

    Choi, Y M; Park, H J; Jang, H I; Kim, S A; Imm, J Y; Hwang, I G; Rhee, M S

    2013-06-01

    The objective of this study was to evaluate the changes in microbial contamination levels of each porcine carcass and fresh pork in a general distribution process. A total of 100 commercial pigs were sampled (six sampling sites per individual, total 600 samples) at four sequential stages: slaughterhouse (after carcass grading and boning), processing line, retail outlet, and local market. No significant differences were observed in the contaminant percentages among sampling sites and sample collection years (P>0.05) with the exception of Bacillus cereus. The contaminant percentage of B. cereus at 1st collection year was higher than these of 2nd collection year (28.31% vs. 12.26%, Pslaughterhouse and markets, respectively. On the other hand, Escherichia coli O157:H7 and Yersinia enterocolitica were not detected in carcasses or pork collected from any carcass sites and pork samples. However, the frequency of pathogenic bacteria in end-products at local markets was not highly related to the initial contamination of porcine carcasses in the slaughterhouse. Thus, the improvement of microbial safety for pork end-products requires hygienic control of porcine carcasses and meat cutting during all operations in the slaughterhouse, processing line, retail outlet, and local market. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Lot quality assurance sampling for monitoring coverage and quality of a targeted condom social marketing programme in traditional and non-traditional outlets in India

    Science.gov (United States)

    Piot, Bram; Navin, Deepa; Krishnan, Nattu; Bhardwaj, Ashish; Sharma, Vivek; Marjara, Pritpal

    2010-01-01

    Objectives This study reports on the results of a large-scale targeted condom social marketing campaign in and around areas where female sex workers are present. The paper also describes the method that was used for the routine monitoring of condom availability in these sites. Methods The lot quality assurance sampling (LQAS) method was used for the assessment of the geographical coverage and quality of coverage of condoms in target areas in four states and along selected national highways in India, as part of Avahan, the India AIDS initiative. Results A significant general increase in condom availability was observed in the intervention area between 2005 and 2008. High coverage rates were gradually achieved through an extensive network of pharmacies and particularly of non-traditional outlets, whereas traditional outlets were instrumental in providing large volumes of condoms. Conclusion LQAS is seen as a valuable tool for the routine monitoring of the geographical coverage and of the quality of delivery systems of condoms and of health products and services in general. With a relatively small sample size, easy data collection procedures and simple analytical methods, it was possible to inform decision-makers regularly on progress towards coverage targets. PMID:20167732

  2. Lot quality assurance sampling for monitoring coverage and quality of a targeted condom social marketing programme in traditional and non-traditional outlets in India.

    Science.gov (United States)

    Piot, Bram; Mukherjee, Amajit; Navin, Deepa; Krishnan, Nattu; Bhardwaj, Ashish; Sharma, Vivek; Marjara, Pritpal

    2010-02-01

    This study reports on the results of a large-scale targeted condom social marketing campaign in and around areas where female sex workers are present. The paper also describes the method that was used for the routine monitoring of condom availability in these sites. The lot quality assurance sampling (LQAS) method was used for the assessment of the geographical coverage and quality of coverage of condoms in target areas in four states and along selected national highways in India, as part of Avahan, the India AIDS initiative. A significant general increase in condom availability was observed in the intervention area between 2005 and 2008. High coverage rates were gradually achieved through an extensive network of pharmacies and particularly of non-traditional outlets, whereas traditional outlets were instrumental in providing large volumes of condoms. LQAS is seen as a valuable tool for the routine monitoring of the geographical coverage and of the quality of delivery systems of condoms and of health products and services in general. With a relatively small sample size, easy data collection procedures and simple analytical methods, it was possible to inform decision-makers regularly on progress towards coverage targets.

  3. [Radial diagnosis MRT and MSCT in assessing the outcomes of surgical correction for complicated congenital heart defects: discordant atrioventricular connections with double outlet right ventricle].

    Science.gov (United States)

    Mershina, E A; Frolova, Iu V; Seliavko, Iu A; Sinitsyn, V E

    2012-01-01

    Discordant atrioventricular connection with double outlet right ventricle is a rare complicated congenital heart defect (CHD) requiring accurate diagnosis and appropriate correction. Magnetic resonance imaging (MRI) and multiple spiral computed tomography (MSCT) were used to assess long-term outcomes of the «classical» repair of the double outlet right ventricle in a patient presenting with discordant atrioventricular connection. Using a modified segmental approach provided all necessary anatomical evidence concerning the condition of the heart, major vessels, and an extracardiac pulmonary valve-containing conduit. MSCT made it possible to evaluate the degree of calcinosis and stenosis of the conduit and to visualize the coronary arteries. MRI was employed to assess the pressure gradient at the level of stenosis of the conduit, the relationship between the pulmonary and systemic circulation, transvalvular regurgitation, and ventricular contractility. Comprehensive use of present-day tomographic methods of imaging made it possible to obtain complete anatomical and functional information about the condition of the heart, vessels, extracardiac vascular transplant, as well as to reveal complications and determine the indications for a repeat operative intervention.

  4. Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets.

    Science.gov (United States)

    Bell, Colin; Pond, Nicole; Davies, Lynda; Francis, Jeryl Lynn; Campbell, Elizabeth; Wiggers, John

    2013-11-25

    Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale. Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green). Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets. Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention

  5. Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets

    Science.gov (United States)

    2013-01-01

    Background Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale. Methods Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green). Results Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets. Conclusions Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers

  6. Co-occurrence of outlet impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysis

    Science.gov (United States)

    2010-01-01

    Background Shoulder complaints, and especially the outlet-impingement syndrome, are a common condition. Among other things, poor posture has been discussed as a cause. A correlation between impingement syndrome and restricted mobility of the thoracic spine (T) has been described earlier, but there has been no motion analysis of the thoracic spine to show these correlations. In the present prospective study, we intended to find out whether there is a significant difference in the thoracic sagittal range of motion (ROM) between patients with a shoulder outlet impingement syndrome and a group of patients who had no shoulder pathology. Secondly, we wanted to clarify whether Ott's sign correlates with ultrasound topometric measurements. Methods Two sex- and age-matched groups (2 × n = 39) underwent a clinical and an ultrasound topometric examination. The postures examined were sitting up straight, sitting in maximal flexion and sitting in maximal extension. The disabilities of the arm, shoulder and hand (DASH) score (obtained by means of a self-assessment questionnaire) and the Constant score were calculated. Lengthening and shortening of the dorsal projections of the spine in functional positions was measured by tape with Ott's sign. Results On examination of the thoracic kyphosis in the erect seated posture there were no significant differences between the two groups (p = 0.66). With ultrasound topometric measurement it was possible to show a significantly restricted segmental mobility of the thoracic spine in the study group compared with the control group (p = 0.01). An in-depth look at the mobility of the subsegments T1-4, T5-8 and T9-12 revealed that differences between the groups in the mobility in the lower two sections of the thoracic spine were significant (T5-8: p = 0.03; T9-12: p = 0.02). The study group had an average Constant score of 35.1 points and the control group, 85.5 (p shoulder outlet impingement syndrome. PMID:20587014

  7. Co-occurrence of outlet impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysis

    Directory of Open Access Journals (Sweden)

    Fuchs-Winkelmann Susanne

    2010-06-01

    Full Text Available Abstract Background Shoulder complaints, and especially the outlet-impingement syndrome, are a common condition. Among other things, poor posture has been discussed as a cause. A correlation between impingement syndrome and restricted mobility of the thoracic spine (T has been described earlier, but there has been no motion analysis of the thoracic spine to show these correlations. In the present prospective study, we intended to find out whether there is a significant difference in the thoracic sagittal range of motion (ROM between patients with a shoulder outlet impingement syndrome and a group of patients who had no shoulder pathology. Secondly, we wanted to clarify whether Ott's sign correlates with ultrasound topometric measurements. Methods Two sex- and age-matched groups (2 × n = 39 underwent a clinical and an ultrasound topometric examination. The postures examined were sitting up straight, sitting in maximal flexion and sitting in maximal extension. The disabilities of the arm, shoulder and hand (DASH score (obtained by means of a self-assessment questionnaire and the Constant score were calculated. Lengthening and shortening of the dorsal projections of the spine in functional positions was measured by tape with Ott's sign. Results On examination of the thoracic kyphosis in the erect seated posture there were no significant differences between the two groups (p = 0.66. With ultrasound topometric measurement it was possible to show a significantly restricted segmental mobility of the thoracic spine in the study group compared with the control group (p = 0.01. An in-depth look at the mobility of the subsegments T1-4, T5-8 and T9-12 revealed that differences between the groups in the mobility in the lower two sections of the thoracic spine were significant (T5-8: p = 0.03; T9-12: p = 0.02. The study group had an average Constant score of 35.1 points and the control group, 85.5 (p Conclusion The mobility of the thoracic spine should

  8. Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective

    Directory of Open Access Journals (Sweden)

    Dillip Angel

    2010-06-01

    Full Text Available Abstract Background To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP to artemether-lumefantrine (ALu in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. Methods The study was carried out in the villages of Kilombero and Ulanga Demographic Surveillance System (DSS and in Ifakara town. Data collection consisted of: 1 yearly censuses of shops selling drugs; 2 collection of monthly data on availability of anti-malarials in public health facilities; and 3 retail audits to measure anti-malarial sales volumes in all public, mission and private outlets. The data were complemented with DSS population data. Results Between 2004 and 2008 access to malaria treatment greatly improved and the number of anti-malarial treatment doses dispensed increased by 78%. Particular improvements were observed in the availability (from 0.24 shops per 1,000 people in 2004 to 0.39 in 2008 and accessibility (from 71% of households within 5 km of a shop in 2004 to 87% in 2008 of drug shops. Despite no improvements in affordability this resulted in an increase of the market share from 49% of anti-malarial sales 2005 to 59% in 2008. The change of treatment policy from SP to ALu led to severe stock-outs of SP in health facilities in the months leading up to the introduction of ALu (only 40% months in stock, but these were compensated by the wide availability of SP in shops. After the introduction of ALu stock levels of the drug were relatively high in public health facilities (over 80% months in stock, but the drug could only be found in 30% of drug shops and in no general shops. This resulted in a low overall utilization of the drug (19% of all anti

  9. Capacitively coupled and direct-current resistivity surveys of selected reaches of Cozad, Thirty-Mile, Orchard-Alfalfa, Kearney, and Outlet Canals in Nebraska, 2012-13

    Science.gov (United States)

    Hobza, Christopher M.; Burton, Bethany L.; Lucius, Jeffrey E.; Tompkins, Ryan E.

    2014-01-01

    Understanding the spatial characteristics of leakage from canals is critical to effectively managing and utilizing water resources for irrigation and hydroelectric purposes. Canal leakage in some parts of Nebraska is the primary source of water for groundwater recharge and helps maintain the base flow of streams. Because surface-water supplies depend on the streamflow of the Platte River and the available water stored in upstream reservoirs, water managers seek to minimize conveyance losses, which can include canal leakage. The U.S. Geological Survey, in cooperation with the Central Platte Natural Resources District and Nebraska Public Power District, used capacitively coupled (CC) and direct-current (DC) resistivity techniques for continuous resistivity profiling to map near-surface lithologies near and underlying the Cozad, Thirty-Mile, Orchard-Alfalfa, Kearney, and Outlet Canals. Approximately 84 kilometers (km) of CC-resistivity data were collected along the five canals. The CC-resistivity data were compared with results from continuous sediment cores and electrical conductivity logs. Generally, the highest resistivities were recorded at the upstream reaches of the Cozad, Thirty-Mile, and Orchard-Alfalfa canals where flood-plain deposits of silt and clay mantle coarser channel deposits of sand and gravel. The finer grained deposits gradually thicken with increasing distance away from the Platte River. Consequently, for many surveyed reaches the thickness of fine-grained deposits exceeded the 8-meter depth of investigation. A detailed geophysical investigation along a 5-km reach of the Outlet Canal southwest of North Platte, Nebraska, used CC and DC resistivity to examine the condition of a compacted-core bank structure and characterized other potential controls on areas of focused seepage. CC-resistivity data, collected along the 5-km study reach, were compared with continuous sediment cores and DC-resistivity data collected near a selected seep near Outlet

  10. Experimental investigation of the performance of a Ranque-Hilsch vortex tube with regard to a plug located at the hot outlet

    Energy Technology Data Exchange (ETDEWEB)

    Dincer, K. [Department of Mechanical Engineering, Faculty of Engineering and Architecture, Selcuk University, Konya (Turkey); Baskaya, S. [Department of Mechanical Engineering, Faculty of Engineering and Architecture, Gazi University, Maltepe, 06570 Ankara (Turkey); Uysal, B.Z. [Department of Chemical Engineering, Faculty of Engineering and Architecture, Gazi University, Maltepe, Ankara (Turkey); Ucgul, I. [Department of Textile Engineering, Faculty of Engineering and Architecture, Suleyman Demirel University, Isparta (Turkey)

    2009-01-15

    In this study, effects of position, diameter (5, 6, 7, 8 mm) and angle (30 -180 ) of a mobile plug, located at the hot outlet side in a Ranque-Hilsch Vortex Tube (RHVT), were determined experimentally for best performance. In addition to plug parameters, effects of supply pressure (200-420 kPa) and number of nozzles (2, 4, 6) were also studied. The internal diameter (D) of the vortex tube used in the experiments was 9 mm; the ratio of the length of the vortex tube to its diameter (L/D) was 15. Four different plug locations were studied. The maximum difference in the temperatures of hot and cold streams was obtained for the plug diameter of 5 mm, tip angles of 30 and 60 , 4 nozzles and by keeping the plug location at the far extreme end. (author)

  11. Water-quality, bed-sediment, and discharge data for the Mississippi River-Gulf Outlet and adjacent waterways, southeastern Louisiana, August 2008 through December 2009

    Science.gov (United States)

    Swarzenski, Christopher M.; Mize, Scott V.; Lovelace, John K.

    2012-01-01

    The Mississippi River-Gulf Outlet navigation channel (MRGO) was constructed in the early 1960s to provide a safer and shorter route between the Gulf of Mexico and the Port of New Orleans for deep-draft, ocean-going vessels and to promote the economic development of the Port of New Orleans. In 2006, the U.S. Army Corps of Engineers developed a plan to de-authorize the MRGO. The plan called for a rock barrier to be constructed across the MRGO near Bayou La Loutre. In 2008, the U.S. Geological Survey, in cooperation with the Louisiana Coastal Area Science and Technology Program began a study to document the impacts of the rock barrier on water-quality and flow before, during, and after its construction. Water-quality, bed-sediment, and discharge data were collected in the MRGO and adjacent water bodies from August 2008 through December 2009.

  12. Influence of outlet geometry on the swirling flow in a simplfied model of a large two-stroke marine diesel engine

    DEFF Research Database (Denmark)

    Haider, Sajjad; Schnipper, Teis; Meyer, Knud Erik

    dummy-valve at the cylinder outlet, the magnitude of reverse flow at the inlet increases, the strong swirl is diminished and the axial jet disappears. We compare these findings with previous measurements in vortex chambers and discuss the relevance of these results with respect to development of marine......We present Stereoscopic particle image velocimetry measurements of the effect of a dummy-valve on the in-cylinder swirling flow in a simplified scale model of a large two-stroke marine diesel engine cylinder using air at room temperature and pressure as the working fluid and Reynolds number 19500....... The static model has stroke-to-bore ratio of 4, is rotationally symmetric and the in-cylinder swirling flow is enforced by angled ports at the inlet. We consider a case analogous to engine when the piston is at bottom-dead-center. In absence of an exhaust valve the overall axial velocity profile is wake...

  13. Gastric Outlet Obstruction--An Unexpected Complication during Coca-Cola Therapy for a Gastric Bezoar: A Case Report and Literature Review.

    Science.gov (United States)

    Lu, Lei; Zhang, Xiao-Feng

    2016-01-01

    Gastric bezoars are concretions of undigested material, and Coca-Cola therapy is an easy, efficacious and safe approach for bezoar treatment. Gastric outlet obstruction due to a migratory gastric bezoar during Coca-Cola therapy is an uncommon presentation and, to the best of our knowledge, no cases have been previously reported. We herein describe one such case with no known predisposing factors that recovered via the endoscopic technique. A thorough literature search was performed, which yielded eight relevant patients from seven publications, all of who developed gastrointestinal obstruction during dissolution treatment and recovered uneventfully after surgical intervention. In conclusion, this potential complication should be kept in mind in the event that alternative treatment is necessary.

  14. PERBANDINGAN KEMAMPUAN KITOSAN DARI LIMBAH KULIT UDANG DENGAN ALUMINIUM SULFAT UNTUK MENURUNKAN KEKERUHAN AIR DARI OUTLET BAK PRASEDIMENTASI IPAM NGAGEL 2

    Directory of Open Access Journals (Sweden)

    Cecilia Dwi Triastiningrum

    2017-01-01

    Full Text Available PDAM Surya Sembada Surabaya menggunakan air dari Kali Surabaya sebagai sumber air baku utama. Koagulan yang digunakan untuk mengolah air baku tersebut adalah aluminium sulfat. Penggunaan aluminium sulfat dapat mempengaruhi pH air dan menyebabkan kerugian baik dalam sisi lingkungan maupun kesehatan konsumen. Di lain hal, terdapat pula masalah peningkatan jumlah limbah kulit udang yang berpotensi namun belum dimanfaatkan secara optimal. Dari masalah-masalah tersebut muncul ide untuk mencari alternatif koagulan yang ramah lingkungan, efektif, efisien dan sekaligus dapat memanfaatkan limbah kulit udang. Kitosan yang terdapat di kulit udang dapat dijadikan alternatif karena sifatnya tidak beracun, mudah terdegradasi dan bahan bakunya mudah didapatkan. Kitosan adalah senyawa polimer dengan ion positif yang diperoleh dari proses hidrolisis kitin menggunakan basa kuat sehingga terjadi deasetilasi gugus asetamida (NH-COCH3 menjadi gugus amino (NH2. Kitosan diperoleh dari serbuk kulit udang yang melalui proses deproteinasi dengan NaOH 6%, proses demineralisasi dengan HCL 1,1 N, dan proses deasetilasi dengan NaOH 50%. Kitosan yang dihasilkan kemudian di cek kualitasnya dengan melakukan uji kelarutan menggunakan CH3COOH 1% dan pengecekan derajat deasetilasi dengan metode titrasi asam basa. Efektifitas dan efisiensi kitosan diuji dengan metode jar test menggunakan sampel air yang berasal dari outlet bak prasedimentasi IPAM Ngagel 2. Aspek yang diuji adalah kekeruhan dan pH dengan variabel berupa dosis koagulan dan kekeruhan air. Dari sisi biaya, yang akan dibandingkan adalah biaya pemakaian koagulan per hari, per jam dan per m3. Penelitian ini membandingkan kemampuan kitosan dengan aluminium sulfat 17% dan 45% untuk menurunkan kekeruhan air dari outlet bak prasedimentasi IPAM Ngagel 2. Hasil penelitian menunjukkan bahwa aluminium sulfat lebih efektif dari kitosan, namun aluminium sulfat tidak lebih efisien dari kitosan. Dari segi biaya, pemakaian aluminium

  15. Clavicle-induced narrowing of the thoracic outlet during shoulder abduction as imaged by computed tomographic angiography and enhanced by three-dimensional reformation.

    Science.gov (United States)

    LaBan, Myron M; Zierenberg, Adam T; Yadavalli, Sailaja; Zaidan, Sultan

    2011-07-01

    This study aimed to confirm the location and degree of compromise of the subclavian vessels within the thoracic outlet during ipsilateral arm abduction in patients with clinical evidence of thoracic outlet syndrome and to identify both the physical and physiologic source of neurovascular compromise that induces the symptoms of thoracic outlet syndrome. After a neuromuscular and vascular examination, all of the subjects underwent a two-part high-resolution computed tomographic angiography with three-dimensional reformation. The initial study was performed with the arm held at the side in an anatomical neutral position. Subsequently, the arm was abducted to 90 degrees with external rotation (ABER). In each position, 60 ml of iodinated nonionic contrast medium was injected in the opposite arm at 4 ml/sec. Three-dimensional volume-rendered images were obtained. Each image was subsequently reviewed by a musculoskeletal radiologist (S. Yadavalli). Patients were initially evaluated in the physiatrist's private office (M.M. LaBan). The computed tomographic scans were obtained from the participants as outpatients in an academic community-based medical center (William Beaumont Hospital). Seventeen outpatients with clinical signs and symptoms of thoracic outlet syndrome were evaluated, including seven men and ten women. This group has an average age of 48 yrs (range, 17-73 yrs). The level of vessel occlusion varied in the costoclavicular space as well as in demonstrating the alterations in the diameter of both the subclavian artery and vein both in the neutral and ABER positions. The possible levels of occlusions included the costoclavicular space, the interscalene triangle, and the retropectoralis minor space. The narrowing of the subclavian vessel was considered significant if the percentage change of the vessel's diameter between the neutral and the ABER positions was 30% or greater for the subclavian artery and 50% or greater for the subclavian vein. The average change in

  16. [Exposure to whole body vibrations in workers moving heavy items by mechanical vehicles in the warehouse of a large retail outlet].

    Science.gov (United States)

    Siciliano, E; Rossi, A; Nori, L

    2007-01-01

    Efficient warehouse management and item transportation is of fundamental importance in the commercial outlet in exam. Whole body vibrations have been measured in various types of machines, some of which not widely studied yet, like the electrical pallet truck. In some tasks (fork lifts drivers) vibrations propagate through the driving seat whereas in some other tasks (electrical pallet trucks, stackers), operated in a standing posture, vibrations propagate through the lower limbs. Results have been provided for a homogeneous job tasks. In particular conditions, the action level of the Italian national (and European) regulations on occupational exposure to WBV may be exceeded. The authors propose a simple system of probabilistic classification of the risk of exposure to whole body vibrations, based on the respective areas of the distribution which lay within the three risk classes.

  17. Gastric outlet obstruction due to adenocarcinoma in a patient with Ataxia-Telangiectasia syndrome: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hammond Sue

    2009-03-01

    Full Text Available Abstract Background Ataxia-Telangiectasia syndrome is characterized by progressive cerebellar dysfunction, conjuctival and cutaneous telangiectasias, severe immune deficiencies, premature aging and predisposition to cancer. Clinical and radiographic evaluation for malignancy in ataxia-telangiectasia patients is usually atypical, leading to delays in diagnosis. Case presentation We report the case of a 20 year old ataxia-telangiectasia patient with gastric adenocarcinoma that presented as complete gastric outlet obstruction. Conclusion A literature search of adenocarcinoma associated with ataxia-telangiectasia revealed 6 cases. All patients presented with non-specific gastrointestinal complaints suggestive of ulcer disease. Although there was no correlation between immunoglobulin levels and development of gastric adenocarcinoma, the presence of chronic gastritis and intestinal metaplasia seem to lead to the development of gastric adenocarcinoma. One should consider adenocarcinoma in any patient with ataxia-telangiectasia who presents with non-specific gastrointestinal complaints, since this can lead to earlier diagnosis.

  18. Risky consumption habits and safety of fluid milk available in retail sales outlets in Viçosa, Minas Gerais State, Brazil.

    Science.gov (United States)

    Pieri, Fabio Alessandro; Colombo, Monique; Merhi, Carolina Milner; Juliati, Vinícius Augusto; Ferreira, Marcello Sebe; Nero, Marcelo Antônio; Nero, Luis Augusto

    2014-06-01

    This study aimed to assess raw milk consumption habits in the urban population of Viçosa, Minas Gerais, Brazil, and the microbiological safety and quality of the fluid milk available in retail sales outlets in the same region. A simplified questionnaire regarding raw milk consumption was applied to the persons responsible for food acquisition in 411 residences. The regular consumption of raw milk was observed by 18.5% of the interviewers, and lack of knowledge of possible risks related to this food product. Microbiological safety and quality were assessed for raw (n=69), pasteurized (n=80), and ultra-high-temperature (UHT)-treated milk (n=80) by analyzing the counts of mesophilic aerobes, coliforms, and Escherichia coli, and detection of Listeria monocytogenes and Salmonella spp.; raw milk samples were also subjected to enumeration of coagulase-positive Staphylococcus. Concerning raw milk, 59.4% of the samples were considered as produced in inadequate hygienic conditions, 5.8% of the samples presented counts of coagulase-positive Staphylococcus lower than 100 colony-forming units (CFU)/mL, and no samples presented with positive results for L. monocytogenes or Salmonella spp. All pasteurized and UHT milk samples presented with low counts of mesophilic aerobes and coliforms, while L. monocytogenes and Salmonella spp. were absent. The data demonstrated that raw milk was consumed by the population studied. Despite the absence of potential hazards, raw milk was of poor hygienic quality, in contrast with the processed fluid milk available in retail sales outlets that was safe and of good hygienic quality, highlighting the suitability of pasteurized and UHT milk for human consumption.

  19. On a two-dimensional mode-matching technique for sound generation and transmission in axial-flow outlet guide vanes

    Science.gov (United States)

    Bouley, Simon; François, Benjamin; Roger, Michel; Posson, Hélène; Moreau, Stéphane

    2017-09-01

    The present work deals with the analytical modeling of two aspects of outlet guide vane aeroacoustics in axial-flow fan and compressor rotor-stator stages. The first addressed mechanism is the downstream transmission of rotor noise through the outlet guide vanes, the second one is the sound generation by the impingement of the rotor wakes on the vanes. The elementary prescribed excitation of the stator is an acoustic wave in the first case and a hydrodynamic gust in the second case. The solution for the response of the stator is derived using the same unified approach in both cases, within the scope of a linearized and compressible inviscid theory. It is provided by a mode-matching technique: modal expressions are written in the various sub-domains upstream and downstream of the stator as well as inside the inter-vane channels, and matched according to the conservation laws of fluid dynamics. This quite simple approach is uniformly valid in the whole range of subsonic Mach numbers and frequencies. It is presented for a two-dimensional rectilinear-cascade of zero-staggered flat-plate vanes and completed by the implementation of a Kutta condition. It is then validated in sound generation and transmission test cases by comparing with a previously reported model based on the Wiener-Hopf technique and with reference numerical simulations. Finally it is used to analyze the tonal rotor-stator interaction noise in a typical low-speed fan architecture. The interest of the mode-matching technique is that it could be easily transposed to a three-dimensional annular cascade in cylindrical coordinates in a future work. This makes it an attractive alternative to the classical strip-theory approach.

  20. Diagnostic value of urodynamic bladder outlet obstruction to select patients for transurethral surgery of the prostate: Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Myong Kim

    Full Text Available To investigate the diagnostic value of urodynamic bladder outlet obstruction (BOO in the selection of patients for transurethral surgery of the prostate.We systematically searched online PubMed, Embase, and Cochrane Library databases from January 1989 to June 2014.A total of 19 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2321 patients with a median number of 92 patients per study (range: 12-437. Of the 19 studies, 15 conducted conventional transurethral prostatectomy (TURP, and 7 used other or multiple modalities. In urodynamic bladder outlet obstruction (BOO positive patients, the pooled mean difference (MD was significant for better improvement of the International Prostate Symptom Score (IPSS (pooled MD, 3.48; 95% confidence interval [CI], 1.72-5.24; p < 0.01; studies, 16; participants, 1726, quality of life score (QoL (pooled MD, 0.56; 95% CI, 0.14-1.02; p = 0.010; studies, 9; participants, 1052, maximal flow rate (Qmax (pooled MD, 3.86; 95% CI, 2.17-5.54; p < 0.01; studies, 17; participants, 1852, and post-void residual volume (PVR (pooled MD, 32.46; 95% CI, 23.34-41.58; p < 0.01; studies, 10; participants, 1219 compared with that in non-BOO patients. Some comparisons showed between-study heterogeneity despite the strict selection criteria of the included studies. However, there was no clear evidence of publication bias in this meta-analysis.Our meta-analysis results showed a significant association between urodynamic BOO and better improvements in all treatment outcome parameters. Preoperative UDS may add insight into postoperative outcomes after surgical treatment of benign prostatic hyperplasia.

  1. Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012-2015.

    Science.gov (United States)

    Nieto-Andrade, Benjamin; Fidel, Eva; Simmons, Rebecca; Sievers, Dana; Fedorova, Anya; Bell, Suzanne; Weidert, Karen; Prata, Ndola

    2017-03-24

    In Angola, many women want to use family planning but lack access to affordable and preferred methods. This article assesses the link between women's choice and availability of contraceptive methods in Luanda, Angola, drawing on data from 3 surveys: a 2012 survey among women ages 15-49 and 2 retail surveys conducted in 2014 and 2015 among outlets and facilities offering contraceptive methods. Descriptive statistics for women's contraceptive knowledge, use, and preferred methods were stratified by age group. We report the percentage of establishments offering different methods and brands of modern contraception, and the mean price, volume of units sold, and value (Angolan Kwanzas) for each brand. Data from the 2 retail surveys are compared to measure changes in availability over time. Results show that 51% of women reported having an unwanted pregnancy. Less than 40% of women knew about long-acting reversible contraceptives (LARCs). Overall, the method most commonly used was male condoms (32.1%), with a substantial proportion (17.3%) of women not using their preferred contraceptive. Trends in contraceptive use mirror availability: in 2015, condoms were available in 73.6% of outlets/facilities, while LARC methods were available in less than 10%. The availability of different methods also dropped significantly between 2014 and 2015-by up to 15 percentage points-with a subsequent price increase in many brands. To meet women's needs for contraception and make informed choice possible, Angola should reinforce demand creation and contraceptive supply in both the public and private sectors through behavior change programs aimed at both women and providers, improved quality of services, training of health personnel on method options and delivery, and improved supply chain distribution of contraceptives. This will allow women to find the methods and brands that best suit their needs, preferences, and ability to pay. © Nieto-Andrade et al.

  2. Association between proximity to and coverage of traditional fast-food restaurants and non-traditional fast-food outlets and fast-food consumption among rural adults

    Directory of Open Access Journals (Sweden)

    Horel Scott A

    2011-05-01

    Full Text Available Abstract Objective The objective of this study is to examine the relationship between residential exposure to fast-food entrées, using two measures of potential spatial access: proximity (distance to the nearest location and coverage (number of different locations, and weekly consumption of fast-food meals. Methods Traditional fast-food restaurants and non-traditional fast-food outlets, such as convenience stores, supermarkets, and grocery stores, from the 2006 Brazos Valley Food Environment Project were linked with individual participants (n = 1409 who completed the nutrition module in the 2006 Brazos Valley Community Health Assessment. Results Increased age, poverty, increased distance to the nearest fast food, and increased number of different traditional fast-food restaurants, non-traditional fast-food outlets, or fast-food opportunities were associated with less frequent weekly consumption of fast-food meals. The interaction of gender and proximity (distance or coverage (number indicated that the association of proximity to or coverage of fast-food locations on fast-food consumption was greater among women and opposite of independent effects. Conclusions Results provide impetus for identifying and understanding the complex relationship between access to all fast-food opportunities, rather than to traditional fast-food restaurants alone, and fast-food consumption. The results indicate the importance of further examining the complex interaction of gender and distance in rural areas and particularly in fast-food consumption. Furthermore, this study emphasizes the need for health promotion and policy efforts to consider all sources of fast-food as part of promoting healthful food choices.

  3. Association between proximity to and coverage of traditional fast-food restaurants and non-traditional fast-food outlets and fast-food consumption among rural adults.

    Science.gov (United States)

    Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R; Horel, Scott A

    2011-05-20

    The objective of this study is to examine the relationship between residential exposure to fast-food entrées, using two measures of potential spatial access: proximity (distance to the nearest location) and coverage (number of different locations), and weekly consumption of fast-food meals. Traditional fast-food restaurants and non-traditional fast-food outlets, such as convenience stores, supermarkets, and grocery stores, from the 2006 Brazos Valley Food Environment Project were linked with individual participants (n = 1409) who completed the nutrition module in the 2006 Brazos Valley Community Health Assessment. Increased age, poverty, increased distance to the nearest fast food, and increased number of different traditional fast-food restaurants, non-traditional fast-food outlets, or fast-food opportunities were associated with less frequent weekly consumption of fast-food meals. The interaction of gender and proximity (distance) or coverage (number) indicated that the association of proximity to or coverage of fast-food locations on fast-food consumption was greater among women and opposite of independent effects. Results provide impetus for identifying and understanding the complex relationship between access to all fast-food opportunities, rather than to traditional fast-food restaurants alone, and fast-food consumption. The results indicate the importance of further examining the complex interaction of gender and distance in rural areas and particularly in fast-food consumption. Furthermore, this study emphasizes the need for health promotion and policy efforts to consider all sources of fast-food as part of promoting healthful food choices.

  4. Advancing cessation research by integrating EMA and geospatial methodologies: associations between tobacco retail outlets and real-time smoking urges during a quit attempt.

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    Watkins, Kellie L; Regan, Seann D; Nguyen, Nga; Businelle, Michael S; Kendzor, Darla E; Lam, Cho; Balis, David; Cuevas, Adolfo G; Cao, Yumei; Reitzel, Lorraine R

    2014-05-01

    Residential tobacco retail outlet (TRO) density and proximity have been associated with smoking behaviors. More research is needed to understand the mechanisms underlying these relations and their potential relevance outside of the residential setting. This study integrates ecological momentary assessment (EMA) and geo-location tracking to explore real-time associations between exposure to TROs and smoking urges among 47 economically disadvantaged smokers in a cessation trial (59.6% female; 36.2% White). EMA data were collected for 1 week postquit via smartphone, which recorded smoking urge strength ≤ 4 random times daily along with real-time participant location data. For each assessment, the participants' proximity to the closest TRO and the density of TROs surrounding the participant were calculated. Linear mixed model regressions examined associations between TRO variables and smoking urges and whether relations varied based on participants' distance from their home. Covariates included sociodemographics, prequit tobacco dependence, treatment group, and daily smoking status. Main effects were nonsignificant; however, the interaction between TRO proximity and distance from home was considered significant (p = .056). Specifically, closer proximity to TROs was associated with stronger smoking urges ≤ 1 mile of home (p = .001) but not >1 mile from home (p = .307). Significant associations were attributable to assessments completed at participants' home addresses. All density analyses were nonsignificant. Technological challenges encountered in this study resulted in a significant amount of missing data, highlighting the preliminary nature of these findings and limiting the inferences that can be drawn. However, results suggest that closer residential proximity to tobacco outlets may trigger stronger urges to smoke among economically disadvantaged smokers trying to quit, perhaps due to enhanced cigarette availability and accessibility. Therefore, limiting

  5. Perbandingan Kemampuan Kitosan dari Limbah Kulit Udang dengan Aluminium Sulfat untuk Menurunkan Kekeruhan Air dari Outlet Bak Prasedimentasi IPAM Ngagel II

    Directory of Open Access Journals (Sweden)

    Cecilia Dwi Triastiningrum

    2017-01-01

    Full Text Available Koagulan yang digunakan IPAM Ngagel II untuk mengolah air baku adalah aluminium sulfat. Penggunaan aluminium sulfat yang tidak sesuai dapat mempengaruhi pH air dan menyebabkan kerugian baik dalam sisi lingkungan maupun kesehatan konsumen. Di lain hal, terdapat pula masalah peningkatan jumlah limbah kulit udang yang berpotensi namun belum dimanfaatkan secara optimal. Dari masalah-masalah tersebut munculah ide untuk mencari alternatif koagulan yang ramah lingkungan, efektif, efisien dan sekaligus dapat memanfaatkan limbah kulit udang. Kitosan yang terdapat di kulit udang dapat dijadikan alternatif karena sifatnya tidak beracun, mudah terdegradasi dan bahan bakunya mudah didapatkan. Kitosan adalah senyawa polimer dengan ion positif yang diperoleh dari proses hidrolisis kitin menggunakan basa kuat sehingga terjadi deasetilasi gugus asetamida (NH-COCH3 menjadi gugus amina (NH2. Kitosan diperoleh dari serbuk kulit udang yang melalui proses deproteinasi dengan NaOH 6%, proses demineralisasi dengan HCl 1,1 N, dan proses deasetilasi dengan NaOH 50%. Kitosan yang dihasilkan kemudian di cek kualitasnya dengan melakukan uji kelarutan menggunakan CH3COOH 1% dan pengecekan derajat deasetilasi dengan metode titrasi asam basa. Efektifitas dan efisiensi kitosan diuji dengan metode jar test menggunakan sampel air yang berasal dari outlet bak prasedimentasi IPAM Ngagel 2. Aspek yang diuji adalah kekeruhan dan pH dengan variabel berupa dosis koagulan dan kekeruhan air. Dari sisi biaya, yang akan dibandingkan adalah biaya pemakaian koagulan per hari dan per jam. Penelitian ini membandingkan kemampuan kitosan dengan aluminium sulfat 45% untuk menurunkan kekeruhan air dari outlet bak prasedimentasi IPAM Ngagel 2. Hasil penelitian menunjukkan bahwa aluminium sulfat 45% lebih efektif dari kitosan, namun kitosan lebih efisien dari aluminium sulfat. Dari segi biaya, pemakaian aluminium sulfat 45% memakan biaya yang jauh lebih sedikit dibandingkan dengan pemakaian kitosan.

  6. Association between proximity to and coverage of traditional fast-food restaurants and non-traditional fast-food outlets and fast-food consumption among rural adults

    Science.gov (United States)

    2011-01-01

    Objective The objective of this study is to examine the relationship between residential exposure to fast-food entrées, using two measures of potential spatial access: proximity (distance to the nearest location) and coverage (number of different locations), and weekly consumption of fast-food meals. Methods Traditional fast-food restaurants and non-traditional fast-food outlets, such as convenience stores, supermarkets, and grocery stores, from the 2006 Brazos Valley Food Environment Project were linked with individual participants (n = 1409) who completed the nutrition module in the 2006 Brazos Valley Community Health Assessment. Results Increased age, poverty, increased distance to the nearest fast food, and increased number of different traditional fast-food restaurants, non-traditional fast-food outlets, or fast-food opportunities were associated with less frequent weekly consumption of fast-food meals. The interaction of gender and proximity (distance) or coverage (number) indicated that the association of proximity to or coverage of fast-food locations on fast-food consumption was greater among women and opposite of independent effects. Conclusions Results provide impetus for identifying and understanding the complex relationship between access to all fast-food opportunities, rather than to traditional fast-food restaurants alone, and fast-food consumption. The results indicate the importance of further examining the complex interaction of gender and distance in rural areas and particularly in fast-food consumption. Furthermore, this study emphasizes the need for health promotion and policy efforts to consider all sources of fast-food as part of promoting healthful food choices. PMID:21599955

  7. Carpal tunnel syndrome assessment with ultrasonography: value of inlet-to-outlet median nerve area ratio in patients versus healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Tengfei Fu

    Full Text Available To evaluate the diagnostic value of the Inlet-to-outlet median nerve area ratio (IOR in patients with clinically and electrophysiologically confirmed carpal tunnel syndrome (CTS.Forty-six wrists in 46 consecutive patients with clinical and electrodiagnostic evidence of CTS and forty-four wrists in 44 healthy volunteers were examined with ultrasonography. The cross-sectional area (CSA of the median nerve was measured at the carpal tunnel inlet (the level of scaphoid-pisiform and outlet (the level of the hook of the hamate, and the IOR was calculated for each wrist. Ultrasonography and electrodiagnostic tests were performed under blinded conditions. Electrodiagnostic testing combined with clinical symptoms were considered to be the gold standard test. Receiver operating characteristic (ROC curves were used to evaluate the diagnostic value between the inlet CSA and IOR.The study population included 16 men and 30 women (mean age, 45.3 years; range, 18-83 years. The control population included 18 men and 26 women (mean age, 50.4 years; range, 18-79 years. The mean inlet CSA was 8.7 mm2 in healthy controls and 14.6mm2 in CTS group (P<0.001. The mean IOR in healthy volunteers (1.0 was smaller than that in patients (1.6, P<0.001. Receiver operating characteristic analysis revealed a diagnostic advantage to using the IOR rather than the inlet CSA (P<0.01. An IOR cutoff value of ≥ 1.3 would yield 93% specificity and 91% sensitivity in the diagnosis of CTS.The IOR of median nerve area promises to be an effective means in the diagnosis of CTS. A large-scale, randomized controlled trial is required to determine how and when this parameter will be used.

  8. Comparing the availability, price, variety and quality of fruits and vegetables across retail outlets and by area-level socio-economic position.

    Science.gov (United States)

    Millichamp, Anna; Gallegos, Danielle

    2013-01-01

    To explore whether area-level socio-economic position or the form of retail stream (conventional v. farmers' market) is associated with differences in the price, availability, variety and quality of a range of fresh fruit and vegetables. A multi-site cross-sectional pilot study of farmers' markets, supermarkets and independent fruit and vegetable retailers. Each was surveyed to assess the price, availability, variety and quality of fifteen fruit and eighteen vegetable items. Retail outlets were located in south-east Queensland. Fifteen retail outlets were surveyed (five of each retail stream). Average basket prices were not significantly different across the socio-economic spectrum, but prices in low socio-economic areas were cheapest. Availability, variety and quality did not differ significantly across levels of socio-economic position; however, the areas with the most socio-economic disadvantage scored poorest for quality and variety. Supermarkets had significantly better fruit and vegetable availability than farmers' markets, although price, variety and quality scores were not different across retail streams. Results demonstrate a trend to fruit and vegetable prices being more expensive at farmers' markets, with the price of the fruit basket being significantly greater at the organic farmers' market compared with the non-organic farmers' markets. Neither area-level socio-economic position nor the form of retail stream was significantly associated with differences in the availability, price, variety and quality of fruit and vegetables, except for availability which was higher in supermarkets than farmers' markets. Further research is needed to determine what role farmers' markets can play in affecting fruit and vegetable intake.

  9. Determining of the Parking Manoeuvre and the Taxi Blockage Adjustment Factor for the Saturation Flow Rate at the Outlet Legs of Signalized Intersections: Case Study from Rasht City (Iran)

    Science.gov (United States)

    Behbahani, Hamid; Jahangir Samet, Mehdi; Najafi Moghaddam Gilani, Vahid; Amini, Amir

    2017-10-01

    The presence of taxi stops within the area of signalized intersections at the outlet legs due to unnatural behaviour of the taxis, sudden change of lanes, parking manoeuvres activities and stopping the vehicle to discharge or pick up the passengers have led to reduction of saturation flow rate at the outlet leg of signalized intersections and increased delay as well as affecting the performance of a crossing lane. So far, in term of evaluating effective adjustment factors on saturation flow rate at the inlet legs of the signalized intersections, various studies have been carried out, however; there has not been any studies on effective adjustment factors on saturation flow rate at the inlet legs. Hence, the evaluating of the traffic effects of unique behaviours on the saturation flow rate of the outlet leg is very important. In this research the parking manoeuvre time and taxi blockage time were evaluated and analyzed based on the available lane width as well as determining the effective adjustment factors on the saturation flow rate using recording related data at four signalized intersections in Rasht city. The results show that the average parking manoeuvre time is a function of the lane width and is increased as the lane width is reduced. Also, it is suggested to use the values of 7.37 and 11.31 seconds, respectively for the average parking manoeuvre time and the average blockage time of taxies at the outlet legs of signalized intersections for the traffic designing in Rasht city.

  10. Availability and quality of anti-malarials among private sector outlets in Myanmar in 2012: results from a large, community-based, cross-sectional survey before a large-scale intervention.

    Science.gov (United States)

    Khin, Hnin Su Su; Chen, Ingrid; White, Chris; Sudhinaraset, May; McFarland, Willi; Littrell, Megan; Montagu, Dominic; Aung, Tin

    2015-07-14

    Global malaria control efforts are threatened by the spread and emergence of artemisinin-resistant Plasmodium falciparum parasites. In 2012, the widespread sale of partial courses of artemisinin-based monotherapy was suspected to take place in the highly accessed, weakly regulated private sector in Myanmar, posing potentially major threats to drug resistance. This study investigated the presence of artemisinin-based monotherapies in the Myanmar private sector, particularly as partial courses of therapy, to inform the targeting of future interventions to stop artemisinin resistance. A large cross-sectional survey comprised of a screening questionnaire was conducted across 26 townships in Myanmar between March and May, 2012. For outlets that stocked anti-malarials at the time of survey, a stock audit was conducted, and for outlets that stocked anti-malarials within 3 months of the survey, a provider survey was conducted. A total of 3,658 outlets were screened, 83% were retailers (pharmacies, itinerant drug vendors and general retailers) and 17% were healthcare providers (private facilities and health workers). Of the 3,658 outlets screened, 1,359 outlets (32%) stocked at least one anti-malarial at the time of study. Oral artemisinin-based monotherapy comprised of 33% of self-reported anti-malarials dispensing volumes found. The vast majority of artemisinin-based monotherapy was sold by retailers, where 63% confirmed that they sold partial courses of therapy by cutting blister packets. Very few retailers (5%) had malaria rapid diagnostic tests available, and quality-assured artemisinin-based combination therapy was virtually nonexistent among retailers. Informal private pharmacies, itinerant drug vendors and general retailers should be targeted for interventions to improve malaria treatment practices in Myanmar, particularly those that threaten the emergence and spread of artemisinin resistance.

  11. The impact of interventions to promote healthier ready-to-eat meals (to eat in, to take away or to be delivered) sold by specific food outlets open to the general public: a systematic review.

    Science.gov (United States)

    Hillier-Brown, F C; Summerbell, C D; Moore, H J; Routen, A; Lake, A A; Adams, J; White, M; Araujo-Soares, V; Abraham, C; Adamson, A J; Brown, T J

    2017-02-01

    Ready-to-eat meals sold by food outlets that are accessible to the general public are an important target for public health intervention. We conducted a systematic review to assess the impact of such interventions. Studies of any design and duration that included any consumer-level or food-outlet-level before-and-after data were included. Thirty studies describing 34 interventions were categorized by type and coded against the Nuffield intervention ladder: restrict choice = trans fat law (n = 1), changing pre-packed children's meal content (n = 1) and food outlet award schemes (n = 2); guide choice = price increases for unhealthier choices (n = 1), incentive (contingent reward) (n = 1) and price decreases for healthier choices (n = 2); enable choice = signposting (highlighting healthier/unhealthier options) (n = 10) and telemarketing (offering support for the provision of healthier options to businesses via telephone) (n = 2); and provide information = calorie labelling law (n = 12), voluntary nutrient labelling (n = 1) and personalized receipts (n = 1). Most interventions were aimed at adults in US fast food chains and assessed customer-level outcomes. More 'intrusive' interventions that restricted or guided choice generally showed a positive impact on food-outlet-level and customer-level outcomes. However, interventions that simply provided information or enabled choice had a negligible impact. Interventions to promote healthier ready-to-eat meals sold by food outlets should restrict choice or guide choice through incentives/disincentives. Public health policies and practice that simply involve providing information are unlikely to be effective. © 2016 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  12. Association between junk food consumption and fast-food outlet access near school among Quebec secondary-school children: findings from the Quebec Health Survey of High School Students (QHSHSS) 2010-11.

    Science.gov (United States)

    Cutumisu, Nicoleta; Traoré, Issouf; Paquette, Marie-Claude; Cazale, Linda; Camirand, Hélène; Lalonde, Benoit; Robitaille, Eric

    2017-04-01

    We investigated the association between junk food consumption at lunchtime (JCL) and fast-food outlet access near school among secondary-school children in Quebec. A geographic information system database was used to characterize the food environment around a sub-sample of 374 public schools in which 26 655 students were enrolled. The outcome variable was JCL during the previous week, dichotomized into low JCL (none or once) v. high JCL (twice or more). Access to fast-food outlets near school was assessed using an existing database of fast-food outlets in Quebec. Covariates included student (age, sex and self-rated perceived health), family (familial status and parental education) and school (urban/rural status and deprivation) variables. Hierarchical logistic regression models were employed for analyses using PROC GLIMMIX of SAS version 9.3. Province of Quebec, Canada. We used data from the Quebec Health Survey of High School Students (QHSHSS) 2010-11, a survey of secondary-school Quebec students. Exposure to two or more fast-food outlets within a radius of 750 m around schools was associated with a higher likelihood of excess JCL (OR=1·50; 95 % CI 1·28, 1·75), controlling for the characteristics of the students, their families and their schools. The food environment surrounding schools can constitute a target for interventions to improve food choices among secondary-school children living in the province of Quebec. Transforming environments around schools to promote healthy eating includes modifying zoning regulations that restrict access to fast-food outlets around schools.

  13. Towards a comprehensive geophysical coverage of a test Glacier; example from various surveys during field campaigns over the Astrolabe outlet Glacier, East Antarctica

    Science.gov (United States)

    Le Meur, E.; Berthier, E.; Blankenship, D.; Drouet, A.; Durand, G.; de Fleurian, B.; Gagliardini, O.; Garambois, S.; Gim, Y.; Holt, J. W.; Kirchner, D. L.; Legresy, B.; Mouginot, J.; Safaeinili, A.; Siegert, M. J.; Rignot, E.; Young, D.

    2009-12-01

    We discuss various field observations that have been (and will still be) carried out during the last two field seasons over a test glacier in East Antarctica under the framework of the DACOTA program (supported by both the French Agence Nationale de la Recherche, and the French Polar Institute). We will use various techniques so as to provide a better characterization of the dynamics of an outlet glacier as well as the required data sets for running and constraining an ice flow model. These outlet glaciers play a crucial role by draining ice situated inland, thereby controlling the overall mass balance of large parts of the ice sheet. As a small, simple, and accessible glacier, Astrolabe Glacier is an ideal test case. Data of the kinds being collected provide a reference against which later measurements will be compared to infer significant trends (velocity and thickness changes). As an example, surface elevation has been measured at various places on the glacier. The order of magnitude of thickness changes expected compared to the measurement techniques accuracy should allow for significant trends after a couple of years. A permanent deformation rate network consisting of autonomous GPS stations has been started last year and should be completed next winter. By being located close to the grounding line, the deformation rate network will yield constraining data for the model by providing the surface velocity changes induced by the mobility of the grounding line. With regard to modelling input data, bedrock topography represents the most important data set but also the most difficult to access. Radar techniques have been used with first a ground-based penetrating radar later completed by two larger scale airborne surveys allowing for full coverage of the entire drainage basin (8000 km2). This airborne campaign has been possible under the frame of a collaboration between the University of Texas (60 MHz airborne radar), the Jet Propulsion Laboratory (2.5 MHz airborne

  14. Histopathological changes induced in an animal model by potentially pathogenic Enterococcus faecalis strains recovered from ready-to-eat food outlets in Osun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Olawale AK

    2015-06-01

    Full Text Available Adetunji Kola Olawale,1,2 Oluwole Moses David,2,3 Adekemi Olubukunola Oluyege,2 Richard Temitope Osuntoyinbo,4 Solomon Anjuwon Laleye,5 Oladiran Famurewa,21Department of Applied Sciences, Osun State Polytechnic, Iree, 2Department of Microbiology, University of Ado-Ekiti, Ado-Ekiti, Nigeria; 3Phytomedicine Research Centre, Department of Botany, University of Fort Hare, Alice, South Africa; 4Department of Microbiology, Waterford Regional Hospital, Waterford, Republic of Ireland; 5Department of Microbiology, Adekunle Ajasin University, Akungba-Akoko, NigeriaAbstract: Enterococci have been implicated as an emerging important cause of several diseases and multiple antibiotic resistance. However, there is little informati