One-half Hour Research Articles

Prediction Of Seizures In Patients With Temporal Lobe Epilepsy, More Than 30 Minutes Before Onset.

Dear Madam, Around 52.5 million people worldwide suffer from the neurological illness known as epilepsy, which is frequently characterized by recurring seizures. (1, 2) As epilepsy is a chronic disorder that can lead to cognitive deficits, sadness, and anxiety in sufferers, it has a considerable negative impact on individuals and society. The most common type of seizures, affecting around 61% of persons with epilepsy, are focal seizures, which raise the risk of injury and early death (2). One of the most common forms of focal epilepsy, temporal lobe epilepsy (TLE), is characterized by recurring spontaneous seizures that begin in the temporal lobe. (s). (3) In the last two decades, many new antiseizure medications (ASMs)have been developed; however, about 40% of people with epilepsy may be drug-resistant, meaning ASMs are unable to control their seizures; therefore, despite the advent of new treatments, a high unmet need remains unaddressed. (2) Surgery is an alternate treatment, however, it cannot be used if larger areas of the brain are affected, in such cases, neuromodulation is a novel and successful therapeutic tool developed. (4) Conventionally, neural activity in epilepsy is categorized into interictal, and post-ictal states. With the help of continuous EEG, researchers have subdivided interictal state into a pre-ictal and pro-ictal state in temporal lobe epilepsy patients (which is the typical drug-resistant focal epilepsy targeted for interventions such as neuromodulation). The pre-ictal states indicate imminent seizure onset, while pro-ictal states reflect changes in neural activity that create a propensity for seizures over longer periods. The EEG-based pro-ictal state detection is critical to adaptive neuromodulation, with early detection of seizure allowing electrodes to be applied therapeutically to the brain's seizure onset zone and thalamus enabling treatment to be modified as per seizure risk. (5) A prospective cohort study was conducted on adults with drug-resistant temporal lobe epilepsy at UTHealth Houston, in which pro-ictal state – i.e., pathologic brain activities during periods of heightened seizure risk could be detected up to one-half hour prior to seizure onset. A classifier was developed that could reasonably accurately distinguish between physiological and pathologic brain states in temporal lobe epilepsy. Thalamocortical dynamics were used to identify pro-ictal states in each patient. As the limbic thalamus exerts a diverse influence on cortex activity, thalamocortical EEG was used for pro-ictal state detection as opposed to previous paradigms derived solely from cortical structures. ---Continue

Analysis of mechanical and anatomical properties of two bamboo species – Thyrostachys siamensis Gamble and Dendrocalamus strictus (Roxb.) Nees (Poaceae)

Bamboos are treated to boost their shelf life from the degrading activity of fungal microbes and other insects and to increase their longevity in use and durability by using various chemicals. The present study is vis-a-vis the standardization of two bamboo species Dendrocalamus strictus and Thyrostachys siamensis for a comparative analysis of the mechanical and anatomical properties of samples treated with CCB (Copper Chrome Boron), and BBA (Borax Boric Acid) as well as untreated samples.Samples were tested for both bending and compression; and the parameters such as MOE (Modulus of Elasticity), MOI (Moment of Inertia), Maximum compressive strength, and ultimate strength were analyzed. The anatomical variations arising in the top and bottom sections were also investigated and it has found that the mechanical properties of the species treated with CCB solutions yield a better result in maximum compressive strength and high value of MOI as compared to BBA whereas the samples treated with BBA provides superior performance with respect to MOE. Anatomical examination revealed that the cellular structure and arrangement of vascular bundles are responsible for the increase in time taken for the rate of penetration of chemicals in D.strictus i.e one-half hour as compared to T.siamensis which got treated in 20 minutes. In D.strictus the density of vascular bundles is high so it takes time to get it treated completely as compared to T. siamensis.

Preface

Proceedings of the joint 13th and 14th International Conferences on Polarized Neutrons for Condensed-Matter Investigations The international Conference on Polarized Neutrons for Condensed-Matter Investigations (PNCMI) started its long journey in Dubna, Russia in 1996 and has taken place biennially since then. The present volume of proceedings represents the 13th and 14th editions of this series. The 13th PNCMI was originally suggested by the International Advisory Committee (IAC) of PNCMI to be held in Maryland, USA in 2020, and was postponed due to the fast-spreading COVID-19 pandemic. The IAC later suggested, due to the still evolving pandemic, to replace PNCMI 2020 with a virtual PNCMI in 2021 and an in-person PNCMI in 2022.The 13th PNCMI, organized by National Institute of Standards and Technology (NIST), was held online from July 27-30, 2021. One of the main objectives was to keep up the frequency of PNCMI conferences for the community, staying up to date on emerging topics using polarized neutrons and on related instrumentation development. 110 participants from 40 institutions and 15 countries crossing Europe, Asia, Australia, and North America attended the virtual conference. The conference was limited to invited speaker and poster sessions since it was run two- and one-half hours daily to accommodate different time zones for the international attendees.The 14th PNCMI was held in-person from July 25-29, 2022 in Annapolis, Maryland, USA and jointly organized by the University of Maryland and NIST. The number of conference participants was affected by international travel restrictions due to the pandemic. The conference attendees included 62 participants from 30 institutions and 10 countries crossing Europe, Asia, and North America. The scientific program featured a Keynote lunch presentation, titled “Polarization can be good”, given by Dr. Charles Majkrzak (NCNR), invited, and contributed oral talks, and poster presentations.The PNCMI conference covers the latest condensed-matter investigations using polarized neutrons and state-of-the-art methodologies and techniques of polarized-neutron production and utilization for novel instrumentation and experiments. The 13th and 14th editions covered the following traditional topics: multiferroics and chirality, strongly correlated electron systems, frustrated and disordered systems, magnetic nanomaterials, thin films and multilayers, imaging, polarized neutron instrumentation and polarized neutron techniques and methods. Quantum materials as an emerging topic was included in the 13th PNCMI as well. A new session, -- polarized quasi-elastic neutron scattering (QENS) driven by recently growing interest and benefitting from modernized polarized neutron spectroscopies, was also included for the first time in the 14th PNCMI.A two-day Polarized Neutron School, for 12 graduate students and young postdoctoral researchers familiar with scattering techniques, was held at the NIST Center for Neutron Research (NCNR) preceding the 2022 in-person conference.We would like to take this opportunity again to thank all participants for their attendance, and the International Advisory Committee for guidance in developing an excellent scientific program. We’d like to extend a special thank you to the University of Maryland and the NIST conference services for all their hard work and planning to help organize and ensure it ran smoothly. The 14th PNCMI was made possible with the generous support of Cryogenic Limited, HTS-110, Mirrotron, ORNL, and SwissNeutronics.List of International Advisory Committee, Local Organizing Committee are available in this Pdf.

Predation of the Federally Endangered Roanoke Logperch (Percina rex) by the Invasive Ozark Crayfish (Faxonius ozarkae)

An observed predation of a federally endangered Percina rex (Roanoke Logperch), by an invasive Faxonius ozarkae (Ozark Crayfish), is detailed herein. We observed the predation on 11 August 2021 in the Roanoke River near downtown Roanoke, Roanoke County, VA. The crayfish had recently captured a sub-adult Roanoke Logperch and was dragging it under a cluster of cobbles. Upon observing this behavior, we retrieved the fish, positively identified it, and confirmed it as dead. The initial state of the Roanoke Logperch was nearly undamaged apart from indentations from the crayfish's chelae behind the operculum and near the caudal peduncle. Coloration of the Roanoke Logperch at time of observation indicated the fish had likely recently been captured. A camera was not readily available, so we returned the fish to the cobble cluster until a photograph could be captured. Upon returning approximately one-half hour later, coloration of the fish had begun to fade, and the ventral portion of the fish was partially consumed by the crayfish. Herein we discuss the significance of this observation and the gravity of the continued expansion for this invasive crayfish species, both within the confines of Virginia's waters as well as throughout the eastern United States.

Cemented Paste Backfill Hydraulic Conductivity Evolution from 30 Minutes to 1 Week

AbstractThe first one to four days constitutes a critical period in filling mining voids with cemented paste backfill (CPB, a mixture of mine tailings, binder, and water) and determining the saturated hydraulic conductivity (ksat) during this period is important to rational engineering design. However, most published studies started testing 24 h after specimen preparation, and those that started earlier did so by preconsolidating the specimens, which results in void ratios lower than those occurring in the field. This study uses a new test method that retains the backfill’s representative bulk properties and starts testing about one-half hour after specimen preparation. During backfilling, CPB undergoes three distinct ksat stages: a relatively constant high-value ksat stage associated with the portland cement’s (PC’s) dissolution phase; a rapidly declining ksat stage associated with PC’s acceleration phase; and then a slowly declining ksat stage associated with PC’s steady-stage and subsequent deceleration phase. The last two stages can be represented by modified Kozeny-Carman equations, in which the hydration effects are constant but different in each stage, and the ksat changes can be related to void ratio changes in each stage. In contrast, the distinct stages are not adequately represented by traditional PC “maturity” models, and, more importantly, the ksat values determined here are at least an order of magnitude higher than previously published results on similar materials.

Disruption of the Body Temperature Circadian Rhythm in Hospitalized Patients

BackgroundDysregulation of the circadian rhythm is linked to immune response deficiencies. Diurnal temperature variation—a surrogate for the circadian rhythm, exists in humans, yet its preservation during illness is not well understood. Materials and MethodsTemperatures measured within one-half hour of 8 am, 12 pm, 4 pm, 8 pm, 12 am, and 4 am from 16,245 hospitalized patients were statistically analyzed. ResultsAlthough we found a diurnal pattern when analyzing the ensemble of temperatures from all patients, stratified by measurement site, the trough-to-peak difference was only 0.2°F, while that for healthy volunteers had been in the 0.5°F to 1.9°F range. The peaks occurred at 8 pm for all patients, regardless of age or sex, which is similar to healthy people. However, the troughs were shifted to later times compared with the 6 am in healthy people–for young patients (age 20-30 years) the trough was at 8 am and for elderly patients (age 70-80 years), at 12 pm, again regardless of patients’ sex. Analysis of individual patients showed that less than 20% of patients exhibited diurnal variation and among those showing variation, the trend was present only on the minority of hospitalization days. The presence or absence of an infectious process or fever did not influence the proportion of patients showing diurnal variation. ConclusionsHospitalization is associated with disruption in the circadian rhythm as reflected by patients’ body temperature. Since abnormality in body temperature is known to affect patient outcomes, an understanding of the diurnal cycle during hospitalization is the first step towards devising approaches to re-establish the circadian rhythm.

Covid-19 Mapping with Microsoft Power BI

The purpose of the map and dashboard is twofold. First, Microsoft’s Power BI software presents a reasonably easy means by which many can make reasonably robust data visualizations with minimal expertise in mapping and programming languages. Unlike some competing data visualization and online mapping software packages that require specialized software or skills, ordinary citizens and students, new to data collection and management can create an appealing dashboard-style presentation within a few minutes with minimal guidance. Familiarity with the function and logic of spreadsheet software seems to be the only prerequisite. Many businesses, colleges, and universities already provide access to the Microsoft Office suite of software, further extending the appeal of using Power BI. The COVID-19 dashboard featuring case data by date, city, county, and / or neighborhood in Southern California was created in less than one-half hour using a connection to publicly available data shared by the Los Angeles Times via GitHub. The map allows visitors to select individual communities from a map, which prompts dynamically linked graphs and tables to display data for only that community. The second purpose of this dashboard is to allow users to rapidly analyze local data trends, perhaps following school openings / closings, changes in the status of businesses, or social protests movements. Epidemiologists have expressed concern over the effects of the protest marches and untimely changes in rules regarding businesses and schools on COVID-19 rates. Compounding the need for such a map are concerns about differential COVID-19 infection rates in communities of color, whose citizens were already at an elevated risk of death from COVID-19. This map and dashboard demonstrates that these concerns were not unfounded.

Impact of the take ACTION Train-the-Trainer model of opioid overdose education with naloxone distribution– who benefits?

Background Overdose education with naloxone distribution (OEND) is a key national strategy to reduce morbidity and mortality related to opioid overdoses. Train-the-trainer model has been one method to increase the pool of trainers to facilitate greater dissemination of OEND. This exploratory study seeks to (1) evaluate participant’s change in knowledge and confidence, (2) examine if pre- and post-training test outcomes differed by occupation and level of experience, and (3) determine if train-the-trainer participants trained others 6 months later. Methods: Fifteen train-the-trainer sessions were delivered to staff from community organizations who served high-risk clients in four counties whose overdose death rates ranged from 11.2 to 32.8 per 100,000. Participants were administered pre- and post-training tests from September 2017 to December 2018. A follow-up survey was conducted 6 months post-training to evaluate outcomes. Final paired pre-and post-training surveys of 109 participants were used for analysis. Paired sample t-tests were used to evaluate changes in the knowledge and confidence in teaching others. One-way ANOVA compared the change scores across groups with different demographic or experiential characteristics. Kruskal-Wallis Test was used for Likert scales. Results: The one and one-half hour train-the-trainer curriculum increased participants’ knowledge and confidence to teach others (p < .001). This was particularly true for participants who had no prior experience compared to those who had some experience with naloxone (p = .0003). Changes in confidence to teach others significantly improved among demographic subgroups of participants. At 6 months after completing the train-the-trainer curriculum, 14 participants had trained 243 new trainees. Conclusions: Implementing a train-the-trainer model for OEND increases knowledge and participants’ confidence to teach others. This demonstrates the important potential of the train-the-trainer model to respond to the growing opioid overdose epidemic.

Combinational frequencies of HF doppler radar signals in the PC1 geomagnetic pulsation range

Urgency. The urgency of this work is determined by the necessity of studying MHD waves originating from various sources within the Earth–atmosphere–ionosphere– magnetosphere system and arriving at ionospheric heights. The object of research. A matter of this study is ionospheric disturbances that accompanied geomagnetic pulsations during the dawn terminator on 23–24 March 2010. Purpose of Work. The present work was aimed at revealing short-period ionospheric disturbances in the Pc1 micropulsation frequency range (1–5-Hz) and at investigating their spectral content. Techniques and Methotology. The dynamic spectra of the variations under study were obtained with the HF Doppler radar. Results. The ionospheric disturbances have been shown to arise mainly at combinational frequencies. The durations of such disturbances have been estimated to be of the order of one minute, and the disturbance frequencies 0.7 Hz, 1.5 Hz, and 2.5 Hz. The quasi-periodic interference in the 1–5-Hz frequency band has been detected to persist for over one-half hour to a few hours. Based on the model of the signal modulated by ULF waves in the ionosphere, the appearance of constructive interference at combinational frequencies has been validated. The intercomparisons of the variations obtained using the spectrograms and the known models for the phase-modulated signals have been made. A model for the amplitude- and phase-modulated signal reflected from the ionosphere has been developed, and the signal basic parameters have been determined. Conclusions. The HF Doppler sounding can be a means for studying ionospheric disturbances in the Pc1 geomagnetic pulsation range. During the study of time variations of the Doppler frequency shift during the spring equinox, the following results were found. The period of ionospheric perturbations reached 0.2–1 s, their duration varied from 1 min to more than 10 min. A noticeable increase in the amplitude of the beat is detected, which may be a sign of the appearance of lateral maxima in the Doppler spectra. The presence of oscillations in the frequency range of the first harmonic of the spectral resonance system of the ionospheric Alfvén resonator is established. Long-term ionospheric perturbations have a linearly increasing frequency of filling the wave packet. The rate of frequency change is close to 10–3 Hz/s.

Effectiveness of Group Therapy Based on Transactional Analysis (TA) in Marital Burnout and Forbearance of Female Students

This research is a semi-experimental study (pretest-posttest design with unequal control group). This study aimed to investigate the effectiveness of the group therapy based on transactional analysis in marital burnout and forbearance of married female students. The research on statistical population comprised all married female students studying in humanities subjects in Neishabour Islamic Azad University in the academic year 2015-16. The sample included 24 of these students, who were selected voluntarily and through Random sampling method and were randomly assigned into two experimental and control groups. Measurement tools consisted of Couple Burnout Measure (CBM) and Evans marital forbearance questionnaire. The experimental group received 10 one-half hour sessions of the treatment based on the transactional analysis whereas in the meantime, the control group received nutritional trainings. The results indicated that the therapy based on the transactional analysis had been effective in reducing marital burnout and increasing the forbearance of couples.

Ginger for Prevention of Antituberculosis-induced Gastrointestinal Adverse Reactions Including Hepatotoxicity: A Randomized Pilot Clinical Trial.

In this study, the potential benefits of ginger in preventing antituberculosis drug-induced gastrointestinal adverse reactions including hepatotoxicity have been evaluated in patients with tuberculosis. Patients in the ginger and placebo groups (30 patients in each group) received either 500 mg ginger (Zintoma)(®) or placebo one-half hour before each daily dose of antituberculosis drugs for 4 weeks. Patients' gastrointestinal complaints (nausea, vomiting, dyspepsia, and abdominal pain) and antituberculosis drug-induced hepatotoxicity were recorded during the study period. In this cohort, nausea was the most common antituberculosis drug-induced gastrointestinal adverse reactions. Forty eight (80%) patients experienced nausea. Nausea was more common in the placebo than the ginger group [27 (90%) vs 21 (70%), respectively, p = 0.05]. During the study period, 16 (26.7%) patients experienced antituberculosis drug-induced hepatotoxicity. Patients in the ginger group experienced less, but not statistically significant, antituberculosis drug-induced hepatotoxicity than the placebo group (16.7% vs 36.7%, respectively, p = 0.07). In conclusion, ginger may be a potential option for prevention of antituberculosis drug-induced gastrointestinal adverse reactions including hepatotoxicity. Copyright © 2016 John Wiley & Sons, Ltd.

Increasing our Understanding of Women’s Sexuality

I have been reading and writing about sexuality in later life for the past 15 years (Wade and DeLamater, 2002: DeLamater and Koepsel 2015). A growing number of papers reporting results from large-scale surveys in the U. S. have appeared since 1999 (AARP 1999; Lindau, et al. 2007; Herbenick, et al. 2010). These papers systematically report results by gender (binary), sometimes highlighting similarities, sometimes differences. Such reports often leave me wondering Bwhat do these results mean?^ What are the psychological, emotional, and relationship realities that underlie, for example, the difference in sexual satisfaction reported by married men and women? If similar questions interest you, read this book. Montemurro addresses a basic question about female sexuality: how dowomen develop a sense of sexual subjectivity, a sense of Bpossessing agency in sexual interactions,^ Bbeing a willing and eager participant in sexual encounters,^ and Bfeeling in control of sexual decision making^ (p. 4). This question has been addressed by several researchers in studies of adolescent women, including Martin (1996), Tolman (2002), and Schalet (2011); Montemurro expands the focus to adult women ages 20 to 68. She posits that this development occurs over time, perhaps a lifetime; hence the subtitle Bsexual evolution.^ She understands that whether a woman has a sense of her subjectivity can be influenced by a variety of events and transitions that may occur in women’s lives – the circumstances surrounding virginity loss, sexual assault, marriage, pregnancy and childbirth, divorce, menopause, extra dyadic relationships. She adopts the life-course perspective to provide a framework that encompasses this diversity, specifically the Gendered Sexuality over the Life Course (GSLC) model (Carpenter and DeLamater 2012). To study the impact of these transitions across the life course, Montemurro purposively sampled an equal number of women from the northeastern U.S. in their 20s, 30s, 40s, 50s, and 60s. She began recruiting by asking women she knew to recommend women of appropriate age; interviewees were asked to recommend other women. She also recruited by posting notices in a variety of settings. She focused on heterosexual women. Participants were diverse in race/ethnicity, self-reported SES, education, and marital and parental status. An Appendix provides detailed information on each of the 95 participants. In-depth face-to-face interviews, averaging one and one-half hours, were conducted with each one. An important, original contribution of the book is the sixstage model of the development of sexual subjectivity that Montemurro presents. The model is based on her careful analysis of the life experiences reported by participants. The stages are:

Observed and Modeled Currents from the Tohoku-oki, Japan and other Recent Tsunamis in Northern California

We investigate the currents produced by recent tsunamis in Humboldt Bay and Crescent City, California. The region is susceptible to both near-field and far-field tsunamis and has a historic record of damaging events. Crescent City Harbor, located approximately 100 kms north of Humboldt Bay, suffered US $28 million in damages from strong currents produced by the 2006 Kuril Islands tsunami and an additional US $26 million from the 2011 Japan tsunami. In order to better evaluate these currents in northern California, we deployed a Nortek Aquadopp 600 kHz 2D acoustic Doppler current profiler (ADCP) with a 1-min sampling interval in Humboldt Bay, near the existing National Oceanic and Atmospheric Administration (NOAA) National Ocean Service (NOS) tide gauge station. The instrument recorded the tsunamis produced by the Mw 8.8 Chile earthquake on February 27, 2010 and the Mw 9.0 Japan earthquake on March 11, 2011. One other tsunami was recorded on the Humboldt Bay tide gauge during the period of ADCP operation, but was not visible on the ADCP, suggesting a threshold water level value of about 0.2 m to produce an observable ADCP record. The 2010 tsunami currents persisted in Humboldt Bay for approximately 30 h with peak amplitudes of about 0.35 m/s. The 2011 tsunami signal lasted for over 40 h with peak amplitude of 0.84 m/s. The strongest currents corresponded to the maximum change in water level approximately 67 min after the initial wave arrival. No damage was observed in Humboldt Bay for either event. In Crescent City, currents for the first three and one-half hours of the 2011 Japan tsunami were estimated using security camera video footage from the Harbor Master, approximately 70 m away from the NOAA–NOS tide gauge station. The largest amplitude tide gauge water-level oscillations and most of the damage occurred within this time window. The currents reached a velocity of approximately 4.5 m/s and six cycles exceeded 3 m/s during this period. Measured current velocities both in Humboldt Bay and in Crescent City were compared to calculated velocities from the Method of Splitting Tsunamis (MOST) numerical model. The frequency and pattern of current amplification and decay at both locations are replicated by the MOST model for the first several hours after the tsunami onset. MOST generally underestimates 2011 peak current velocities by about 10–30 %, with a few peaks by as much as 50 %. At Humboldt Bay, MOST predicted attenuation of the signal after 4 h but the actual signal persisted at a nearly constant level for at least twice as long. The results from this project demonstrate that ADCPs can effectively record tsunami currents for small to moderate events and can be used to calibrate and validate models (i.e., MOST) in order to better understand hazardous tsunami conditions within harbors.

Scale-Inhibitor Consumption in Long-Term Static Barium Sulfate Inhibition Efficiency Tests

Summary In typical bulk barite inhibition-efficiency (IE) experiments testing scale inhibitors (SIs), the IE is determined by comparing the concentrations of the barium ion in the mix to that in an uninhibited "blank" solution. That is, [Ba2+] vs. time is monitored for both a blank and an inhibited solution. The fate of the SI itself over this test time period is rarely monitored, although this can give some important insights into the inhibition mechanism. This paper presents a series of long-term (up to 96 hours) barium sulfate static IE experiments in which both the supernatant SI concentration, [SI], and [Ba2+] are assayed at multiple sampling times after initial mixing of seawater (SW) and formation-water (FW) brines. In standard IE tests to determine SI minimum inhibitor concentration (MIC), sampling is normally carried out at 2 hours and 22 hours only. The long-term IE experiments described in this paper involve up to eleven sampling times, typically at t = 0.5, 1, 2, 3, 4, 5, 6, 22, 48, 72, and 96 hours after mixing. The aim of this type of experiment is to determine the fate of the SI over time and to determine whether the IE and percentage of SI (%SI) in solution vs. time profiles correlate with each other. Clearly, SI removed from solution is consumed into the forming barium sulfate lattice in the barite precipitate. IE and solution SI often continue to decline beyond 22 hours, up to 96 hours after the mixing stage. In these experiments, the SI concentration is set at a pre-2-hour MIC threshold concentration, such that the IE and %SI consumption profiles will both decline sufficiently over time, possibly even as early as one-half hour after mixing. The SI consumption profiles obtained by testing an extensive range of phosphonate and polymeric SIs are compared and discussed. Normally, a phosphorus-containing SI is selected for evaluation to facilitate assay of SI by means of inductively coupled plasma (ICP) spectroscopy. However, some novel results are also presented in which selected polymeric SIs were assayed by non-ICP analytical techniques. We interpret this extensive series of SI lattice-consumption experiments in terms of the mechanisms of barite inhibition and Type 1/Type 2 SI classifications presented in previous papers (Shaw et al. 2012a, b). The relevance and practical application of these findings are also discussed.

Severe Acute Illness in a Toddler Exposed to Multiple Agricultural Pesticides and an Insect Repellent

ABSTRACT Acute severe pesticide-related illness among farm worker children is rarely reported. The authors report a toddler with acute onset of apnea, cyanosis, somnolence, hypotonia, tachycardia, and miosis who required hospitalization. Health care providers suspected pesticide poisoning, but were unable to determine the causal agent. Investigation by a public health program documented four pesticide exposures that occurred within one-half hour of acute illness. This case illustrates the importance of a thorough environmental/occupational exposure history and obtaining biological samples. It also documents the need to strengthen the Worker Protection Standard for agricultural workers and the importance of reporting and investigating pesticide-related illness.

Virtual Health Assessment: An Impossible Task?

How does one TEACH A HANDS-ON SKILL SET LIKE HEALTH ASSESSMENT WITHOUT HAVING THE OPPORTUNITY TO PUT HANDS ON? That was the question I asked myself when I was invited to teach health assessment as an online/virtual course for RN-BSN students. This was not a new course, but, for the first time, students were not required to visit the campus to take part in laboratory sessions. I was eager for the challenge. My success can be attributed to a number of factors, most notably the support I received from the university. Class size was limited to 24 in contrast to the 50 or more students in face-to-face classes. The university provides introduction/orientation classes for faculty as well as technological support via a Help Desk. The computer platform system we used to provide structure for the management of course content and communication, Angel[R] (now part of Blackboard), also provides online tutorials and technical support. As I put together Health Assessment: Basis for Professional Practice, I made use of Zsohar and Smith's (2008) guidelines for success in the virtual classroom. They recommend actively involving students in the course; keeping requirements in sync with the course credits; clear deadlines for assignments, quizzes/exams, and discussion postings; and using instructional rubrics for grading each component of the course for which students receive credit. All of these suggestions proved valuable. Most important, Zsohar and Smith stress that material must be thoughtfully presented with a clear progression. The content should be diverse, with lectures, readings, and interactive assignments that engage students in their own learning (Short, 2000). In addition, students demand control over the conditions of learning (Jeffries, 2005) and flexibility is paramount. The Process The first step in designing the virtual course was to review the traditional course and see how components could be modified to the virtual environment. The traditional course encompasses two and one-half hours of didactic content weekly, plus 22.5 hours of lab over the duration of the semester. Video presentations, faculty demonstration, and hands-on practice are the cornerstones of this on-campus class. Before getting started, I prepared an orientation folder required for students to navigate through the course, find items, post a small document in a drop box, and post contributions to the Discussion Board. It was important to identify potential problems with the hardware or software interface and resolve them before assignments were due. I found that my students completed their work at different times of the day and night, with many students working nights or weekends. With the input of students, we decided that all assignments would open in the Angel system on Monday afternoon at 5 PM, and all assignments would be due at that time. Sticking to this schedule helped students know when they had to check in. I also kept track of students' discussions and would contact them if I noticed a lapse in participation. Email and telephone calls and messages were our methods of contact; students had both my office and cell phone numbers, which enabled them to reach me and get timely answers to their questions. Many of my students were voices on the telephone until graduation when I would meet them at commencement. My greatest concern was how to provide hands-on practice. Since students lived in various parts of the state, it became the student's responsibility to enlist an advanced practice RN as a preceptor and negotiate with the preceptor how to arrange lab time totaling 22.5 hours. The guidelines for choosing a preceptor were clearly outlined. Labs could not be done during the student's work time and had to follow the progression of the course for content, with a check-off sheet to use as a guideline. There was no set number of hours per week; the student and preceptor negotiated learning contracts together and formulated goals for the lab experience. …

A Supervised and Fuzzy-based Approach to Determine Optimal Multi-resolution Image Segmentation Parameters

Image segmentation is important for object-based classification. One of the most advanced image segmentation techniques is multi-resolution segmentation implemented by eCognition (R). Multi-resolution segmentation requires users to determine a set of proper segmentation parameters through a trial-and-error process. To achieve accurate segmentations of objects of different sizes, several sets of segmentation parameters are required: one for each level. However, the trial-and-error process is time consuming and operator dependent. To overcome these problems, this paper introduces a supervised and fuzzy-based approach to determine optimal segmentation parameters for eCognition (R). This approach is referred to as the Fuzzy-based Segmentation Parameter optimizer (FBSP, optimizer) in this paper. It is based on the idea of discrepancy evaluation to control the merging of sub-segments to reach a target segment. Experiments demonstrate that the approach improves the segmentation accuracy by more than 16 percent, reduces the operation time from two hours to one-half hour, and is operator independent.

The effect of cold ischemic time on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma

AbstractThe American Society of Clinical Oncology/College of American Pathologist (ASCO/CAP) guidelines on breast cancer currently recommend a cold ischemic time of <1 h, although data are limited. Breast resection specimens were subjected to variable cold ischemic time periods (0.5, 1, 2, 3, 4, 24, and 48 h) within the refrigerator and at room temperature. The study included 25 tumors, all of which had refrigerated samples. Non-refrigerated samples (samples at room temperature) were present on 23 cases. Hormone receptors were semi-quantitatively scored using the H-score method. Human epidermal growth factor receptor 2 gene ERBB2 (HER2) was scored using the ASCO/CAP guidelines. The results were compared with the core biopsy scores, which have negligible cold ischemic time period before fixation. Mild reduction in staining for hormone receptors was judged present if the H-score on the resection specimen was between one-half and three-fourth of the H-score at core biopsy. Significant reduction was judged present when the H-score on resection was less than one-half of the core biopsy H-score. Mild reduction in HER2 staining was judged present if there was one-step reduction; and significant reduction was judged present if there was two-step reduction in staining. A true reduction was judged present only when the reduction was consistently present for the increasing time interval. A focal reduction for a particular time sample was attributed to the heterogeneity of the tumor sample. Non-refrigerated samples are affected more by prolonged cold ischemic time than refrigerated samples. Cold ischemic time period of as short as one-half hour may occasionally impact the immunohistochemical (IHC) staining for progesterone receptor. Significant reduction in IHC staining for hormone receptors, and HER2, however, generally does not result until 4 h for refrigerated samples and 2 h for non-refrigerated samples. The ASCO/CAP guideline of cold ischemic time period of <1 h is a prudent guideline to follow.

Determinants of mortality in patients with traumatic brain injury.

We aimed to determine factors associated with mortality rates in patients with traumatic brain injury (TBI). Registered data of a national trauma project conducted in eight major cities in Iran during a five-year period were used. Patients with a TBI were identified and both univariate and multivariate analyses were performed. 2274 brain-injured patients including 1794 males (78.9%) were identified. The mean age of the patients was 30.1 ± 19.11 years. The age of 345 patients was less than 12, while 137 patients were older than 65. 383 patients (16.9%) died as a result of their injury. Univariate analysis showed a significant association between mortality and the following factors: age, sex, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), systolic, diastolic and mean arterial blood pressure (BP), and respiratory rate (RR) (p<0.05).The logistic regression analysis revealed a statistically significant association between death and age (odds ratio [OR]=1.04), GCS (OR=0.59), ISS (OR=1.03), mean arterial BP (OR=0.71), and RR (OR=0.82) one-half hour after hospital arrival. Our results demonstrated that age, GCS, ISS, BP, and RR as prognostic factors in patients with TBI indicate those that need special care during the initial management in the emergency department.

Determinants of mortality in patients with traumatic brain injury.

We aimed to determine factors associated with mortality rates in patients with traumatic brain injury (TBI).Registered data of a national trauma project conducted in eight major cities in Iran during a five-year period were used. Patients with a TBI were identified and both univariate and multivariate analyses were performed.2274 brain-injured patients including 1794 males (78.9%) were identified. The mean age of the patients was 30.1 ± 19.11 years. The age of 345 patients was less than 12, while 137 patients were older than 65. 383 patients (16.9%) died as a result of their injury. Univariate analysis showed a significant association between mortality and the following factors: age, sex, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), systolic, diastolic and mean arterial blood pressure (BP), and respiratory rate (RR) (p<0.05).The logistic regression analysis revealed a statistically significant association between death and age (odds ratio [OR]=1.04), GCS (OR=0.59), ISS (OR=1.03), mean arterial BP (OR=0.71), and RR (OR=0.82) one-half hour after hospital arrival.Our results demonstrated that age, GCS, ISS, BP, and RR as prognostic factors in patients with TBI indicate those that need special care during the initial management in the emergency department.