Damage control surgery: it's evolution over the last 20 years

In less than twenty years, what began as a concept for the treatment of exsanguinating truncal trauma patients has become the primary treatment model for numerous emergent, life threatening surgical conditions incapable of tolerating traditional methods. Its core concepts are relative straightforward and simple in nature: first, proper identification of the patient who is in need of following this paradigm; second, truncation of the initial surgical procedure to the minimal necessary operation; third, aggressive, focused resuscitation in the intensive care unit; fourth, definitive care only once the patient is optimized to tolerate the procedure. These simple underlying principles can be molded to a variety of emergencies, from its original application in combined major vascular and visceral trauma to the septic abdomen and orthopedics. A host of new resuscitation strategies and technologies have been developed over the past two decades, from permissive hypotension and damage control resuscitation to advanced ventilators and hemostatic agents, which have allowed for a more focused resuscitation, allowing some of the morbidity of this model to be reduced. The combination of the simple, malleable paradigm along with better understanding of resuscitation has proven to be a potent blend. As such, what was once an almost lethal injury (combined vascular and visceral injury) has become a survivable one.

Can endometrial arylsulfatase A activity predict the onset of endometrial polyps over the years?

PURPOSE: To assess if arylsulfatase A activity (ASA) and sulfatide (SL) concentration in the human endometrium can be predictive of the development of endometrial polyps over the years, since ASA activity reflects the endometrial sensitivity to hormones. METHODS: ASA activity and SL concentration were determined by biochemical procedures on endometrial samples collected between 1990 and 1994 in non-menopausal women. These women underwent a new endometrial sampling following the clinical indication some years after the first endometrial sampling. The histological assessment of the second endometrial specimens found four patients with normal endometrial pattern and 10 patients with one or more endometrial polyps. ASA activity/years elapsed and SL concentration/years elapsed were compared using two tailed Mann-Whitney test for unpaired data between patients with normal pattern and patients with endometrial polyps. RESULTS: Median ASA activities were 2.62 (normal pattern) versus 1.85 (endometrial polyps) nmol hydrolized substrate/min. Median activity/years elapsed is higher in patients with second endometrial sample presenting normal pattern (p=0.006) and median SL concentration/years elapsed does not differ significantly among groups, even if median SL concentration seems to be higher in patients who subsequently developed polyps (1031 µg/g of fresh tissue versus 341,5 µg/g of fresh tissue). CONCLUSIONS: ASA activity can predict the onset of endometrial polyps over the years.

Solving large sparse linear systems over the field GF(2)

Nowadays problem of solving sparse linear systems over the field GF(2) remain as a challenge. The popular approach is to improve existing methods such as the block Lanczos method (the Montgomery method) and the Wiedemann-Coppersmith method. Both these methods are considered in the thesis in details: there are their modifications and computational estimation for each process. It demonstrates the most complicated parts of these methods and gives the idea how to improve computations in software point of view. The research provides the implementation of accelerated binary matrix operations computer library which helps to make the progress steps in the Montgomery and in the Wiedemann-Coppersmith methods faster.

Over the Falls : Annie Edson Taylor's story of her trip : how the Horseshoe Fall was conquered /

"June, 1902"-- title page.

Report of the Committee on Military Affairs, on the differences that exist, between the United States and some of the individual States, respecting the relative powers of the general and state governments over the militia.--

February 28, 1815. Printed by order of the Senate of the United States.

Report of the Committee on Military Affairs, on the differences that exist, between the United States and some of the individual States, respecting the relative powers of the general and state governments over the militia

February 28, 1815. Printed by order of the Senate of the United States. Printed be Roger C. Weightman

Sketch of the bridge over Hurst’s Point and calculations about the bridge over the pond at Allenburgh

Sketch of the bridge over Hurst’s Point and calculations about the bridge over the pond at Allenburgh, n.d.

Letter to S.D. Woodruff from Fred Holmes stating that there are 4 bents in the Port Robinson Bridge over the Chippawa

Letter to S.D. Woodruff from Fred Holmes stating that there are 4 bents in the Port Robinson Bridge over the Chippawa. This is more than are shown in the plan, Oct. 5, 1857.

Study of cyclohexanol decomposition reaction over the ferrospinels, A1−xCuxFe2O4 (A=Ni or Co and x=0, 0.3, 0.5, 0.7 and 1), prepared by ‘soft’ chemical methods

Preparation of simple and mixed ferrospinels of nickel, cobalt and copper and their sulphated analogues by the room temperature coprecipitation method yielded fine particles with high surface areas. Study of the vapour phase decomposition of cyclohexanol at 300 °C over all the ferrospinel systems showed very good conversions yielding cyclohexene by dehydration and/or cyclohexanone by dehydrogenation, as the major products. Sulphation very much enhanced the dehydration activity over all the samples. A good correlation was obtained between the dehydration activities of the simple ferrites and their weak plus medium strength acidities (usually of the Brφnsted type) determined independently by the n-butylamine adsorption and ammonia-TPD methods. Mixed ferrites containing copper showed a general decrease in acidities and a drastic decrease in dehydration activities. There was no general correlation between the basicity parameters obtained by electron donor studies and the ratio of dehydrogenation to dehydration activities. There was a leap in the dehydrogenation activities in the case of all the ferrospinel samples containing copper. Along with the basic properties, the redox properties of copper ion have been invoked to account for this added activity.

A Study on the Transport and Distribution of Atmospheric Aerosols and its Influence on Regional Meteorological Parameters over the Indian Subcontinent

This doctoral thesis addresses the growing concern about the significant changes in the climatic and weather patterns due to the aerosol loading that have taken place in the Indo Gangetic Plain(IGP)which includes most of the Northern Indian region. The study region comprises of major industrial cities in India (New Delhi, Kanpur, Allahabad, Jamshedpur and Kolkata). Northern and central parts of India are one of the most thickly populated areas in the world and have the most intensely farmed areas. Rapid increase in population and urbanization has resulted in an abrupt increase in aerosol concentrations in recent years. The IGP has a major source of coal; therefore most of the industries including numerous thermal power plants that run on coal are located around this region. They inject copious amount of aerosols into the atmosphere. Moreover, the transport of dust aerosols from arid locations is prevalent during the dry months which increase the aerosol loading in theatmosphere. The topography of the place is also ideal for the congregation of aerosols. It is bounded by the Himalayas in the north, Thar Desert in the west, the Vindhyan range in the south and Brahmaputra ridge in the east. During the non‐monsoon months (October to May) the weather in the location is dry with very little rainfall. Surface winds are weak during most of the time in this dry season. The aerosols that reach the location by means of long distance transport and from regional sources get accumulated under these favourable conditions. The increase in aerosol concentration due to the complex combination of aerosol transport and anthropogenic factors mixed with the contribution from the natural sources alters the optical properties and the life time of clouds in the region. The associated perturbations in radiative balance have a significant impact on the meteorological parameters and this in turn determines the precipitation forming process. Therefore, any change in weather which disturbs the normal hydrological pattern is alarming in the socio‐economic point of view. Hence, the main focus of this work is to determine the variation in transport and distribution of aerosols in the region and to understand the interaction of these aerosols with meteorological parameters and cloud properties.

A Study on Aerosol Transport Dynamics over the Indian Landmass and the Adjoining Oceanic Regions Using Satellite Data

The present study brings out the influence of transport dynamics on the aerosol distribution over the Indian region at a few selected geographically distinct locations. Over the Bay of Bengal the dominant pathway of aerosol transport during the pre-monsoon period is through higher altitudes (~ 3 km); directed from the Indian main land. In contrast, the aerosol pathways over the Arabian Sea during the same period are quite complex. They are directed from geographically different environments around the ocean through different altitudes. However in general, the day-to-day variability of AOD at both these regions is significantly influenced by the features of atmospheric circulation especially, the wind convergence at higher altitudes (around 3 km). Over the Ganga Basin during the winter period, the wind convergence at lower altitudes (< I km) govems the shon term variations in AOD, while the mean AOD distribution at this location is mainly governed by the local anthropogenic sources.

Studies on the horizontal and vertical distribution of clouds and their impact on energetics of the Atmosphere over the Indian Region

Motivation for the present study is to improve the scienti c understanding on the prominent gap areas in the average three-dimensional distribution of clouds and their impact on the energetics of the earth-atmosphere system. This study is focused on the Indian subcontinent and the surrounding oceans bound within the latitude-longitude bands of 30 S to 30 N and 30 E to 110 E. Main objectives of this study are to : (i) estimate the monthly and seasonal mean vertical distributions of clouds and their spatial variations (which provide the monthly and seasonal mean 3-dimensional distributions of clouds) using multi-year satellite data and investigate their association with the general circulation of the atmosphere, (ii) investigate the characteristics of the `pool of inhibited cloudiness' that appear over the southwest Bay of Bengal during the Asian summer monsoon season (revealed by the 3-dimensional distribution of clouds) and identify the potential mechanisms for its genesis, (iii) investigate the role of SST and atmospheric thermo-dynamical parameters in regulating the vertical development and distribution of clouds, (iv) investigate the vertical distribution of tropical cirrus clouds and their descending nature using lidar observations at Thiruvananthapuram (8.5 N, 77 E), a tropical coastal station at the southwest Peninsular India, and (v) assessment of the impact of clouds on the energetics of the earth-atmosphere system, by estimating the regional seasonal mean cloud radiative forcing at top-of-the-atmosphere (TOA) and latent heating of the atmosphere by precipitating clouds using satellite data

Characteristics of SST over the Arabian Sea and Bay of Bengal

Evolution of mini warm pool in the Arabian Sea just before the onset of southwest monsoon and behavior of SST in the vicinity of weather systems formed during the premonsoon, southwest monsoon and post monsoon seasons were studied using TMI SST data. The Arabian Sea mini warm pool is formed about three weeks ahead of onset of southwest monsoon. Maximum SST is found about one week ahead of monsoon onset and then the warm pool gradually dissipated. Generally, a low-pressure system is formed when the SST exceeds a certain threshold value for the formation of the system. Daily SST values are examined both in Arabian sea and Bay of Bengal to bring out the quantity of increase in SST just before the formation of the system, quantity of rapid decrease in SST during the formation of the system and the number of days required for returning to normal SST. Many cases were examined for pre-monsoon, southwest monsoon and post monsoon seasons to understand the behavior of SST pattern. It is found that the SST increases about 3° C just before the formation of the system and decreases about 4° C during the formation within 2 to 3 days and takes about 4 to 6 days to return to normal SST pattern. However, the SST pattern depends on the weather system

Study of the Oceanic Heat Budget Components over the Arabian Sea during the Formation and Evolution of Super Cyclone, Gonu

Oceans play a vital role in the global climate system. They absorb the incoming solar energy and redistribute the energy through horizontal and vertical transports. In this context it is important to investigate the variation of heat budget components during the formation of a low-pressure system. In 2007, the monsoon onset was on 28th May. A well- marked low-pressure area was formed in the eastern Arabian Sea after the onset and it further developed into a cyclone. We have analysed the heat budget components during different stages of the cyclone. The data used for the computation of heat budget components is Objectively Analyzed air-sea flux data obtained from WHOI (Woods Hole Oceanographic Institution) project. Its horizontal resolution is 1° × 1°. Over the low-pressure area, the latent heat flux was 180 Wm−2. It increased to a maximum value of 210 Wm−2 on 1st June 2007, on which the system was intensified into a cyclone (Gonu) with latent heat flux values ranging from 200 to 250 Wm−2. It sharply decreased after the passage of cyclone. The high value of latent heat flux is attributed to the latent heat release due to the cyclone by the formation of clouds. Long wave radiation flux is decreased sharply from 100 Wm−2 to 30 Wm−2 when the low-pressure system intensified into a cyclone. The decrease in long wave radiation flux is due to the presence of clouds. Net heat flux also decreases sharply to −200 Wm−2 on 1st June 2007. After the passage, the flux value increased to normal value (150 Wm−2) within one day. A sharp increase in the sensible heat flux value (20 Wm−2) is observed on 1st June 2007 and it decreased there- after. Short wave radiation flux decreased from 300 Wm−2 to 90 Wm−2 during the intensification on 1st June 2007. Over this region, short wave radiation flux sharply increased to higher value soon after the passage of the cyclone.

Variations of surface boundary layer parameters associated with Cyclone Gonu over the Arabian Sea using QuikSCAT data

This study attempted to quantify the variations of the surface marine atmospheric boundary layer (MABL) parameters associated with the tropical Cyclone Gonu formed over the Arabian Sea during 30 May–7 June 2007 (just after the monsoon onset). These characteristics were evaluated in terms of surface wind, drag coefficient, wind stress, horizontal divergence, and frictional velocity using 0.5◦ × 0.5◦ resolution Quick Scatterometer (QuikSCAT) wind products. The variation of these different surface boundary layer parameters was studied for three defined cyclone life stages: prior to the formation, during, and after the cyclone passage. Drastic variations of the MABL parameters during the passage of the cyclone were observed. The wind strength increased from 12 to 22 m s−1 in association with different stages of Gonu. Frictional velocity increased from a value of 0.1–0.6 m s−1 during the formative stage of the system to a high value of 0.3–1.4 m s−1 during the mature stage. Drag coefficient varied from 1.5 × 10−3 to 2.5 × 10−3 during the occurrence of Gonu. Wind stress values varied from 0.4 to 1.1 N m−2. Wind stress curl values varied from 10 × 10−7 to 45 × 10−7 N m−3. Generally, convergent winds prevailed with the numerical value of divergence varying from 0 to –4 × 10−5 s−1. Maximum variations of the wind parameters were found in the wall cloud region of the cyclone. The parameters returned to normally observed values in 1–3 days after the cyclone passage