The Risk of Paradoxical Embolism (RoPE) Study: initial description of the completed database

BACKGROUND: Detecting a benefit from closure of patent foramen ovale in patients with cryptogenic stroke is hampered by low rates of stroke recurrence and uncertainty about the causal role of patent foramen ovale in the index event. A method to predict patent foramen ovale-attributable recurrence risk is needed. However, individual databases generally have too few stroke recurrences to support risk modeling. Prior studies of this population have been limited by low statistical power for examining factors related to recurrence. AIMS: The aim of this study was to develop a database to support modeling of patent foramen ovale-attributable recurrence risk by combining extant data sets. METHODS: We identified investigators with extant databases including subjects with cryptogenic stroke investigated for patent foramen ovale, determined the availability and characteristics of data in each database, collaboratively specified the variables to be included in the Risk of Paradoxical Embolism database, harmonized the variables across databases, and collected new primary data when necessary and feasible. RESULTS: The Risk of Paradoxical Embolism database has individual clinical, radiologic, and echocardiographic data from 12 component databases, including subjects with cryptogenic stroke both with (n = 1925) and without (n = 1749) patent foramen ovale. In the patent foramen ovale subjects, a total of 381 outcomes (stroke, transient ischemic attack, death) occurred (median follow-up 2·2 years). While there were substantial variations in data collection between studies, there was sufficient overlap to define a common set of variables suitable for risk modeling. CONCLUSION: While individual studies are inadequate for modeling patent foramen ovale-attributable recurrence risk, collaboration between investigators has yielded a database with sufficient power to identify those patients at highest risk for a patent foramen ovale-related stroke recurrence who may have the greatest potential benefit from patent foramen ovale closure.

Correlation properties of spontaneous motor activity in healthy infants: a new computer-assisted method to evaluate neurological maturation

Qualitative assessment of spontaneous motor activity in early infancy is widely used in clinical practice. It enables the description of maturational changes of motor behavior in both healthy infants and infants who are at risk for later neurological impairment. These assessments are, however, time-consuming and are dependent upon professional experience. Therefore, a simple physiological method that describes the complex behavior of spontaneous movements (SMs) in infants would be helpful. In this methodological study, we aimed to determine whether time series of motor acceleration measurements at 40-44 weeks and 50-55 weeks gestational age in healthy infants exhibit fractal-like properties and if this self-affinity of the acceleration signal is sensitive to maturation. Healthy motor state was ensured by General Movement assessment. We assessed statistical persistence in the acceleration time series by calculating the scaling exponent α via detrended fluctuation analysis of the time series. In hand trajectories of SMs in infants we found a mean α value of 1.198 (95 % CI 1.167-1.230) at 40-44 weeks. Alpha changed significantly (p = 0.001) at 50-55 weeks to a mean of 1.102 (1.055-1.149). Complementary multilevel regression analysis confirmed a decreasing trend of α with increasing age. Statistical persistence of fluctuation in hand trajectories of SMs is sensitive to neurological maturation and can be characterized by a simple parameter α in an automated and observer-independent fashion. Future studies including children at risk for neurological impairment should evaluate whether this method could be used as an early clinical screening tool for later neurological compromise.

Repair of superficial osteochondral defects with an autologous scaffold-free cartilage construct in a caprine model: implantation method and short-term results

OBJECTIVE: To compare four different implantation modalities for the repair of superficial osteochondral defects in a caprine model using autologous, scaffold-free, engineered cartilage constructs, and to describe the short-term outcome of successfully implanted constructs. METHODS: Scaffold-free, autologous cartilage constructs were implanted within superficial osteochondral defects created in the stifle joints of nine adult goats. The implants were distributed between four 6-mm-diameter superficial osteochondral defects created in the trochlea femoris and secured in the defect using a covering periosteal flap (PF) alone or in combination with adhesives (platelet-rich plasma (PRP) or fibrin), or using PRP alone. Eight weeks after implantation surgery, the animals were killed. The defect sites were excised and subjected to macroscopic and histopathologic analyses. RESULTS: At 8 weeks, implants that had been held in place exclusively with a PF were well integrated both laterally and basally. The repair tissue manifested an architecture similar to that of hyaline articular cartilage. However, most of the implants that had been glued in place in the absence of a PF were lost during the initial 4-week phase of restricted joint movement. The use of human fibrin glue (FG) led to massive cell infiltration of the subchondral bone. CONCLUSIONS: The implantation of autologous, scaffold-free, engineered cartilage constructs might best be performed beneath a PF without the use of tissue adhesives. Successfully implanted constructs showed hyaline-like characteristics in adult goats within 2 months. Long-term animal studies and pilot clinical trials are now needed to evaluate the efficacy of this treatment strategy.

Development of a physically-based method for delineation of hydrologically homogeneous regions and flood quantile estimation in ungauged basins via the index flood method

Regional flood frequency techniques are commonly used to estimate flood quantiles when flood data is unavailable or the record length at an individual gauging station is insufficient for reliable analyses. These methods compensate for limited or unavailable data by pooling data from nearby gauged sites. This requires the delineation of hydrologically homogeneous regions in which the flood regime is sufficiently similar to allow the spatial transfer of information. It is generally accepted that hydrologic similarity results from similar physiographic characteristics, and thus these characteristics can be used to delineate regions and classify ungauged sites. However, as currently practiced, the delineation is highly subjective and dependent on the similarity measures and classification techniques employed. A standardized procedure for delineation of hydrologically homogeneous regions is presented herein. Key aspects are a new statistical metric to identify physically discordant sites, and the identification of an appropriate set of physically based measures of extreme hydrological similarity. A combination of multivariate statistical techniques applied to multiple flood statistics and basin characteristics for gauging stations in the Southeastern U.S. revealed that basin slope, elevation, and soil drainage largely determine the extreme hydrological behavior of a watershed. Use of these characteristics as similarity measures in the standardized approach for region delineation yields regions which are more homogeneous and more efficient for quantile estimation at ungauged sites than those delineated using alternative physically-based procedures typically employed in practice. The proposed methods and key physical characteristics are also shown to be efficient for region delineation and quantile development in alternative areas composed of watersheds with statistically different physical composition. In addition, the use of aggregated values of key watershed characteristics was found to be sufficient for the regionalization of flood data; the added time and computational effort required to derive spatially distributed watershed variables does not increase the accuracy of quantile estimators for ungauged sites. This dissertation also presents a methodology by which flood quantile estimates in Haiti can be derived using relationships developed for data rich regions of the U.S. As currently practiced, regional flood frequency techniques can only be applied within the predefined area used for model development. However, results presented herein demonstrate that the regional flood distribution can successfully be extrapolated to areas of similar physical composition located beyond the extent of that used for model development provided differences in precipitation are accounted for and the site in question can be appropriately classified within a delineated region.

Microscopic wire guide-based orotracheal mouse intubation: description, evaluation and comparison with transillumination

Airway access is needed for a number of experimental animal models, and the majority of animal research is based on mouse models. Anatomical conditions in mice are small, and the narrow glottic opening allows intubation only with a subtle technique. We therefore developed a microscopic endotracheal intubation method with a wire guide technique in mice anaesthetized with halothane in oxygen. The mouse is hung perpendicularly with its incisors on a thread fixed on a vertical plate. The tongue is placed with a pair of forceps between the left hand's thumb and forefinger and slightly pulled, while the neck and thorax are positioned using the third and fourth fingers. By doing so, the neck can be slightly stretched, which allows optimal visualization of the larynx and the vocal cords. To ensure a safe intubation, a fine wire guide is placed under vision between the vocal cords and advanced about 5 mm into the trachea. An intravenous 22G x 1 in. plastic or Teflon catheter is guided over this wire. In a series of 41 mice, between 21 and 38 g, the success rate for the first intubation attempt was >95%. Certainty of the judgement procedure was 100% and success rate was higher using the described method when compared with a transillumination method in a further series. The technique is safe, less invasive than tracheostomy and suitable for controlled ventilation and pulmonary substance application.

Synthesis of Semi-Natural Grassland Vegetation of a Biogeographically Heterogeneous Area: Mesophilous Species-Rich Meadows in Switzerland

For a hundred years semi-natural species-rich meadow vegetation has been described from various areas of Switzerland. The first description dates from 1892 by Stebler and Schröter. In the present study, relevés of 65 semi-natural mesophilous meadow associations and communities reported by 26 authors, which were collected throughout the century, are summarized. An increasing number of descriptions dating from the 1980s and 1990s is included. A numerical classification of these 65 types resulted in four main groups of meadow-types. When compared with the existing literature of alliances a high correlation is found with the Polygono-Trisetion Br.-Bl. et R. Tx. ex Marshall 1947, the Arrhenatherion W. Koch 1926, the Agrostio-Festucion Puscaru et al. 1956, the Mesobromion Br.-Bl. et Moor 1938 em. Oberdorfer 1957, and with the Chrysopogonetum W. Koch 1943. The Agrostio-Festucion is characteristic for the montane belt in southern Switzerland and was until recently poorly known. This alliance is discussed in detail. Some classifications of meadow types by the original authors had to be rearranged for the present purpose. The present classification coincides well with the one Stebler and Schröter gave in 1892. Today, after a century of intensive changes in land use, their four main types are still valid.

Analysis of the LIFO inventory valuation method during the onset of IFRS

I propose that the Last in, First out (LIFO) inventory valuation method needs to be reevaluated. I will evaluate the impact of the LIFO method on earnings of publically traded companies with a LIFO reserve over the past 10 years. I will begin my proposal with the history of how the LIFO method became an acceptable valuation method and discuss the significance of LIFO within the accounting profession Next I will provide a description of LIFO, the First in, First out (FIFO), and the weighted average inventory valuation methods and explore the differences among each. More specifically, I will explore the arguments for and against the use of the LIFO method and the potential shift towards financial standards that do not allow LIFO (a standard adopted and influenced by the International Financial Accounting Standards Board). Data will be collected from Compustat for publicly traded companies (with a LIFO Reserve) for the past 10 years. I will document which firms use LIFO, analyze trends relating to LIFO usage and LIFO reserves (the difference in the cost of inventory between using LIFO and FIFO), and evaluate the effect on earnings. The purpose of this research is to evaluate the accuracy of LIFO in portraying earnings and to see how much tax has gone uncollected over the years because of the use of LIFO. Moreover, I will provide an opinion as to whether U.S. GAAP should adopt a standard similar to IFRS and ban the LIFO method.

Description and analysis of variation in dairy product and concomitant nutrient purchases between Hispanic and non -Hispanic households using a panel of shoppers' purchase records

The purpose of this research was development of a method of estimating nutrient availability in populations as approximated by supermarket purchase records. Demographic information describing 12,516 panel households was obtained from a marketing and advertising program operated by H. E. Butt Grocery Company of San Antonio, Texas. A non-probability sample of 2,161 households meeting expenditure criteria was selected and all purchases of dairy products for this sample of households were organized into a database constructed to facilitate the retrieval, aggregation, and analysis of dairy product purchases and their nutrient contents. Two hypotheses were tested: (1) no difference would be found between Hispanic and non-Hispanic purchases of dairy product categories during the study period and (2) no difference would be found between Hispanic and non-Hispanic purchases of nutrients contained in those dairy products during the thirteen-week study period.^ Food purchase records were used to estimate nutrient exposure on a weekly, per capita basis for Hispanic and non-Hispanic households by linking some 40,000 dairy purchase Universal Product code (UPC) numbers with food composition values contained in USDA Handbook 8-1. Results of this study suggest Hispanic sample households consistently purchased fewer dairy products than did non-Hispanic sample households and consequently had fewer nutrients available from dairy purchases. While weekly expenditures for dairy products among the sample households remained relatively constant during the study period, shifts in the types of dairy products purchased were observed. The effect of ethnicity on dairy product and nutrient purchases was significant over the thirteen-week period. A database consisting of customer, household, and purchase information can be developed to successfully associate food item UPC numbers with a standard reference of food composition to estimate nutrient availability in a population over extended periods of time. ^

Description and chemical composition of manganese nodules collected in the Pacific Ocean

Chemical and X-ray analyses were performed on the fifteen manganese nodules collected from the Pacific Ocean floor. The results were discussed compared with the previous data on the manganese nodules. Minerals were found to be todorokite, delta-MnO2 and other silicates, montmorillonite, illite, phillipsite and alpha-Si02. Average composition shows that copper is concentrated on the deep sea nodules more than the shallow ones, and that the todorokite rich nodules contain more copper and nickel than the delta-MnO2 rich ones. The analyses of fresh water iron-manganese precipitates by bacterial activity suggest that biological process is one of the important factors on the genesis of the sedimentary iron-manganese deposits, in¬cluding the manganese nodule.

Geochemistry on manganese nodules from Loch Fyne, Scotland

Manganese nodules and manganese carbonate concretions occur in the upper 10-15 cm of the Recent sediments of Loch Fyne, Argyllshire in water depths of 180-200 m. The nodules are spherical, a few mm to 3 cm in diameter, and consist of a black, Mn-rich core and a thin, red, Fe-rich rim. The carbonate occurs as irregular concretions, 0.5-8 cm in size, and as a cement in irregular nodule and shell fragment aggregates. It partially replaces some nodule material and clastic silicate inclusions, but does not affect aragonitic and calcitic shell fragments. The nodules are approximately 75% pure oxides and contain 30% Mn and 4% Fe. In the cores, the principal mineral phase is todorokite, with a Mn/Fe ratio of 17. The rim consists of X-ray amorphous Fe and Mn oxides with a Mn/Fe ratio of 0.66. The cores are enriched, relative to Al, in K, Ba, Co, Mo, Ni and Sr while the rims contain more P, Ti, As, Pb, Y and Zn. The manganese carbonate has the composition (Mn47.7 Ca45.1 Mg7.2) CO3. Apart from Cu, all minor elements are excluded from significant substitution in the carbonate lattice. Manganese nodules and carbonates form diagenetically within the Recent sediments of Loch Fyne. This accounts for the high Mn/Fe ratios in the oxide phases and the abundance of manganese carbonate concretions. Mn concentrations in the interstitial waters of sediment cores are high (ca. 10 ppm) as also, by inference, are the dissolved carbonate concentrations.

Radiocarbon ages, diatom abundance and laminae description of sediment core MD03-2597

Laminated sediments are unique archives of palaeoenvironmental and palaeoceanographic conditions, recording changes on seasonal and interannual timescales. Diatom-rich laminated marine sediments are examined from Dumont d'Urville Trough, East Antarctic Margin, to determine changes in environmental conditions on the continental shelf from 1136 to 3122 cal. yr BP. Scanning electron microscope backscattered electron imagery (BSEI) and secondary electron imagery are used to analyse diatom assemblages from laminations and to determine interlamina relationships. Diatom observations are quantified with conventional assemblage counts. Laminae are primarily classified according to visually dominant species identified in BSEI and, secondarily, by terrigenous content. Nine lamina types are identified and are characterized by: Hyalochaete Chaetoceros spp. resting spores (CRS); CRS and Fragilariopsis spp.; Fragilariopsis spp.; Corethron pennatum and Rhizosolenia spp.; C. pennatum; Rhizosolenia spp.; mixed diatom assemblage; Stellarima microtrias resting spores (RS), Porosira glacialis RS and Coscinodiscus bouvet; and P. glacialis RS. Formation of each lamina type is controlled by seasonal changes in sea ice cover, nutrient levels and water column stability. Quantitative diatom assemblage analysis revealed that each lamina type is dominated by CRS and Fragilariopsis sea ice taxa, indicating that sea ice cover was extensive and persistent in the late Holocene. However the lamina types indicate that the sea ice regime was not consistent throughout this period, notably that a relatively warmer period, ~3100 to 2500 cal. yr BP, was followed by cooling which resulted in an increase in year round sea ice by ~1100 cal. yr BP.

Description of sampling sites in Northern Russia

The youngest ice marginal zone between the White Sea and the Ural mountains is the W-E trending belt of moraines called the Varsh-Indiga-Markhida-Harbei-Halmer-Sopkay, here called the Markhida line. Glacial elements show that it was deposited by the Kara Ice Sheet, and in the west, by the Barents Ice Sheet. The Markhida moraine overlies Eemian marine sediments, and is therefore of Weichselian age. Distal to the moraine are Eemian marine sediments and three Palaeolithic sites with many C-14 dates in the range 16-37 ka not covered by till, proving that it represents the maximum ice sheet extension during the Weichselian. The Late Weichselian ice limit of M. G. Grosswald is about 400 km (near the Urals more than 700 km) too far south. Shorelines of ice dammed Lake Komi, probably dammed by the ice sheet ending at the Markhida line, predate 37 ka. We conclude that the Markhida line is of Middle/Early Weichselian age, implying that no ice sheet reached this part of Northern Russia during the Late Weichselian. This age is supported by a series of C-14 and OSL dates inside the Markhida line all of >45 ka. Two moraine loops protrude south of the Markhida line; the Laya-Adzva and Rogavaya moraines. These moraines are covered by Lake Komi sediments, and many C-14 dates on mammoth bones inside the moraines are 26-37 ka. The morphology indicates that the moraines are of Weichselian age, but a Saalian age cannot be excluded. No post-glacial emerged marine shorelines are found along the Barents Sea coast north of the Markhida line.

Consolidation properties and hydraulic conductivities of sediments from ODP Leg 207 sites

The stress history, permeability, and compressibility of sediments from Demerara Rise recovered during Ocean Drilling Program Leg 207 were determined using one-dimensional incremental load consolidation and low-gradient flow pump permeability tests. Relationships among void ratio, effective stress, and hydraulic conductivity are presented for sampled lithologic units and used to reconstruct effective stress, permeability, and in situ void ratio profiles for a transect of three sites across Demerara Rise. Results confirm that a significant erosional event occurred on the northeastern flank of the rise during the late Miocene, resulting in the removal of ~220 m of upper Oligocene-Miocene deposits. Although Neogene and Paleogene sediments tend to be overconsolidated, Cretaceous sediments are normally consolidated to underconsolidated, suggesting the presence of overpressure. A pronounced drop in permeability occurs at the transition from the Cretaceous black shales into the overlying Maastrichtian-upper Paleocene chalks and clays. The development of a hydraulic seal at this boundary may be responsible for overpressure in the Cretaceous deposits, leading to the lower overconsolidation ratios of these sediments. Coupled with large regional variations in sediment thickness (overburden stresses), the higher permeability overpressured Cretaceous sediments represent a regional lateral fluid conduit on Demerara Rise, possibly venting methane-rich fluids where it outcrops on the margin's northeastern flank.