Runoff Water Quality and Pollutant Mass Loads From Extensive Green Roofs

Green roof mitigation of volume and peak flow-rate of stormwater runoff has been studied extensively. However, due to the common practice of green roof fertilization, there is the potential for introduction of nutrients into local bodies of water. Therefore, this study compares green roof runoff quality with the water quality of precipitation and runoff from a bare shingle roof. The runoff from a demonstration-scale extensive green roof was analyzed during the summer of 2011 for its effect on runoff volume and analyzed during eleven storm events in the fall and winter for concentrations of copper, cadmium, zinc, lead, nitrogen species, total nitrogen, total organic carbon, sulfate, orthophosphate, and other monovalent and divalent ions. The green roof reduced the overall volume of runoff and served as a sink for NO3 - and NH4 +. However, the green roof was also a source for the pollutants PO4 3-, SO4 2-, TOC, cations, and total nitrogen. Metals such as zinc and lead showed trends of higher mass loads in the bare roof runoff than in precipitation and green roof runoff, although results were not statistically significant. The green roof also showed trends, although also not statistically significant, of retaining cadmium and copper. With the green roof serving as a source of phosphorous species and a sink for nitrogen species, and appearing to a retain metals and total volume, the life cycle impact analysis shows minimum impacts from the green roof, when compared with precipitation and bare roof runoff, in all but fresh water eutrophication. Therefore, the best environments to install a green roof may be in coastal environments.

Evaluation of the Design of Komendant's Cycloidal, Thin Shell Roofs At the Kimbell Art Museum Using Finite Element Analysis

The analysis of Komendant's design of the Kimbell Art Museum was carried out in order to determine the effectiveness of the ring beams, edge beams and prestressing in the shells of the roof system. Finite element analysis was not available to Komendant or other engineers of the time to aid them in the design and analysis. Thus, the use of this tool helped to form a new perspective on the Kimbell Art Museum and analyze the engineer's work. In order to carry out the finite element analysis of Kimbell Art Museum, ADINA finite element analysis software was utilized. Eight finite element models (FEM-1 through FEM-8) of increasing complexity were created. The results of the most realistic model, FEM-8, which included ring beams, edge beams and prestressing, were compared to Komendant's calculations. The maximum deflection at the crown of the mid-span surface of -0.1739 in. in FEM-8 was found to be larger than Komendant's deflection in the design documents before the loss in prestressing force (-0.152 in.) but smaller than his prediction after the loss in prestressing force (-0.3814 in.). Komendant predicted a larger longitudinal stress of -903 psi at the crown (vs. -797 psi in FEM-8) and 37 psi at the edge (vs. -347 psi in FEM-8). Considering the strength of concrete of 5000 psi, the difference in results is not significant. From the analysis it was determined that both FEM-5, which included prestressing and fixed rings, and FEM-8 can be successfully and effectively implemented in practice. Prestressing was used in both models and thus served as the main contribution to efficiency. FEM-5 showed that ring and edge beams can be avoided, however an architect might find them more aesthetically appropriate than rigid walls.

Multimodality Preoperative Planning and Postoperative Follow-up of a Hybrid Cardiac Intervention

We describe the case of a 59-year-old man who had aortic regurgitation and a hypoplastic aortic valve and for whom an echocardiography evaluation revealed a vascular tumor in the roof of the left atrium, which was suspected to be a hemangioma. After undergoing preoperative invasive catheter coronary angiography, echocardiography, and multislice computed tomography examinations, the patient underwent an aortic miniroot replacement. Intraoperative findings confirmed the findings of the preoperative evaluations. The tumor, although macroscopically verified as a hemangioma, was not resected because of the tumor's position and size, and the threat of uncontrollable bleeding. After an uneventful postoperative clinical course, a subsequent successful transcatheter coil occlusion of the coronary fistula from the left circumflex coronary artery was performed as an alternative to surgical resection of the tumor. This case emphasizes the future role of a multimodality hybrid approach for diagnosis, planning (different 2- and 3-dimensional imaging modalities), and treatment in the form of combining interventional (transcatheter) and surgical (open heart) techniques, which could optimize different treatment strategies. This approach could be further improved by increasing the installations of hybrid operating rooms.

Hydrologic monitoring of an integrated low impact development (LID) underdrained stormwater management system

In 2005, Wetland Studies and Solutions, Inc. (WSSI) installed an extensive Low Impact Development (LID) stormwater management system on their new office site in Gainesville, Virginia. The 4-acre site is serviced by a network of LID components: permeable pavements (two proprietary and one gravel type), bioretention cell / rain garden, green roof, vegetated swale, rainwater harvesting and drip irrigation, and slow-release underground detention. The site consists of heavy clay soils, and the LID components are mostly integrated by a series of underdrain pipes. A comprehensive monitoring system has been designed and installed to measure hydrologic performance throughout the LID, underdrained network. The monitoring system measures flows into and out of each LID component independently while concurrently monitoring rainfall events. A sensitivity analysis and laboratory calibration has been performed on the flow measurement system. Field data has been evaluated to determine the hydrologic performance of the LID features. Finally, hydrologic models amenable to compact, underdrained LID sites have been reviewed and recommended for future modeling and design.

The Geology of Lost Creek Canyon with Special Reference to Igneous Activity

This investigation was undertaken primarily as a problem in geologic mapping, coupled with a study of stratigraphy, glaciation, igneous phenomena, and structure. The area is admirably suited to a study of geology and geologic events. Because it is small in extent, the area was studied in some detail during the time which was devoted to field work. The record of igneous activity of past geological ages is re­markably well exposed, since Lost Creek Canyon was carved through the roof of a stock or batholith by the glaciers of the Pleistocene epoch.

The Testing and Concentration of Lake Chelan Copper Ore

The geologic history of the Holden area and Lake Chelan district is an integral part of the history of the Cascade Mountain Range. The structure is very complex and the rocks, which have been subjected to intense metamorphic action, are portions of a roof pendant and consists of gneisses, schists and quartzites that are often difficult to correlate.

Rare retinal haemorrhages in translational accidental head trauma in children

PURPOSE: The characteristic findings in accidental head injury consist of linear skull fracture, epidural haematoma, localized subdural haematoma, or cortical contusion because of a linear or translational impact force. Retinal haemorrhages have been found, although uncommon, in accidental head trauma. METHODS: We performed a retrospective study of 24 consecutive cases of children with severe head injuries caused by falls. Inclusion criteria were skull fractures and/or intracranial haemorrhages documented by computerized tomography. All patients underwent a careful ophthalmic examination including dilated indirect fundoscopy within the first 48 h following admission. RESULTS: No retinal haemorrhages could be found in patients whose accidents were plausible and physical and imaging findings were compatible with reported histories. Excessive bilateral retinal haemorrhages were found in only three children with the typical signs of shaken baby syndrome. In eight children, trauma had led to orbital roof fractures. CONCLUSIONS: Retinal haemorrhages were not found in any of the patients with accidental trauma despite the severity of their head injuries. Hence, we add more evidence that there are strong differences between the ocular involvement in accidental translational trauma and those in victims of non-accidental trauma. Fall-related injuries carry a very low risk of retinal haemorrhages.

Validation of novel 3-dimensional electrocardiographic mapping of atrial tachycardias by invasive mapping and ablation: a multicenter study

OBJECTIVES This study prospectively evaluated the role of a novel 3-dimensional, noninvasive, beat-by-beat mapping system, Electrocardiographic Mapping (ECM), in facilitating the diagnosis of atrial tachycardias (AT). BACKGROUND Conventional 12-lead electrocardiogram, a widely used noninvasive tool in clinical arrhythmia practice, has diagnostic limitations. METHODS Various AT (de novo and post-atrial fibrillation ablation) were mapped using ECM followed by standard-of-care electrophysiological mapping and ablation in 52 patients. The ECM consisted of recording body surface electrograms from a 252-electrode-vest placed on the torso combined with computed tomography-scan-based biatrial anatomy (CardioInsight Inc., Cleveland, Ohio). We evaluated the feasibility of this system in defining the mechanism of AT-macro-re-entrant (perimitral, cavotricuspid isthmus-dependent, and roof-dependent circuits) versus centrifugal (focal-source) activation-and the location of arrhythmia in centrifugal AT. The accuracy of the noninvasive diagnosis and detection of ablation targets was evaluated vis-à-vis subsequent invasive mapping and successful ablation. RESULTS Comparison between ECM and electrophysiological diagnosis could be accomplished in 48 patients (48 AT) but was not possible in 4 patients where the AT mechanism changed to another AT (n = 1), atrial fibrillation (n = 1), or sinus rhythm (n = 2) during the electrophysiological procedure. ECM correctly diagnosed AT mechanisms in 44 of 48 (92%) AT: macro-re-entry in 23 of 27; and focal-onset with centrifugal activation in 21 of 21. The region of interest for focal AT perfectly matched in 21 of 21 (100%) AT. The 2:1 ventricular conduction and low-amplitude P waves challenged the diagnosis of 4 of 27 macro-re-entrant (perimitral) AT that can be overcome by injecting atrioventricular node blockers and signal averaging, respectively. CONCLUSIONS This prospective multicenter series shows a high success rate of ECM in accurately diagnosing the mechanism of AT and the location of focal arrhythmia. Intraprocedural use of the system and its application to atrial fibrillation mapping is under way.

Pattern and timing of the coronary sinus activation to guide rapid diagnosis of atrial tachycardia after atrial fibrillation ablation

BACKGROUND Atrial tachycardias (AT) during or after ablation of atrial fibrillation frequently pose a diagnostic challenge. We hypothesized that both the patterns and the timing of coronary sinus (CS) activation could facilitate AT mapping. METHODS AND RESULTS A total of 140 consecutive postpersistent atrial fibrillation ablation patients with sustained AT were investigated by conventional mapping. CS activation pattern was defined as chevron or reverse chevron when the activations recorded on both the proximal and the distal CS dipoles were latest or earliest, respectively. The local activation of mid-CS was timed with reference to Ppeak-Ppeak (P-P) interval in lead V1. A ratio, mid-CS activation time to AT cycle length, was computed. Of 223 diagnosed ATs, 124 were macroreentrant (56%) and 99 were centrifugal (44%). When CS activation was chevron/reverse chevron (n=44; 20%), macroreentries were mostly roof dependent. With reference to P-P interval, mid-CS activation timing showed specific consistency for peritricuspid and perimitral AT. Proximal to distal CS activation pattern and mid-CS activation at 50% to 70% of the P-P interval (n=30; 13%) diagnosed peritricuspid AT with 81% sensitivity and 89% specificity. Distal to proximal CS activation and mid-CS activation at 10% to 40% of the P-P interval (n=44; 20%) diagnosed perimitral AT with 88% sensitivity and 75% specificity. CONCLUSIONS The analysis of the patterns and timing of CS activation provides a rapid stratification of most likely macroreentrant ATs and points toward the likely origin of centrifugal ATs. It can be included in a stepwise diagnostic approach to rapidly select the most critical mapping maneuvers.

Perception of atrial fibrillation before and after radiofrequency catheter ablation: relevance of asymptomatic arrhythmia recurrence.

BACKGROUND The objective of this study was to assess the incidence and impact of asymptomatic arrhythmia in patients with highly symptomatic atrial fibrillation (AF) who qualified for radiofrequency (RF) catheter ablation. METHODS AND RESULTS In this prospective study, 114 patients with at least 3 documented AF episodes together with corresponding symptoms and an ineffective trial of at least 1 antiarrhythmic drug were selected for RF ablation. With the use of CARTO, circumferential lesions around the pulmonary veins and linear lesions at the roof of the left atrium and along the left atrial isthmus were placed. A continuous, 7-day, Holter session was recorded before ablation, right after ablation, and after 3, 6, and 12 months of follow-up. During each 7-day Holter monitoring, the patients recorded quality and duration of any complaints by using a detailed symptom log. More than 70,000 hours of ECG recording were analyzed. In the 7-day Holter records before ablation, 92 of 114 patients (81%) had documented AF episodes. All episodes were symptomatic in 35 patients (38%). In 52 patients (57%), both symptomatic and asymptomatic episodes were recorded, whereas in 5 patients (5%), all documented AF episodes were asymptomatic. After ablation, the percentage of patients with only asymptomatic AF recurrences increased to 37% (P<0.05) at the 6-month follow-up. An analysis of patient characteristics and arrhythmia patterns failed to identify a specific subset who were at high risk for the development of asymptomatic AF. CONCLUSIONS Even in patients presenting with highly symptomatic AF, asymptomatic episodes may occur and significantly increase after catheter ablation. A symptom-only-based follow-up would substantially overestimate the success rate. Objective measures such as long-term Holter monitoring are needed to identify asymptomatic AF recurrences after ablation.

Mid-term results in relation to age and analysis of predictive factors after fixation of acetabular fractures using the modified Stoppa approach.

INTRODUCTION Data concerning outcome after management of acetabular fractures by anterior approaches with focus on age and fractures associated with roof impaction, central dislocation and/or quadrilateral plate displacement are rare. METHODS Between October 2005 and April 2009 a series of 59 patients (mean age 57 years, range 13-91) with fractures involving the anterior column was treated using the modified Stoppa approach alone or for reduction of displaced iliac wing or low anterior column fractures in combination with the 1st window of the ilioinguinal approach or the modified Smith-Petersen approach, respectively. Surgical data, accuracy of reduction, clinical and radiographic outcome at mid-term and the need for endoprosthetic replacement in the postoperative course (defined as failure) were assessed; uni- and multivariate regression analysis were performed to identify independent predictive factors (e.g. age, nonanatomical reduction, acetabular roof impaction, central dislocation, quadrilateral plate displacement) for a failure. Outcome was assessed for all patients in general and in accordance to age in particular; patients were subdivided into two groups according to their age (group "<60yrs", group "≥60yrs"). RESULTS Forty-three of 59 patients (mean age 54yrs, 13-89) were available for evaluation. Of these, anatomic reduction was achieved in 72% of cases. Nonanatomical reduction was identified as being the only multivariate predictor for subsequent total hip replacement (Adjusted Hazard Ratio 23.5; p<0.01). A statistically significant higher rate of nonanatomical reduction was observed in the presence of acetabular roof impaction (p=0.01). In 16% of all patients, total hip replacement was performed and in 69% of patients with preserved hips the clinical results were excellent or good at a mean follow up of 35±10 months (range: 24-55). No statistical significant differences were observed between both groups. CONCLUSION Nonanatomical reconstruction of the articular surfaces is at risk for failure of joint-preserving management of acetabular fractures through an isolated or combined modified Stoppa approach resulting in total joint replacement at mid-term. In the elderly, joint-preserving surgery is worth considering as promising clinical and radiographic results might be obtained at mid-term.

Virtopsy--fatal motor vehicle accident with head injury.

A man wearing no protective helmet was struck by a motor vehicle while riding a bicycle. He was loaded on his left side, and the impact point of his head was his occiput on the car roof girder. He was immediately transported to the general hospital, where he passed away. Postmortem examination using multi-slice computed tomography (MSCT) revealed an extensively comminuted fracture of the posterior part and the base of the skull. Observed were deep direct and contrecoup brain bruises, with the independent fractures of the roof of the both orbits. Massive subdural and subarachnoidal hemorrhage with cerebral edema and shifting of the mid-line towards left side were also detected. MSCT and autopsy results were compared and the body injuries were correlated to vehicle damages. In conclusion, postmortem imaging is a good forensic visualization tool with great potential for documentation and examination of body injuries and pathology.

Lithothamnion Prolifer Foslie: A Common Non-Geniculate Coralline Alga (Rhodophyta: Corallinaceae) from the Tropical and Subtropical Indo-Pacific

A little-known, but ecologically important non-geniculate coralline, Lithothamnion prolifer, is recorded from a number of tropical Indo-Pacific sites, including Fiji, Australia, Kiribati and Indonesia. The species occurs primarily on vertical walls of caves and overhangs in Fiji and Australia, but was also found as rhodoliths in Kiribati. Lithothamnion prolifer is characterized by the combination of characters which follow. The thallus is extremely glossy, smooth, and rosy coloured. Thalli usually produce complanate protuberances, but protuberances become terete when growing on well lit, horizontal substrata, when unattached, or when growing on loose substrata. Conceptacles occur mainly on the tips of protuberances, and tetra/bisporangial conceptacles are large (to 1300 mu m external diameter, with chambers up to 1100 mu m diameter). The tetra/bisporangial conceptacles are flush or only slightly raised, and often extensive and irregularly shaped (resembling small sori). They lack a raised rim, and have flattened pore plates. The rosette cells surrounding the tetra/bisporangial pore appear somewhat sunken below the surrounding roof cells in SEM, and the cells of filaments lining the pore canals of tetra/bisporangial conceptacles do not differ from the cells of filaments making up the rest of the roof. Old conceptacles persist and become buried in the thallus, and are then usually completely filled in by irregularly arranged calcified cells.

Functional analysis of BMP4 signaling in mouse neural development

During early mouse neural development, bone morphogenetic protein (BMP) signaling patterns the dorsal neural tube and defines distinct neural progenitor cell domains along the dorsoventral axis. Unlike the ventral signaling molecule Sonic hedgehog, which has long-range activity by establishing a concentration gradient in the ventral neural tube, these dorsally expressed BMPs appear to have a limited domain of action. This raises questions as to how BMP activity is restricted locally and how restricted BMP signaling directs dorsal neural patterning and differentiation. I hypothesize that BMPs are restricted in the dorsal neural tube for correct dorsoventral patterning. ^ Previous studies have shown that the positively charged basic amino acids located at the N-terminus of several BMPs are essential for heparin binding and diffusion. This provides a novel tool to address these questions. Here I adapted a UAS/GAL4 bigenic mouse system to control the ectopic expression of BMP4 and a mutant form of BMP4 that lacks a subset of the N-terminal basic amino acids. The target genes, UAS-Bmp4 and UAS-mBmp4 , were introduced into the Hprt locus by gene targeting in mouse embryonic stem cells. The expression of the GAL4 transactivator was driven by a roof plate specific Wnt1 promoter. ^ The bigenic mouse embryos exhibit phenotype variations, ranging from mid/hindbrain defects, hemorrhage, and eye abnormalities to vasculture formation. Embryonic death starts around E11.5 because of severe hemorrhage. The different expression levels of the activated transgene may account for the phenotype variation. Further marker analysis reveals that mutant BMP4 induces ectopic expression of the dorsal markers MSX1/2 and PAX7 in the ventral neural tube. In addition, the expression of the ventral neural marker NKX2.2 is affected by the expanded BMP4 activity, indicating that ectopic BMP signaling can antagonize ventral signaling. Comparison of the phenotypes of the Wnt1/ Bmp4 and Wnt1/mBmp4 bigenic embryos that express transgenes at the same level, respectively, shows that mutant BMP4 causes the expansion of dorsal neural fates ventrally while wild type BMP4 does not, suggesting that mutant BMP4 acts farther than wild type BMP4. Together, these data suggest that the N-terminus basic amino acid core controls BMP4 long-range activity in neural development, and that BMP signaling patterns the dorsal neural tube through a secondary signaling pathway that involves homeodomain transcription factors MSX1/2 and PAX7. ^

Understanding and Fostering Family Resilience

This paper examines a model of resilience and provides a fictional case example from the classical musical, Fiddler on the Roof along with a discussion of how this model may be helpful in assisting families at various levels of functioning to bounce back and perhaps even experience growth through facing difficult challenges.