Does this child have a foreign body aspiration?

Context: Foreign body aspiration (FbA) is a serious problem in children. Accurate clinical and radiographic diagnosis is important because missed or delayed diagnosis can result in respiratory difficulties ranging from life-treatening airway obstruction to chronic wheezing or recurrent pneumonia. Bronchoscopy also has risks and accurate clinical and radiographc diagnosis can support the decision of bronchoscopy. Objective: To rewiev the diagnostic accuracy of clinical presentation (CP) and pulmonary radiograph (PR) for the diagnosis of FbA. There is no previous rewievMethods: A search of Medline is conducted for articles containing data regarding CP and PR signes of FbA. Calculation of likelihood ratios (LR) and pre and post test probability using Bayes theorem were performed for all signs of CP and PR. Inclusion criteria: Articles containing prospective data regarding CP and PR of FbA. Exclusion criteria: Retrospectives studies. Articles containing incomplete data for calculation of LR. Results: Five prospectives studies are included with a total of 585 patients. Prevalence of FbA is 63% in children suspected of FbA. If CP is normal, probability of FbA is 25% and if PR is normal, probability is 14%. If CP is pathologic, probability of FbA is 69-76% with presence of cough (LR = 1.32) or dyspnea (LR = 1.84) or localized crackles (LR = 1.5). Probability is 81-88% if cyanosis (LR = 4.8) or decreased breaths sounds (LR = 4.3) or asymetric auscultation (LR = 2.9) or localized wheezing (LR = 2.5) are present. When CP is anormal and PR show mediatinal shift (LR = 100), pneumomediatin (LR = 100), radio opaque foreign body (LR = 100), lobar distention (LR = 4), atelectasis (LR = 2.5), inspiratory/expiratory abnormal (LR = 7), the probability of FbA is 96-100%. If CP is normal and PR is abnormal the probability is 40-100%. If CP is abnormal and PR is normal the probability is 55-75%. Conclusions: This rewiev of prospective studies demonstrates the importance of CP and PR and an algorithm can be proposed. When CP is abnormal with or without PR pathologic, the probability of FbA is high and bronchoscopy is indicated. When CP and PR are normal the probability of FbA is low and bronchoscopy is not necessary immediatly, observation should be proposed. This approach should be validated with prospective study.

Task 6: Material Thermal Input for Iowa Materials, May 2008

The present research project was designed to determine thermal properties, such as coefficient of thermal expansion (CTE) and thermal conductivity, of Iowa concrete pavement materials. These properties are required as input values by the Mechanistic-Empirical Pavement Design Guide (MEPDG). In this project, a literature review was conducted to determine the factors that affect thermal properties of concrete and the existing prediction equations for CTE and thermal conductivity of concrete. CTE tests were performed on various lab and field samples of portland cement concrete (PCC) at the Iowa Department of Transportation and Iowa State University. The variations due to the test procedure, the equipment used, and the consistency of field batch materials were evaluated. The test results showed that the CTE variations due to test procedure and batch consistency were less than 5%, and the variation due to the different equipment was less than 15%. Concrete CTE values were significantly affected by different types of coarse aggregate. The CTE values of Iowa concrete made with limestone+graval, quartzite, dolomite, limestone+dolomite, and limestone were 7.27, 6.86, 6.68, 5.83, and 5.69 microstrain/oF (13.08, 12.35, 12.03, 10.50, and 10.25 microstrain/oC), respectively, which were all higher than the default value of 5.50 microstrain/oF in the MEPDG program. The thermal conductivity of a typical Iowa PCC mix and an asphalt cement concrete (ACC) mix (both with limestone as coarse aggregate) were tested at Concrete Technology Laboratory in Skokie, Illinois. The thermal conductivity was 0.77 Btu/hr•ft•oF (1.33 W/m•K) for PCC and 1.21 Btu/hr•ft•oF (2.09 W/m•K) for ACC, which are different from the default values (1.25 Btu/hr•ft•oF or 2.16 W/m•K for PCC and 0.67 Btu/hr•ft•oF or 1.16 W/m•K for ACC) in the MEPDG program. The investigations onto the CTE of ACC and the effects of concrete materials (such as cementitious material and aggregate types) and mix proportions on concrete thermal conductivity are recommended to be considered in future studies.

Foreign trade traps in the european periphery: Spain, 1870-1913

In this article we research into the difficulties that foreign trade imposed onSpanish process of integration into the international economy in the years priorto the First World War. We start out by examining some features of the foreigntrade structure of the country. By means of an econometric analysis of importand export series, it is possible to observe the presence of a trend towards tradedeficit, which was in force when Spain grew at a rate similar to that of itstrading partners. We also check that, in the absence of these compensatorymechanisms, adjustment in foreign payments could be reached by means ofprotective measures and the exchange rate.

Material Thermal Inputs of Iowa Materials for MEPDG, 2011

The thermal properties of concrete materials, such as coeffi cient of thermal expansion (CTE), thermal conductivity, and heat capacity, are required by the MEPDG program as the material inputs for pavement design. However, a limited amount of test data is available on the thermal properties of concrete in Iowa. The default values provided by the MEPDG program may not be suitable for Iowa concrete, since aggregate characteristics have signifi cant infl uence on concrete thermal properties.

A two-level analysis of the determinants of direct democratic choices in European, immigration and foreign policy in Switzerland

This article employs a unique data set - covering 25 popular votes on foreign, European and immigration/asylum policy held between 1992 and 2006 in Switzerland - in order to examine the conditional impact of context upon utilitarian, cultural, political and cognitive determinants of individual attitudes toward international openness. Our results reveal clear patterns of cross-level interactions between individual determinants and the project-related context of the vote. Thus, although party cues and political competence have a strong impact on individuals' support for international openness, this impact is substantially mediated by the type of coalition that is operating within the party elite. Similarly, subjective utilitarian and cultural considerations influence the voters' decision in interaction with the content of the proposal submitted to the voters as well as with the framing of the voting campaign.

Foreign migrations and new couples in Spain. Nuptiality and Gender Imbalance in the new century

Nuptiality is not a central item in Migration Research now. In the past, especially for American countries, many scholars were really interested in marriages of immigrants, specially knowing the exchanges between different communities; that is, mixed marriages. Here is the Spanish case in nuptiality between foreign and local people.

Reflexiones en torno a la cultura material. nuevas aproximaciones

Para cualquier arqueólogo, la cultura material representa la base de toda investigación ya que es la documentación prioritaria sobre la cual construye sus teorías e interpretaciones. En los últimos años, algunos antropólogos como Appadurai o Kopitoff han propuesto una nueva lectura de cómo analizar la cultura material en el ámbito de la etnografía. Algunas de sus propuestas, debidamente adaptadas, permiten una reflexión más amplia sobre el estudio de la cultura material, que proponemos aquí.

Cela Espín, X. i Revilla Calvo, V., Annexos de Jaume Buxeda i Garrigós i Miquel Ângel Cau Ontiveros; Mariana Pérez-Sala i Rodés; Eva Orri Terrado i Alicia Estrada Martín.: La transició del municipium d'Iluro a Alarona (Mataró). Cultura material i transformacions d"un espai urbà entre els segles V i VII dC. Laietania, 15, 2004

Aquest llibre reuneix un estudi arqueològic extraordinàriament acurat referit a tot un seguit d'actuacions detectades a partir del registre arqueològic, que caracteritzen l'espai urbà de l'antiga Iluro durant el període de l'Antiguitat tardana. S'hi estudia amb molt deteniment cadascuna de les accions detectades -així com tot el mobiliari ceràmic relacionat- amb la finalitat de situar-les correctament en el temps, però també per entendre, a través de la cultura material, la dinàmica que pren la ciutat a les darreries de l'Antiguitat; per a poder intuir, més que saber, quina societat es desenvolupa darrere d¿aquests contenidors plens de productes alimentaris arribats d¿un ultramar llunyà i alhora molt proper; una societat capaç de respondre a l¿estímul exterior amb una producció pròpia que competirà o substituirà una gran part de la que ve de fora.

The total material requirement -concept applied to agriculture : a case study from Finland

Selostus: Luonnonvarojen kokonaiskäyttö sovellettuna maatalouteen: esimerkki Suomesta

Role of rifampin against Propionibacterium acnes biofilm in vitro and in an experimental foreign-body infection model.

Propionibacterium acnes is an important cause of orthopedic-implant-associated infections, for which the optimal treatment has not yet been determined. We investigated the activity of rifampin, alone and in combination, against planktonic and biofilm P. acnes in vitro and in a foreign-body infection model. The MIC and the minimal bactericidal concentration (MBC) were 0.007 and 4 μg/ml for rifampin, 1 and 4 μg/ml for daptomycin, 1 and 8 μg/ml for vancomycin, 1 and 2 μg/ml for levofloxacin, 0.03 and 16 μg/ml for penicillin G, 0.125 and 512 μg/ml for clindamycin, and 0.25 and 32 μg/ml for ceftriaxone. The P. acnes minimal biofilm eradication concentration (MBEC) was 16 μg/ml for rifampin; 32 μg/ml for penicillin G; 64 μg/ml for daptomycin and ceftriaxone; and ≥128 μg/ml for levofloxacin, vancomycin, and clindamycin. In the animal model, implants were infected by injection of 10⁹ CFU P. acnes in cages. Antimicrobial activity on P. acnes was investigated in the cage fluid (planktonic form) and on explanted cages (biofilm form). The cure rates were 4% for daptomycin, 17% for vancomycin, 0% for levofloxacin, and 36% for rifampin. Rifampin cured 63% of the infected cages in combination with daptomycin, 46% with vancomycin, and 25% with levofloxacin. While all tested antimicrobials showed good activity against planktonic P. acnes, for eradication of biofilms, rifampin was needed. In combination with rifampin, daptomycin showed higher cure rates than with vancomycin in this foreign-body infection model.

Monitoring detrital input and resuspension effects on sediment trap material using mineralogy and stable isotopes (δ18O and δ13C): the case of Lake Neuchatel (Switzerland)

Isotopic analyses on bulk carbonates are considered a useful tool for palaeoclimatic reconstruction assuming calcite precipitation occurring at oxygen isotope equilibrium with local water and detrital carbonate input being absent or insignificant. We present results from Lake Neuchatel (western Switzerland) that demonstrate equilibrium precipitation of calcite, except during high productivity periods, and the presence of detrital and resuspended calcite. Mineralogy, geochemistry and stable isotope values of Lake Neuchatel trap sediments and adjacent rivers suspension were studied. Mineralogy of suspended matter in the major inflowing rivers documents an important contribution of detrital carbonates, predominantly calcite with minor amounts of dolomite and ankerite. Using mineralogical data, the quantity of allochthonous calcite can be estimated by comparing the ratio ankerite + dolomite/calcite + ankerite + dolomite in the inflowing rivers and in the traps. Material taken from sediment traps shows an evolution from practically pure endogenic calcite in summer (10-20% detrital material) to higher percentages of detrital material in winter (up to 20-40%). Reflecting these mineralogical variations, delta(13)C and delta(18)O values of calcite from sediment traps are more negative in summer than in winter times. Since no significant variations in isotopic composition of lake water were detected over one year, factors controlling oxygen isotopic composition of calcite in sediment traps are the precipitation temperature, and the percentage of resuspended and detrital calcite. Samples taken close to the river inflow generally have higher delta values than the others, confirming detrital influence. SEM and isotopic studies on different size fractions (<2, 2-6, 6-20, 20-60, >60 mu m) of winter and summer samples allowed the recognition of resuspension and to separate new endogenic calcite from detrital calcite. Fractions >60 and (2 mu m have the highest percentage of detritus, Fractions 2-6 and 6-20 mu m are typical for the new endogenic calcite in summer, as given by calculations assuming isotopic equilibrium with local water. In winter such fractions show similar values than in summer, indicating resuspension. Using the isotopic composition of sediment traps material and of different size fractions, as well as the isotopic composition of lake water, the water temperature measurements and mineralogy, we re-evaluated the bulk carbonate potential for palaeoclimatic reconstruction in the presence of detrital and re-suspended calcite. This re-evaluation leads to the following conclusion: (1) the endogenic signal can be amplified by applying a particle-size separation, once the size of endogenic calcite is known from SEM study; (2) resuspended calcite does not alter the endogenic signal, but it lowers the time resolution; (3) detrital input decreases at increasing distances from the source, and it modifies the isotopic signal only when very abundant; (4) influence of detrital calcite on bulk sediment isotopic composition can be calculated. (C) 1998 Elsevier Science B.V. All rights reserved.