The Effect of the No-Passing Zone Sign on "Passing" Accidents, 1963

The No Passing Zone sign (Wl0-4) was designed in 1958 for the purpose of informing the driver contemplating a passing maneuver of hazardous sight conditions ahead. This warning sign, of pennent shape design, was placed on the left side of the road so as to be more conspicuous to the intended driver. During the two year period 1959-1960, the Wl0-4 signs were erected throughout the Iowa Primary Road System.

Iowa Study of No Passing Zone Signing, 1962

This report is compiled from data gathered by interviewing motorists to sample their opinion of Iowa's method of supplementing the yellow barrier line pavement marking of no passing zones on primary highways with yellow pennant shaped "No Passing Zone" signs mounted on the left shoulder of the highway. The effective designation of no passing zones is one form of control that can contribute to a reduction in the number of fatal high-speed head-on collisions resulting from passing in areas which do not afford sufficient sight distance of approaching traffic. It is the purpose of this report to present an evaluation of the Iowa "No Passing Zone" sign by individuals from all states who have traveled on Iowa's primary highways and who must obey the no passing zone restrictions and be warned by this sign of the presence of the zones. The "No Passing Zone" sign was formulated and approved by the Governor's Safety Committee a short time prior to the experimental erection of the signs. The Governor's Safety Committee adopted this sign as they felt that such a sign should be distinctive (not similar to any other type of sign) and easily visible to a driver attempting a passing maneuver.

Differential diagnosis of leukocoria and strabismus, first presenting signs of retinoblastoma.

Leukocoria in infants is always a danger signal as retinoblastoma, a malignant retinal tumor, is responsible for half of the cases in this age group. More common signs should also be considered suspicious until proved otherwise, such as strabismus, the second most frequent sign of retinoblastoma. Less frequent manifestations are inflammatory conditions resistant to treatment, hypopyon, orbital cellulitis, hyphema or heterochromia. Other causal pathologies, including persistent hyperplastic primary vitreous (PHPV), Coats' disease, ocular toxocariasis or retinopathy of prematurity, may also manifest the same warning signs and require specialized differential diagnosis. Members of the immediate family circle are most likely to notice the first signs, the general practitioner, pediatrician or general ophthalmologist the first to be consulted. On their attitude will depend the final outcome of this vision and life-threatening disease. Early diagnosis is vital.

Comment explorer une exophtalmie? [How to investigate a patient with exophthalmos?]

Exophthalmos is the main symptom revealing orbital masses. This sign needs to be imaged mainly by MRI and/or CT. As Graves disease is the main etiology of exophthalmos, CT scan should be performed as the initial imaging modality. Indications for US and Doppler are mostly limited to the study of ocular masses, and eventually may help the characterization of extra-ocular lesions. In all cases, imaging is useful to characterize: the precise location of the lesion which can be the intra-conal space (including muscles), the extra-conal space (associated or not to an extra-orbital lesion), or the eyeball; the features of the lesion (density, signal, enhancement.). These findings are used to generate a differential diagnosis. Imaging is also useful to precise the extension of the mass, and in some cases to select the appropriate surgical approach, and for follow-up.

Estimativa amostral objetiva de área plantada regional, apoiada em imagens de sensoriamento remoto

O objetivo deste trabalho foi desenvolver e avaliar um método para estimar a área plantada de soja em escala regional e calcular o erro estatístico associado à estimação. O método (Geosafras), que associa técnicas de amostragem estatística com características das imagens obtidas por sensoriamento remoto orbital, foi aplicado para obter estimativa amostral objetiva da área cultivada com soja, na safra de 2005/2006, no Estado do Rio Grande do Sul. Os municípios produtores de soja, no RS, foram distribuídos em dez estratos, com base em dados pré‑existentes de área cultivada com a cultura. O número de municípios selecionados, em cada estrato, seguiu a regra de alocação de Neyman. Em cada município selecionado, foram aleatorizados pontos correspondentes aos pixels das imagens, classificados como "soja" ou "não soja" após visita a campo. A partir dos dados de 3.000 pontos distribuídos nos 30 municípios selecionados, nos dez estratos, foi estimada a área cultivada com soja no RS, que totalizou 4.069.887 ha, com coeficiente de variação (CV) de 3,4%. Esta estimativa foi consistente com os dados oficiais. O método amostral objetivo estratificado, auxiliado por sensoriamento remoto, permite estimar a área cultivada com soja no Rio Grande do Sul e é capaz de quantificar o erro associado à estimativa realizada.

Impact of enhanced compliance initiatives on the efficacy of rosuvastatin in reducing low density lipoprotein cholesterol levels in patients with primary hypercholesterolaemia.

The effectiveness of lipid-lowering medication critically depends on the patients' compliance and the efficacy of the prescribed drug. The primary objective of this multicentre study was to compare the efficacy of rosuvastatin with or without access to compliance initiatives, in bringing patients to the Joint European Task Force's (1998) recommended low-density lipoprotein cholesterol (LDL-C) level goal (LDL-C, <3.0 mmol/L) at week 24. Secondary objectives were comparison of the number and percentage of patients achieving European goals (1998, 2003) for LDL-C and other lipid parameters. Patients with primary hypercholesterolaemia and a 10-year coronary heart disease risk of >20% received open label rosuvastatin treatment for 24 weeks with or without access to compliance enhancement tools. The initial daily dosage of 10 mg could be doubled at week 12. Compliance tools included: a) a starter pack for subjects containing a videotape, an educational leaflet, a passport/goal diary and details of the helpline and/or website; b) regular personalised letters to provide message reinforcement; c) a toll-free helpline and a website. The majority of patients (67%) achieved the 1998 European goal for LDL-C at week 24. 31% required an increase in dosage of rosuvastatin to 20 mg at week 12. Compliance enhancement tools did not increase the number of patients achieving either the 1998 or the 2003 European target for plasma lipids. Rosuvastatin was well tolerated during this study. The safety profile was comparable with other drugs of the same class. 63 patients in the 10 mg group and 58 in the 10 mg Plus group discontinued treatment. The main reasons for discontinuation were adverse events (39 patients in the 10 mg group; 35 patients in the 10 mg Plus group) and loss to follow-up (13 patients in the 10 mg group; 9 patients in the 10 mg Plus group). The two most frequently reported adverse events were myalgia (34 patients, 3% respectively) and back pain (23 patients, 2% respectively). The overall rate of temporary or permanent study discontinuation due to adverse events was 9% (n = 101) in patients receiving 10 mg rosuvastatin and 3% (n = 9) in patients titrated up to 20 mg rosuvastatin. Rosuvastatin was effective in lowering LDL-C values in patients with hypercholesterolaemia to the 1998 European target at week 24. However, compliance enhancement tools did not increase the number of patients achieving any European targets for plasma lipids.

A proposal for an international retinoblastoma staging system.

BACKGROUND: Although intra-retinal tumor has long been staged presurgically according to the Reese-Ellsworth (R-E) system, retinoblastoma differs from other pediatric neoplasms in never having had a widely accepted classification system that encompasses the entire spectrum of the disease. Comparisons among studies that consider disease extension, risk factors for extra-ocular relapse, and response to therapy require a universally accepted staging system for extra-ocular disease. PROCEDURE: A committee of retinoblastoma experts from large centers worldwide has developed a consensus classification that can encompass all retinoblastoma cases and is presented herein. Patients are classified according to extent of disease and the presence of overt extra-ocular extension. In addition, a proposal for substaging considering histopathological features of enucleated specimens is presented to further discriminate between Stage I and II patients. RESULTS: The following is a summary of the classification system developed-Stage 0: Patients treated conservatively (subject to presurgical ophthalmologic classifications); Stage I: Eye enucleated, completely resected histologically; Stage II: Eye enucleated, microscopic residual tumor; Stage III: Regional extension [(a) overt orbital disease, (b) preauricular or cervical lymph node extension]; Stage IV: Metastatic disease [(a) hematogenous metastasis: (1) single lesion, (2) multiple lesions; (b) CNS extension: (1) prechiasmatic lesion, (2) CNS mass, (3) leptomeningeal disease]. A proposal is also presented for substaging of enucleated Stages I and II eyes. CONCLUSIONS: The proposed staging system is the product of an international effort to adopt a uniform staging system for patients with retinoblastoma to cover the whole spectrum of the disease.

Computer-aided volume measurement of posttraumatic orbits reconstructed with AO titanium mesh plates: accuracy and reliability

PURPOSE: To prospectively evaluate the accuracy and reliability of "freehand" posttraumatic orbital wall reconstruction with AO (Arbeitsgemeinschaft Osteosynthese) titanium mesh plates by using computer-aided volumetric measurement of the bony orbits. METHODS: Bony orbital volume was measured in 12 patients from coronal CT scan slices using OsiriX Medical Image software. After defining the volumetric limits of the orbit, the segmentation of the bony orbital region of interest of each single slice was performed. At the end of the segmentation process, all regions of interest were grouped and the volume was computed. The same procedure was performed on both orbits, and thereafter the volume of the contralateral uninjured orbit was used as a control for comparison. RESULTS: In all patients, the volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 1.85 cm3 (7%). CONCLUSIONS: This preliminary study has demonstrated that posttraumatic orbital wall reconstruction using "freehand" bending and placement of AO titanium mesh plates results in a high success rate in re-establishing preoperative bony volume, which closely approximates that of the contralateral uninjured orbit.

Percutaneous Endovascular Salvage Techniques for Implanted Venous Access Device Dysfunction.

PURPOSE: Implanted venous access devices (IVADs) are often used in patients who require long-term intravenous drug administration. The most common causes of device dysfunction include occlusion by fibrin sheath and/or catheter adherence to the vessel wall. We present percutaneous endovascular salvage techniques to restore function in occluded catheters. The aim of this study was to evaluate the feasibility, safety, and efficacy of these techniques. METHODS AND MATERIALS: Through a femoral or brachial venous access, a snare is used to remove fibrin sheath around the IVAD catheter tip. If device dysfunction is caused by catheter adherences to the vessel wall, a new "mechanical adhesiolysis" maneuver was performed. IVAD salvage procedures performed between 2005 and 2013 were analyzed. Data included clinical background, catheter tip position, success rate, recurrence, and rate of complication. RESULTS: Eighty-eight salvage procedures were performed in 80 patients, mostly women (52.5 %), with a mean age of 54 years. Only a minority (17.5 %) of evaluated catheters were located at an optimal position (i.e., cavoatrial junction ±1 cm). Mechanical adhesiolysis or other additional maneuvers were used in 21 cases (24 %). Overall technical success rate was 93.2 %. Malposition and/or vessel wall adherences were the main cause of technical failure. No complications were noted. CONCLUSION: These IVAD salvage techniques are safe and efficient. When a catheter is adherent to the vessel wall, mechanical adhesiolysis maneuvers allow catheter mobilization and a greater success rate with no additional risk. In patients who still require long-term use of their IVAD, these procedures can be performed safely to avoid catheter replacement.

Spectral energy distribution of the gamma-ray microquasar LS 5039

The microquasar LS 5039 has recently been detected as a source of very high energy (VHE) $\gamma$-rays. This detection, that confirms the previously proposed association of LS 5039 with the EGRET source 3EG~J1824$-$1514, makes of LS 5039 a special system with observational data covering nearly all the electromagnetic spectrum. In order to reproduce the observed spectrum of LS 5039, from radio to VHE $\gamma$-rays, we have applied a cold matter dominated jet model that takes into account accretion variability, the jet magnetic field, particle acceleration, adiabatic and radiative losses, microscopic energy conservation in the jet, and pair creation and absorption due to the external photon fields, as well as the emission from the first generation of secondaries. The radiative processes taken into account are synchrotron, relativistic Bremsstrahlung and inverse Compton (IC). The model is based on a scenario that has been characterized with recent observational results, concerning the orbital parameters, the orbital variability at X-rays and the nature of the compact object. The computed spectral energy distribution (SED) shows a good agreement with the available observational data.

Mekanisoidun hitsauksen käyttö ydinvoimalaitoksella

Diplomityössä päätavoitteena oli selvittää kuinka mekanisointia voitaisiin hyödyntää Fortum Power & Heat Oy:n Loviisan voimalaitoksen hitsauksissa. Työn osatavoitteisiin kuului mm. tutkia saadaanko mekanisoinnin käytön seurauksena parannettua laatua pienennettyä säteilyannoksia tai kustannuksia. Käytännön esimerkkinä oli pääkiertopumpun pesän tiivistepinnan korjaushitsaus. Teoriaosuus käsittelee nykyaikaisia hitsausmenetelmiä sekä hitsauksen mekanisoinnista ja automatisoinnista saatavia etuja. Käytännön osuudessa käytiin läpi Loviisan voimalaitoksen mekanisoidun hitsauksen historia ja hitsauksen nykytila ja tulevaisuus. Tulevaisuuden tarkastelussa kartoitettiin kohteita missä mekanisoinnin käytöstä saataisiin hyötyä ja mietittiin miten kyseinen kohteen mekanisointi voitaisiin toteuttaa. Tarkastelujen perusteella Loviisan voimalaitokselta löytyi kolme kohdetta, jossa hitsauksen mekanisointi olisi järkevä toteuttaa tavoitteiden puitteissa. Mekanisoitavissa olevat kohteet olivat putkiston hitsaus, suurien säiliöiden vuorauksien hitsaus ja suurien tiivistepintojen pinnoitushitsaus. Pääkiertopumpun pesän tiivistepinnan hitsaukselle löydettiin kolme laitteistovaihtoehtoa, joiden pohjalta lopullinen päätös voidaan tehdä.

Thoracocervicofacial Emphysema after Heimlich's Maneuvre.

We report an extremely rare example of a thoracocervicofacial subcutaneous emphysema after Heimlich maneuver case.

Long-term X-ray variability of the microquasar system LS5039/RX J1826.2-1450

We report on the results of the spectral and timing analysis of a BeppoSAX observation of the microquasar system LS 5039/RX J1826.2-1450. The source was found in a low-flux state with Fx(1-10 keV)= 4.7 x 10^{-12} erg cm^{-2} s^{-1}, which represents almost one order of magnitude lower than a previous RXTE observation 2.5 years before. The 0.1--10 keV spectrum is described by an absorbed power-law continuum with photon-number spectral index Gamma=1.8+-0.2 and hydrogen column density of NH=1.0^{+0.4}_{-0.3} x 10^{22} cm^{-2}. According to the orbital parameters of the system the BeppoSAX observation covers the time of an X-ray eclipse should one occur. However, the 1.6-10 keV light curve does not show evidence for such an event, which allows us to give an upper limit to the inclination of the system. The low X-ray flux detected during this observation is interpreted as a decrease in the mass accretion rate onto the compact object due to a decrease in the mass-loss rate from the primary.

Investigating ferromagnetism and charge order in Bi1-xSrxMnO3(x<0.3)ceramic oxides.

The possible coexistence of ferromagnetism and charge/orbital order in Bi3/4Sr1/4MnO3 has been investigated. The manganite Bi0.75Sr0.25MnO3, with commensurate charge balance, undergoes an electronic transition at TCO~600 K that produces a longrange modulation with double periodicity along a and c axis, and unusual anisotropic evolution of the lattice parameters. The previously proposed ferromagnetic properties of this new ordered phase were studied by magnetometry and diffraction techniques. In zero field the magnetic structure is globally antiferromagnetic, ruling out the apparition of spontaneous ferromagnetism. However, the application of magnetic fields produces a continuous progressive canting of the moments, inducing a ferromagnetic phase even for relatively small fields (H<<1 T). Application of pulsed high fields produces a remarkable and reversible spin polarization (under 30 T, the ferromagnetic moment is ~3 ¿B/Mn, without any sign of charge order melting). The coexistence of ferromagnetism and charge order at low and very-high fields is a remarkable property of this system.

Dopplervelocimetria colorida dos vasos orbitais: técnica de exame e anatomia vascular normal

A dopplervelocimetria colorida é uma modalidade do exame ultra-sonográfico que se expandiu rapidamente em todas as áreas da medicina, em virtude da sua riqueza de informações. A dopplervelocimetria colorida das artérias orbitais tem sido empregada no auxílio diagnóstico de doenças oftalmológicas, bem como para o estudo de doenças específicas como a pré-eclâmpsia. O objetivo deste estudo é descrever a anatomia normal da região orbital e detalhar a técnica de exame dopplervelocimétrico colorido, tendo em vista ser este um exame acessível e reprodutível. Acreditamos que surgirão novas aplicações deste método, que deverá ser inserido na prática diária do radiologista, visando à melhoria da qualidade do diagnóstico e seguimento das doenças oculares e sistêmicas.