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Resources @ A to Z
- Handprint Turkey Poem Printables – Use this printable for creating a cute handprint craft keepsake for Thanksgiving.
- First Thanksgiving Storytelling Bracelet Printable – Make a bracelet to retell the story of the First Thanksgiving.
- Turkey Glyph
- Turkey Alphabetization Worksheet -Put the Thanksgiving holiday food words in order and write the words on the lines.
- Thanksgiving Writing Practice – Writing practice for Thanksgiving. I am thankful for…
- Thanksgiving Newsletter Template
A newsletter template to fill in with your own details.
- Turkey Tracing Practice
- Turkey Number Tracing 1-10
- Turkey Letter Tracing Practice – Lowercase & Uppercase
- Thanksgiving Alphabet Turkeys
- Turkey Number Cards 1 to 30
- Turkey Number Tracing 1 to 10
- Turkey Color By Number
- Turkey Nameplates / Desk Tags
- Turkey Coloring Sheet
- Turkey Cutting Practice
- Blank Turkey– blank turkey coloring page/shape book cover
- I’m Not a Turkey Coloring Page
- Thanksgiving Writing Pages – large handwriting lines – 3 pages
- Thanksgiving Writing Pages – handwriting lines
- Thanksgiving Writing Pages – regular lines – 3 pages
- Turkey Coloring Page
Thanksgiving Teaching Ideas – Little Giraffes
Several pages of photos and activities for a Thanksgiving theme. These ideas mainly deal with turkeys:
- Turkeys and Thanksgiving Songs and Poems
- Turkeys and Thanksgiving Class Books and Literacy Activities
- Thanksgiving Turkey Arts and Craft Activities
- Thanksgiving Math, Science, and Social Studies Activities
- Thanksgiving Bulletin Boards, Recipes, and Classroom Feast Ideas
Why we are thankful for what we have and what makes us thankful. Grade Level(s): K
Students create their own quilt square showing what they are thankful for and assemble into a class quilt.
Thanksgiving : The Mayflower
Students will be able to identify what a pilgrim is and what it was like to travel on The Mayflower. Grades: 1-2
Group Turkey Wreath
Students help make a classroom Thanksgiving decoration using fine motor skills–cutting & rolling–to create paper curls. Grade: Preschool
Resources @ Other Sites
A collection of printable coloring pages and worksheets.
Thanksgiving Writing Craftivity Create a Cute Turkey with a “Thankful Pilgrim Hat” to go with one of two writing prompts.
Thanksgiving Turkey Crafts
Learning turkeys, paper plate turkeys, turkey wreath, fingerprint turkeys, handprint turkeys, and more.
Thanksgiving Theme Unit
Lessons: Thanksgiving KWL, Thankful Thoughts, Native American Culture; A Closer Look, Who Were the “Pilgrims?,” Thanksgiving Day 1621; What Really Happened? – also contains other activities & literature selections. Grade Level(s): 3-5
Hedgie Makes a Thanksgiving Apple Pie
Coloring Page by Jan Brett
Thanksgiving Word Puzzle
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sáb., 22 de jul.|
Project Based Learning - 101 - Online
Projects are a wonderful learning tool and allow for learners to be protagonists of their own learning process.
Horário e local
22 de jul. 10:00 – 12:00 BRT
Sobre o evento
Projects are a wonderful learning tool and allow for learners to be protagonists of their own learning process. It's implementation, however, may not be that obvious, especially because many times teachers didn't have the opportunity of experiencing project-based learning (PBL) in their own school years. This course aims at shedding some light at what PBL is exactly and how it can take shape in the classroom. For that, we will explore the characteristics of projects, its gold standards, and possible ways of planning PBL lessons.
Tutor? Letícia Moraes and Troika Team.
When? July 22, 2023. Fron 10pm to 12pm
How Much? Non-member - R$299,00
Public Sector Teachers - R$149,50
Troika Members - Free (according to the membership rules)
Special conditions apply for Troika Members. Become a member now!
Project Based Learning 101 | <urn:uuid:ce3f4360-bc11-469c-9a1b-242ffed5b8af> | CC-MAIN-2023-23 | https://www.troikabr.com/events/pbl-project-based-learning-101-online-2 | s3://commoncrawl/crawl-data/CC-MAIN-2023-23/segments/1685224652494.25/warc/CC-MAIN-20230606082037-20230606112037-00770.warc.gz | en | 0.916207 | 311 | 2.765625 | 3 |
Did you know that by 2025, the market for CNC machines will reach over 100.9 billion globally? Several industries have incorporated CNC machining into their process of production. This is because CNC machines increase production by using them. In contrast to manually operated machinery, it also allows for a wider range of applications. In this article, we’ll discuss everything you should know about CNC machines, including the definition of CNC machines, types of CNC machines, and how to use a CNC machine.
What Is A CNC Machine?
CNC stands for Computer Numeric Control. A CNC machine is an automated manufacturing technique that allows for fast efficient and repetitive CNC cutting, CNC drilling, CNC machining, and fabricating of material by Computer Controlled devices. A CNC machine consists of a mini or microcomputer that acts as a controller of the machine. All cutting processes are carried out by a range of complex machining tools that are directed by instructions fed into the computer. Once a part has been designed and instructions for machining it has been written a CNC machine is programmed with those instructions, the raw material is fed into the machine, the setup is completed and the computer does everything else rotating the part, cutting off various layers, drilling holes, even changing cutting bits automatically. Identical parts can be machined over and over with little or no variants the basis of each CNC project is a 2D or 3D cad drawing which is translated into the computer code for the CNC machine to execute. CNC machines are designed to be very accurate, they are programmed to carry out dimensional tasks as specified similar to robots.
What Are The Different Types Of CNC Machines?
Some common types of CNC machines include the CNC milling machines, CNC lathes, CNC routers, CNC plasma cutters, CNC laser cutters, 3D printers and pick and place machines.
To learn more about the different types of CNC machines you can visit CNCLATHING.COM as we update the news about CNC timely.
How To Use A CNC Machine?
In order to make full use of the power of a CNC machine, CNC machinists must gain skills in both programming and metal-working. In order to get a feel for how to cut metal, technical trade schools and learning programs often start students on manual lathes. It should be possible for the machinist to envision all three dimensions. Software today makes it easier than ever to create complicated components because the component shape can be virtually drawn and software can suggest tool paths to create those components.
CNC Machine Applications
CNC machines have been designed with a wide range of materials to work with. Metal, glass, plastic, wood, foam, and composites are involved in this. We have used them to produce everything from apparel to aerospace components. | <urn:uuid:43fcafd8-7169-4fd6-bb5f-731750f51404> | CC-MAIN-2021-10 | https://www.solutionhow.com/en-us/technology/what-is-a-cnc-machine-types-applications-how-to-use-a-cnc-machine/ | s3://commoncrawl/crawl-data/CC-MAIN-2021-10/segments/1614178360293.33/warc/CC-MAIN-20210228054509-20210228084509-00057.warc.gz | en | 0.94085 | 592 | 3.46875 | 3 |
Awareness Color: Lime Green
Awareness Month/Day(s): May
Mental health describes a level of psychological well-being, or an absence of a mental disorder. From the perspective of 'positive psychology' or 'holism', mental health may include an individual's ability to enjoy life, and create a balance between life activities and efforts to achieve psychological resilience. Mental health can also be defined as an expression of emotions, and as signifying a successful adaptation to a range of demands.
The World Health Organization defines mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community". It was previously stated that there was no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. There are different types of mental health problems, some of which are common, such as depression and anxiety disorders, and some not so common, such as schizophrenia and Bipolar disorder.
Most recently, the field of Global Mental Health has emerged, which has been defined as 'the area of study, research and practice that places a priority on improving mental health and achieving equity in mental health for all people worldwide'.
*Sources: From Wikipedia, http://en.wikipedia.org/wiki/Mental_health | <urn:uuid:983f1f02-9aa3-4a89-9f2d-c81ea3e1189b> | CC-MAIN-2014-41 | http://www.awarenessdepot.com/bycausetype-meheaw.html | s3://commoncrawl/crawl-data/CC-MAIN-2014-41/segments/1412037663551.47/warc/CC-MAIN-20140930004103-00354-ip-10-234-18-248.ec2.internal.warc.gz | en | 0.961585 | 300 | 3.53125 | 4 |
Are lame sheep a problem on your farm? Maybe it’s because of genetics
Health is one of the biggest costs on sheep farms, but genetics can be used to breed healthier sheep, according to Teagasc’s Noirin McHugh.
“It is difficult for management to compensate for bad genetics, if there are bad genes in a flock there will be consistent problems. One of the biggest issues the sheep industry faces is health,” she said.
McHugh spoke at the Teagasc National Sheep conference, where she said that lameness is definitely a problem in a lot of Irish sheep flocks.
“There has been a lot of health data gathered by Sheep Ireland over the last number of years. There are about 33,000 lameness records.
23% of ewes show some signs of lameness, while 19% of lambs that were looked at by Sheep Ireland had some incidences of lameness.
She said that lameness on sheep farms is relatively heritable, as it passed from parents to offspring.
McHugh said that in the future, lameness could be controlled by genetics and it may even be incorporated in breeding programmes.
“Genetics can help identify rams that have superior genetics for health. Sheep Ireland is hoping to have indexes and star ratings on health traits such as lameness in the near future,” she said.
McHugh also spoke about the current Euro-star rating system for sheep.
“There are two indexes published by Sheep Ireland. There is a terminal and a replacement index. They are an indicator of the profitability that will be generated by the rams progeny.
“Rams are classified as one of five-star ratings, with one-star rams sitting in the bottom 20% of the breed and five-star rams being in the top 20%.”
The Teagasc expert presented the results of a study which compared the performance of one-star and five-star ewes in a 100 ewe commercial flock.
She said that the five-star ewes required less labour at lambing, as fewer ewes needed assistance, compared to the one-star flock.
“The five-star flock also had a higher litter size and a lower mortality, which meant that there were more lambs to sell.
The lambs from the five-star flock were also heavier at weaning, there were just over 1kg heavier.
She said that the research also showed that the five-star ewes were lighter, which is beneficial when increasing stocking rate as more of these ewes can be kept.
“Good traits will pass on to the rams progeny, if you retain some of the subsequent ewe lambs, it will pass on to the next generation again,” she said.
The replacement index
The replacement index | <urn:uuid:7a532bf5-a641-42c2-8546-0b1967f2c56d> | CC-MAIN-2019-43 | https://www.agriland.ie/farming-news/lame-sheep-problem-farm-maybe-genetics/?utm_source=Agriland&utm_medium=also_read_section&utm_campaign=also_read_section | s3://commoncrawl/crawl-data/CC-MAIN-2019-43/segments/1570986655735.13/warc/CC-MAIN-20191015005905-20191015033405-00343.warc.gz | en | 0.969212 | 601 | 2.765625 | 3 |
Tuberculosis (TB) is an infectious disease caused by bacteria whose scientific name is Mycobacterium tuberculosis. TB most commonly affects the lungs but also can involve almost any organ of the body. Many years ago, this disease used to be called “consumption” because without effective treatment, these patients often would waste away. Today, of course, tuberculosis usually can be treated successfully with antibiotics.
There is also a group of organisms referred to as atypical tuberculosis. These involve other types of -bacteria that are in the Mycobacterium family. Often, these organisms do not cause disease and are referred to a “colonizers,” because they simply live alongside other bacteria in our bodies without causing damage. At times, these bacteria can cause an infection that sometimes appears as typical tuberculosis. | <urn:uuid:1456b2d1-c896-4e4f-8661-0055847935a1> | CC-MAIN-2019-13 | http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:tuberculosis | s3://commoncrawl/crawl-data/CC-MAIN-2019-13/segments/1552912202688.89/warc/CC-MAIN-20190322180106-20190322202106-00264.warc.gz | en | 0.965787 | 169 | 3.578125 | 4 |
If you look at a photo of leopards, would you be able to tell which two are related based on their spots?
Unless you’re a leopard expert, the answer probably isn’t, says Tanya Berger-Wolf, director of the Translational Data Analytics Institute (TDAI) at Ohio State University. But, she says, computers can.
Berger-Wolf and her team are pioneering a new field called imageomics. As the name suggests, imageomics uses machine learning to extract biological data from photos and videos of living organisms. Berger-Wolf and her team recently began collaborating with researchers studying leopards in India to compare maternal and infant spotting patterns using algorithms.
“Images have now become the most abundant source of information, and we have the technology. We have computer vision machine learning,” says Berger-Wolf. She likens this technology to the invention of the microscope, which allows scientists to look at wildlife in a completely different way.
Building on TDAI’s open source platform called game book, which allows naturalists to collect and analyze images, the team is now turning to generative AI approaches. These programs use existing content to generate meaningful data. In this case, they’re trying to analyze crowdsourced images to compute biological features that humans might naturally overlook, such as the curvature of a fish’s fin or a leopard’s spots. The algorithms scan images of leopards available online, from social media to digitized museum collections.
Simply put, the algorithms “quantify the similarity,” she says. The goal is to help naturalists solve a data shortage problem and, ultimately, better protect animals at risk of extinction.
Ecologists and other naturalists are currently facing a data crisis – it is tedious, expensive and time consuming for people to spend time in the field guarding animals. Because of these challenges, 20,054 species on the International Union for Conservation of Nature (IUCN) Red List of Endangered Species are labeled as “data defective,” meaning there is not enough information to make a good estimate of the risk of extinction. As Berger-Wolf sums it up, “biologists make decisions without having good data about what we’re losing and how quickly.”
The platform started supervised learning – Berger-Wolf says the computer uses algorithms that are “simpler than Siri” to count how many animals are in the image, as well as where it was taken and when, which could contribute to statistics such as the number of populations. AI can do this not only at a much lower cost than hiring humans, but at a faster pace. In August 2021, the platform automatically analyzed 17 million images.
There are also barriers that only a computer can seem to overcome. “People aren’t the best at figuring out what the informational aspect is,” she says, noting how people are biased in how we view nature, focusing primarily on facial features. Instead, AI can scan for features humans would likely miss, such as the color range of a tiger moth’s wings. A March 2022 study found that the human eye couldn’t distinguish male polymorphic wood tiger moth genotypes — but moth vision models with ultraviolet light sensitivity could.
“That’s where all the real innovation is in all of this,” says Berger-Wolf. The team implements algorithms that create pixel values from patterned animals, such as leopards, zebras and whale sharks, and analyze hot spots where the pixel values change the most — it’s like comparing fingerprints. With these fingerprints, researchers can track animals non-invasively and without GPS collars, count them to estimate population sizes, understand migration patterns and more.
As Berger-Wolf points out, population size is the most basic measure of a species’ well-being. The platform scanned 11,000 images of whale sharks to create hotspots and help researchers identify individual whale sharks and track their movement, leading to updated information about their population sizes. These new data prompted the IUCN to change the whale shark’s conservation status from “vulnerable” to “endangered” in 2016.
There are also algorithms that use facial recognition for primates and cats, which have been shown to be about 90 percent accuratecompared to people who are about 42 percent accurate.
Generative AI is still a fast-growing field when it comes to conservation, but Berger-Wolf is hopeful. For now, the team is cleaning up preliminary data from leopard hot spots to ensure the results aren’t data artifacts — or flawed — and are genuine biologically meaningful information. If meaningful, the data can teach researchers how species respond to changing habitats and climates and show us where humans can help.
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How Does Video Outreach Impact Pork Consumption?
Many animal advocacy groups educate the public about the horrors of factory farming through the use of video outreach. The goal, of course, is to change people’s attitudes toward eating animal products, and to spur them to reduce or eliminate those products from their diet. However, few organizations have rigorously tested their videos’ effectiveness in changing minds and behavior. Animal Equality and Faunalytics (with support from Statistics without Borders) have now conducted a study to do exactly that.
Over 3,000 people from Animal Equality’s typical college outreach audience participated: These were individuals on 35 US college campuses on the east and west coasts, many of them students. This study was a cluster randomized controlled trial (in other words, an experiment with a control group). Depending on the day they approached the Animal Equality booth on their campus, participants who agreed to complete the study either used a tablet to watch a video showing the day-to-day life of pigs in factory farms and slaughterhouses, watched the same video using a 360-degree, virtual-reality headset, or did not watch a video.
In all three conditions, participants then answered a short questionnaire that asked demographic questions as well as whether they think it is important to minimize pork consumption and whether eating pork contributes to the suffering of pigs. Most importantly, one month later, we re-contacted participants and asked them those same questions plus another one: how much pork they ate over the month since the study.
In a nutshell, the results presented a consistent picture of the two videos (360 and 2-dimensional) as effective advocacy tools. Compared to the control condition, participants who watched either video had stronger anti-pork attitudes immediately after watching and one month later. Most importantly, the videos had the desired effect on pork consumption: Relative to the control condition, participants who saw one of the videos ate marginally less pork. For example, 38% of people who watched the 360-degree VR video and 37% of people who watched the 2D video said they hadn’t eaten any pork at all in the last month, versus 33% of people in the control group.
The results support a likely process by which Animal Equality’s videos produce behavior change over time. Having more anti-pork attitudes right after watching a video was associated with eating less pork over the subsequent month. This suggests that watching a video about farmed pigs has the desired effect of making the average person’s attitudes more anti-pork, and that that attitude shift leads them to reduce their pork consumption.
It is important to note that the results described held true when we statistically controlled for socially desirable responding—people’s tendency to say what they think the researcher wants to hear. Therefore, we can be reasonably confident that the difference in pork consumption cannot simply be attributed to biased reporting. If you are interested in the study’s methodology, the full report provides more detail about social desirability concerns, as well as our other procedures, methods, and limitations.
A huge amount of work also went into designing and pilot testing the methodology and measures for this study. This involved the coordination of dozens of staff and volunteers from three organizations over more than a year. The details of that lengthy but rewarding process may provide valuable insight to other groups considering large-scale field studies. They are conveyed in our research design document, which was largely written and managed by Faunalytics’ former research director, Kathryn Asher. Please note that this is a legacy document, started when planning for the first pilot study began and last updated just prior to data collection for the main study.
In a related blog post, Faunalytics research director Jo Anderson describes the many challenges of this study, and passes on some key lessons learned.
February 7, 2018 - by Jo Anderson
Faunalytics (2018). An Experimental Investigation of the Impact of Video Media on Pork Consumption. Retrieved from: https://faunalytics.org/wp-content/uploads/2017/12/Animal-Equality-Report-Final.pdf | <urn:uuid:a0d0520d-a0d9-4de4-a73e-53c4991b35a2> | CC-MAIN-2018-09 | https://faunalytics.org/video-outreach-impact-pork-consumption/ | s3://commoncrawl/crawl-data/CC-MAIN-2018-09/segments/1518891814311.76/warc/CC-MAIN-20180223015726-20180223035726-00654.warc.gz | en | 0.959691 | 841 | 2.984375 | 3 |
Disability nurses work with patients who have mental or physical challenges, learning disabilities or developmental disorders. Many of them care for patients with impairments that manifested in childhood, such as Down's Syndrome, autism or cerebral palsy. They work with patients of all ages, from children just diagnosed with learning disabilities to adults living in group homes.They provide care both on an outpatient basis and for patients living in group homes or other facilities. They also work with patients one-on-one in their homes. To qualify, you'll need a nursing degree and knowledge of emotional, developmental and physical disabilities.
Take as many science, health and math courses as you can in high school to prepare for the requirements of a nursing degree. Child development and psychology courses are also helpful because they provide an understanding of the causes of mental impairments, the implications for patients and families, and treatment options and strategies for managing symptoms.
Obtain a degree in nursing. You can qualify with either an associate degree, offered by many community colleges and technical schools, or a bachelor of science in nursing, offered by four-year universities. Associate's degrees typically require two to three years of study, while bachelor's programs require four years. Seek out elective courses focusing on child development, on specific disabilities such as autism, or on caring for patients with mental and physical impairments.
Pass your state's licensing requirements. While many specialties require nurses to be licensed as registered nurses (RN), disability nursing is open to licensed practical nurses (LPN), as well. To obtain your RN or LPN license, you must pass the National Council Licensure Exam, or NCLEX, administered by the National Council of State Boards of Nursing. To qualify for the exam, you must apply to take the test, pay a testing fee and wait for an authorization letter from the board.
Get hands-on training and experience through a preceptorship. Many nursing students and recent graduates start their careers with a preceptorship, similar to an internship or apprenticeship, where they work under the close supervision of a veteran nurse. Seek a preceptorship with a nurse experienced in disability nursing, who can offer clinical advice and suggestions for career advancement. Preceptor programs vary by health care facility, with some lasting just a few weeks and others lasting an entire summer or academic term.
Now that you've completed the necessary training and licensing, seek full-time employment at health care facilities who hire disability nurses. The career services office at your college or university can often guide you during this process. In addition, many health care facilities hold regular job fairs where you can learn about employment opportunities. Target facilities willing to hire recent graduates.
Obtain certification in disability nursing. Certification isn't required, but it can make it easier for nurses to find employment or to move up to supervisory roles. You'll need a combination of education and experience to qualify. The Developmental Disabilities Nurse Association, for example, requires applicants to have at least 4,000 hours of developmental disabilities nursing as an RN or LPN within the last five years. Once accepted as a candidate, you must pass a computer-based certification exam.
- Jupiterimages/Comstock/Getty Images | <urn:uuid:995e18e5-54d9-4234-880e-28c72b7e957d> | CC-MAIN-2016-44 | http://work.chron.com/become-disability-nurse-15525.html | s3://commoncrawl/crawl-data/CC-MAIN-2016-44/segments/1476988719542.42/warc/CC-MAIN-20161020183839-00219-ip-10-171-6-4.ec2.internal.warc.gz | en | 0.961667 | 649 | 2.828125 | 3 |
The dry conditions that continue to persist over much of Illinois and the Midwest are causing nutrient deficiency problems. Unfortunately, only rainfall will fix some of these problems.
University of Illinois crop scientist Fabián Fernández said he does not recommend foliar or soil application of nutrients. Many corn fields show potassium deficiency even though adequate fertility is present in the soil. One question being asked is: Why is potassium deficiency showing up in corn more often than any other nutrient deficiency?
“I believe the most likely reason is that, early in development, corn takes up larger amounts of potassium than of nitrogen and phosphorous,” Fernández explained. “Soon after the V12 development stage, corn has already taken up half of all the potassium it will need.” By the R1-R2 development stages, the plant has taken up all of the potassium it will need (around 170 lbs./acre).
In contrast, nitrogen and phosphorus are taken up until sometime after the dent stage (R5). Unlike nitrogen, which moves freely over large distances in the soil solution, phosphorous and potassium can move only a few millimeters at most; thus, when the soil dries out, their position makes them unavailable to the crop.
The reason this happens is that pore space in the soil contains water and air. Plant-available potassium ions are dissolved in the soil water or attached to soil particles ready to come into solution as the plant needs them. When there is sufficient water in the soil, the potassium ions dissolved in water have to travel (by diffusion) only a short distance to be taken up by the crop.
As the soil dries out, the pore space fills with air. The potassium ion has to travel across a larger distance to reach the root because it cannot diffuse through air. Increased diffusion time can cause important reductions in potassium availability to corn during vegetative stages when potassium demands are large.
“Under dry conditions, the soil is unable to keep up with the crop demand even though there might be sufficient potassium in the soil,” Fernández said.
Phosphorus availability can be limited in a similar way. However, the plant does not have high demands for it over a relatively short period of time as it does for potassium, and the crop needs less phosphorus than potassium (about 80 pounds of P2O5 per acre). Thus, the plant is probably still able to obtain enough phosphorus and the crop is less likely to show phosphorus deficiency symptoms.
In the worst case, as the soil dries out, the distance that the potassium ion has to travel becomes so large that it is not available to the plant. “This is what we are seeing in many fields,” Fernández said. “Even though these fields have adequate K levels, as far as the plant is concerned the nutrient is out of reach.”
While there is nothing that can be done to solve the current drought problems, this year has taught producers a number of important lessons.
“For the future, I recommend that we minimize the effect of drought by ensuring that any water in the soil is protected to be used by the crop,” Fernández said. “This year some farmers have seen firsthand how much water weeds can take up when not treated early in the season.”
Similarly, too much tillage in some situations has caused unnecessary water evaporation from the soil and those fields are running out of water sooner than those that were managed more carefully. | <urn:uuid:99cb52fe-055b-4544-bf80-ab5111fc756b> | CC-MAIN-2015-48 | http://farmindustrynews.com/print/fertilizer/2012-drought-nutrient-deficiency-problems-created?intlink=rceoc | s3://commoncrawl/crawl-data/CC-MAIN-2015-48/segments/1448398447769.81/warc/CC-MAIN-20151124205407-00075-ip-10-71-132-137.ec2.internal.warc.gz | en | 0.96302 | 722 | 3.765625 | 4 |
Robot probes sent to one of Japan's wrecked Fukushima nuclear reactors have suggested worse-than-anticipated challenges for the plant's ongoing cleanup.
The plant's operator Tokyo Electric Power Co. said the remote-controlled "scorpion" robot was sent into the Unit 2 reactor's containment vessel Thursday to investigate the area around the core that had melted six years ago, but its crawling function failed while climbing over highly radioactive debris.
The robot, carrying a dosimeter, thermometer and two small cameras, transmitted some data and visuals but could not locate melted fuel — key information to determine how to remove debris out of the reactor. The robot was abandoned inside the vessel at a location where it won't block a future probe.
Preliminary examinations over the past few weeks have detected structural damage to planned robot routes and higher-than-expected radiation inside the Unit 2 containment chamber, suggesting the need to revise robot designs and probes.
Similar probes are being planned for the two other melted reactors. A tiny waterproof robot that can go underwater will be sent to Unit 1 in coming weeks, but experts haven't figured out a way to access badly torn Unit 3.
TEPCO needs to know the melted fuel's exact location and condition and other structural damage in each of the three wrecked reactors to figure out the best and safest ways to remove the fuel.
Despite the incomplete probe missions, TEPCO stuck to its schedule to determine methods for the melted fuel removal this summer and start work in 2021, company spokesman Yuichi Okamura said.
TEPCO is struggling with the plant's decommissioning, which is expected to last decades, following the 2011 earthquake and tsunami that led to the meltdown. Tens of thousands of residents had evacuated their homes, many of them still unable to return due to high radiation.
Earlier this month, another robot, designed for cleaning debris for the main "scorpion" probe, had to return midway through because two of its cameras became inoperable after two hours when its total radiation exposure reached a maximum tolerance of 1,000 Sievert — a level that can kill a human within seconds. The original duration planned for the robot was 10 hours, or 100 Sievert per hour.
Inadequate cleaning, high radiation and structural damage could limit subsequent probes, and may require more radiation-resistant cameras and other equipment, TEPCO officials said.
TEPCO officials said that despite the dangerously high figures, radiation is not leaking outside of the reactor.
Images captured from inside the chamber have showed damage and structures coated with molten material, possibly mixed with melted nuclear fuel, and part of a disc platform hanging below the melted core. | <urn:uuid:73f8bdd6-9376-41e8-a95f-54dedbab06b9> | CC-MAIN-2019-51 | https://www.manufacturing.net/home/news/13115175/robot-probes-show-japan-reactor-cleanup-worse-than-expected | s3://commoncrawl/crawl-data/CC-MAIN-2019-51/segments/1575541308149.76/warc/CC-MAIN-20191215122056-20191215150056-00225.warc.gz | en | 0.950475 | 541 | 2.859375 | 3 |
Even with zero shipment on the tanker, there could be harmful explosive gases existing in the wait. If the vapour generated by a cargo of oil is blended with a specific air concentration mainly comprising oxygen, it may ensue in an outbreak which yields in destruction to the commodity, marine deterioration and failure of life. An Inert Gas System helps in avoiding this.
Seaward and Marine Safety is particularly significant
Marine designers are for the most part capable of really taking a look at a boat’s security. Dangers on boats, similar to boat bursts and motor separate, are scarcely at any point discuss.
Listed here are some benefits of Inert gas systems that will help the marine systems go a long way
Global Warming Potential is zero
Argon and Nitrogen are the main components of inert gas and they don’t have any atmospheric energy. So they have zero global warming capability. They present zero peril to the environment.
We borrow Argon and Nitrogen from the atmosphere. When they are expelled, they automatically rescind to their typical territory in the atmosphere.
The weight of inert gas is the same as the weight of air
The weight of inert gas and normal air is identical. It can leave a space faster than any halocarbon agents post detonation.
The By Products emit Zero combustion
Inert gas is quite stable and harmless to the atmosphere as it doesn’t decompose into corrosive or toxic components.
This gas system may be terrific for occupied areas because withdrawal paths remain visible during a release and post.
Scarce Thermal Shock
There is almost zero thermal impact when this gas is released into air. There is no thermal impact which means the temperature does not drop unexpectedly compared to sterile agents of other forms. | <urn:uuid:865959d8-9ebc-4e25-bc1d-4ee1621bb177> | CC-MAIN-2023-40 | http://symbol-icons.com/the-myriad-benefits-of-an-inert-gas-system.html | s3://commoncrawl/crawl-data/CC-MAIN-2023-40/segments/1695233510810.46/warc/CC-MAIN-20231001073649-20231001103649-00885.warc.gz | en | 0.933716 | 371 | 3.078125 | 3 |
35.5: Asexual Reproduction
Asexual reproduction allows plants to reproduce without growing flowers, attracting pollinators, or dispersing seeds. Offspring are genetically identical to the parent and produced without the fusion of male and female gametes.
Vegetative reproduction is a common type of asexual reproduction, in which detached fragments—such as stems, roots, or leaves—from individual plants develop into complete organisms. Dandelions of the Taraxacum genus use a method of asexual reproduction called apomixis, which produces seeds without pollination or fertilization.
Plant breeders also use artificial methods of asexual reproduction—including cutting, grafting, layering, and micropropagation.
Some plants can be propagated by merely placing stem cuttings that contain nodes into moist soil and allowing them to root.
Grafting can be used to combine the desirable traits of different plants. A stem segment (the scion) from one plant is grafted, or attached, to a root section (the stock) from another plant. Over time, the vascular systems of the two plants fuse, forming a graft. The scion grows, producing new shoots and eventually flowers and fruit. Grafting is typically used to produce different varieties of grapes, roses, and citrus trees, among other species.
Layering involves bending a young stem of a plant and covering the stem with soil. Rooting hormones may also be applied. When roots appear, the new plant can be transplanted to a different area.
Micropropagation quickly produces several plants from a single plant using plant tissue culture methods. These techniques are useful for propagating rare or endangered species that are difficult to grow in natural conditions.
While asexual reproduction confers several advantages, strictly asexually-reproducing species are at an increased risk of extinction. Asexual reproduction can reduce genetic variability, limiting an organism’s ability to adapt to changing environmental conditions. | <urn:uuid:271f9bb6-c473-4a04-b23b-160dc658cb9f> | CC-MAIN-2021-04 | https://www.jove.com/science-education/11111/asexual-reproduction | s3://commoncrawl/crawl-data/CC-MAIN-2021-04/segments/1610703517966.39/warc/CC-MAIN-20210119042046-20210119072046-00141.warc.gz | en | 0.902313 | 402 | 4.25 | 4 |
India, a land so vast and diverse
in culture, heritage, language and people is bestowed with an
equally rich and vast treasure of natural beauty. The British
must be given credit for developing most of India's hill
stations. They did to escape the blistering
heat of the long
Indian summer. Towering and as if blessing this land is the
world's youngest and largest East to West mountain chain, known
as the Himalayas Stretching some 2560 Kilometers in an arc
across the top of the Indian subcontinent.
The picturesque Hill stations are popular providing a relaxing
and salubrious retreat from the heat and dust of the plains. Not
only they offer relief from the heat and dust of the plains,
their beautiful green surroundings, solitude, salubrious weather
and spectacular views makes them ideal holiday spots offering
quick relief from the hustle and bustle of city life. India has
seven principal mountain ranges and the most important amongst
them are the Himalayas. Most are well
connected by rail and road and offer some beautiful retreats to
Glimpse of few suggestive Hill Stations in India by State:
Located 60kms away from Vizag. Driving through
picturesque coffee plantations the road to Anantagiri
is enveloped with mango groves, waterfalls. Train travel is
also an exhilarating experience as lush landscapes of
forest afford a memorable
Araku Valley: Located
115km away from Vizag. This place lures people with
pleasant weather, hills and valleys. The area of the valley is roughly 36-km
and the altitude is between 600 and 900m above the
Horsley Hills: Located
144km away from Tirupathi. It is situated at an
altitude of 1,265 m, which makes this place
delightfully cool, with a max summer temperature of
32°C, and minimum of 20°C. the shady slopes found in
this are wooded with luxurious vegetation.
Along: Located 125km
away from Pasighat. Set in a wide open valley where
the Sipu river merges with Siyom against the
backdrop of hills covered with snow during winters,
it presents a panoramic view tot he delight of
visitors. Along by night with hundreds of electric
lights flickering and glowing over the broad valley
looks like a wonderland from the top of the hills.
Pasighat and its surrounding areas abound
in natural beauty and the place has rightly been
called as a photographers delight. The mighty Brahmaputra River, called the "Siang"
here transcends down from Tibet and gives its name
to the district. It flows through the entire length
of the area until it descends down into the plains
of Assam south of Pasighat town, where it meets
Dihang and Lohit and becomes the Brahmaputra.
Haflong: Located 84km
away from North of Silchar, Assam. It is the name of
variety of orchids, one of them being the rare Blue
Vanda. Haflong Lake, situated in the heart of the
hill station is a picturesque area. The Jatinga
village unravel the mystery of the flocks of little
migratory birds crashing to death on still dark
Best Time To Visit: Aug - Nov
Umrongso/ Umrongshu: It is located at the borders of
Assam and Meghalaya, 112-km away from Haflong. This
hill station is blessed with the natural backdrop of
North Cacher Hills region. For the sake of enjoying
this alluring journey, one should travel from
Haflong Hill to Umrangshu and from their via Jowai
to Shillong hill. Near Umrangsu, there is a hot
water spring (Garampani) which is believed to
possess medicinal properties.
Chamba: Situated at the
height of 996m. above sea level on the south bank of
the Ravi River. The valley is noted for the
magnificence of it's scenery-touching the fringe of
the Shivaliks and having three well-defined snowy
ranges, the Dauladhar, constituting the outer
Himalayas, the Pir Panjal or the mid Himalayas, and
the Zanskar range or the inner Himalayas.
Kullu: Located at an altitude of 1220m. and by the
banks of the shining river Beas. The 'Silver Valley' has nature's
treasures that lie carelessly scattered as flowers
on the high meadows. The town of Kullu has long been
a centre of faith.
Manali: Situated at an
altitude of 2,050m. The Kullu valley has an ancient
town in its lap called Manali. Surrounded by
towering peaks at an arm length, Manali's major
asset is its proximity to the snowline. It is a
flourishing orchard industry, a popular honeymoon
destination and trailhead for numerous treks as well
as a great countryside ideal for adventure sport
Dalhousie: This hill
station spreads over five low-level hills at the
western edge of the Dhauladhar range, just east of
the Ravi River. The pine-covered slopes around it
are intersected with paths and treks, which are
ideal for short undemanding walks.
Dharamsala: Set against
the backdrop of the dramatic Dhauladhar mountains,
Dharamsala is perched on the high slopes in the
upper reaches of Kangra Valley. Dharamsala is
a busy bazaar town and has established itself as the
travellers base camp, who come to explore the nearby
Shimla: Situated at an altitude of 2,159m. Dwelling on a panoramic location, the
hilly town is surrounded by green pastures and
snow-capped peaks. The spectacular cool hills
accompanied by the structures made during the
colonial era create an aura, which is very different
from other hill stations.
Gulmarg: The valley of Gulmarg, a large meadow about 3sq.kms in area,
stands at 2,730 meters, 56km south west of Srinagar.
The name means 'Meadow Of Flowers' and in the spring
it's just that, a rolling meadow dotted with
countless colourful Bluebells, Daisies, Forget Me
Nots and Buttercups. The valley itself is about 3-km
long and up to a km wide. All around are snow-capped
mountains, and on a clear day one can see all the
way to Nanga Parbat is one direction and Srinagar is
another. It's a popular day trip from Srinagar to
Best Time To Visit: In Summer - May to September In
Winter - Nov to February
Pahalgam: At an
altitude of 2,130m and about 95-km from Srinagar and
is the most popular in the Kashmir valley. Since it
is rather lower than Gulmarg the nighttime
temperatures do not drop so low and it has the
further advantage of the beautiful Lidder River
running right through the town.
Best Time To Visit: In Summer-May To September In
Winter-Nov To Feb.
Patnitop: With all its
beauty at a hill station, it is a charming plateau
at 2,024m. Picturesquely situated at a high
altitude, there are good bridle paths passing
through wooded lanes and fascinating scenery. There
are three ice-cold freshwater springs in the area,
which are said to have medicinal properties.
Best Time To Visit:
Summer: May To June Autumn: September To October
Winter: December To March
Srinagar: The capital of Jammu and Kashmir
and the largest city in the state, Srinagar (1,730m)
is famous for its canals, houseboats and Mughal
gardens. The city itself is quite unlike most other
large Indian cities for here you are much more in
Central Asia than on the sub continent.
Best Time To Visit:
In Summer: June To Early Nov In Winter: Dec To Feb
Biligiriranga Betta (B.R.Hills):
120 kms from Mysore and 247 kms from Bangalore, the
range of hills is picturesquely situated between the
Cauvery and the Tungabhadra rivers. At a height of
5,091 ft above sea level, this hill stretches from
north to south for about 16kms. Surrounded by
deciduous trees, the forests are teeming with
wildlife. So if you're looking for a 'cool' time
with a little bit of 'wild' excitement thrown in,
welcome to B.R. Hills.
Kudremukh: 95kms south-west of Chikmaglur town is
the Kudremukh (Horse Face) range. Overlooking the
Arabian Sea, the broad hills are chained to one
another with deep valleys and steep precipices. As
yet 'undiscovered' by tourists, Kudremukh is a
secluded hill station, which retains much of its
pristine, natural beauty.
Nandi Hills: 60kms north of Bangalore also known as Nandidurga.
This 1478m high hill was one of the summer retreats of Tipu
Sultan. It is a hot favourite among Bangaloreans who
find this an ideal get-away for weekends. The
Hill is the originating point of many rivers. Forests
abound with wild animals.
Located 16 kms from Munnar, this gorgeous hill station
symbolizes nature in her pristine glory. The crisp
and cool mountain air heavily laden with the
fragrance of wild flowers and rare herbs is any
nature lover's paradise.
Topstation: The idyllic hill station is located 32 kms from Munnar, on the Munnar-Kodaikanal Road.
Perched at an altitude of 1700 m above sea level, it
is the highest point on Munnar-Kodaikanal Road. The
rare Neelakurinji (Strobilanthus), the flower that
blooms once in 12 years, belongs to this region.
Located at an altitude of 1600m above sea level, was
once the summer resort of the erstwhile British
government in South India. Sprawling tea
plantations, picture book towns, winding lanes and
holiday facilities make this a popular resort town.
at a distance of 52kms from Palakkad, nestling atop the Western Ghats, offer a breathtaking view of the misty
mountains and enchanting valleys interspersed with
sprawling tea, coffee, cardamom and orange
Located 7kms at an altitude of 1740m above
sea level, north east of Thirunelli Temple in
Brahma Giri Hills is a challenging tourist spot offers great
site for bird watching.
One has to trek 17kms through the wild forests, to
reach the hills.
Ponmudi: The salubrious
hill station of Ponmudi is at a distance of 61kms
from Trivandrum. Perched at an altitude of
over 100 m above sea level on the Western Ghats, the
picturesque view of Ponmudi is afford a memorable
spectacle and trekking is a passion to the visitors.
Mount Abu: The only
hill station in Rajasthan, Mount Abu huddles among
the rocks on a 1,220-m granite table mountain at the
far southwestern end of the Aravalli hills. It is
built around a lake and is surrounded by forested
hills. According to a legend, the place derives its
name from Arbuda, a serpent who descended to the
spot to rescue Shiva’s bull, Nandi. Besides having
all the features of a pleasant hill resort, Mount
Abu is also well known for the famous Dilwara
Gangtok: Gangtok, the
"Lofty Hill" or the "Hill made flat to build the
Gangtok monastery in 1716". Gangtok is a city,
which, till one sees it, one would believe exists
only in picture-story books.
An air of enchantment hangs over the city, indeed
the whole valley; the mysticism, the stupas, the
monasteries reach out as soon as one has crossed the
border. While across the hills and valleys comes the
sounding of the long trumpets by robed lamas.
Coonoor: Situated on
the eastern side of the southern extremity of the Doddabetta range, at an altitude of 1,858m
above the sea level. It is the second largest hill
station in the Nilgiris and is located just 19kms
away from Ooty. Coonoor is
essentially a small tea garden town where the
weather remains pleasantly cool throughout the year.
The town is physically divided into upper and lower
Ketti: Ketti is famous
for having the highest railway station in the
country, situated at a height of 7,000 ft, in the
Nilgiri Mountains of South India. The weather of
Ketti valley is salubrious. Ketti is a wealth of
natural beauty reposing in the Wenlock Downs, the
Municipal Gardens and Doddabetta Peak, at 2,623 m
the highest in the Nilgiris.
Kodaikanal: It is
located amidst the folds of the verdant Pali hills.
With her wooded slopes, mighty rocks, enhancing
waterfalls and a beautiful lake, Kodaikanal is a
charming hill station which mesmerises any visitor.
Kodai is situated at an altitude of about 2,133-m
high and covers an area of 21.45sq.km. The pride of
Kodaikanal is the 'Kurinji-flower', which blossoms
once in 12 years. The hill-plantain fruits and plums
are known for their freshness and taste.
Kotagiri: Kotagiri is
located 16-km away from Ooty and it is the oldest
hill station of the Nilgiris. Kotagiri is situated
at an altitude of 1950m, which was once a British
hill resort, that dates back to 1819 and is quieter
than Ooty. Elk Falls, Kodanad Viewpoint and
Catherine Falls are a few places to visit.
Toy Train -Ooty
The capital of Nilgiri district, is popularly known
as the "Queen of hill stations' among the tourist
circuits. It is situated at a distance of 105km away
from Coimbatore. The height of the hills in the
Nilgiri range varies between 2280 and 2290 meters,
the highest peak being Doddabetta at a height of
Yercaud: Yercaud is a lesser-known hill station when
compared to Ooty and Kodaikanal. Yercaud is situated
at an altitude of 1,500 meters (4,920 feet), on the
Shevaroy hills of the Eastern Ghats. The lofty hills
are of extraordinary scenic beauty endowed with a
salubrious climate. Yercaud is also called "Ooty of
the Poor " and is known for Coffee Plantations and
Mussoorie: It is
located at a height of 2,500m in the green
Himalayan range. Due to its location and beauty it
is considered as the best hill station in the
northern region. The name is derived
from plants of 'Mussoorie' which were found in
abundance here. The modern bungalows, malls and well
laid gardens around the area are enough to attract any tourist.
Nainital: A small town in the hills of Kumaon,
Nainital is a lovely hill station surrounded by
mountains on three sides. Once this area had many
lakes and it was called the City of 60 lakes.
Most of the lakes in the region have disappeared and
whatever remains is just a glimpse of what they
might have been in the past. Today the life of Nainital revolves around the lake of Naini.
Pithoragarh: The easternmost hill district Pithoragarh is often referred as
“Miniature Kashmir”. Nestling in a small valley,
barely 5km long and 2km wide, the Sore Valley was an important landmark of the Chand
Rajas of Kumaon. It is situated at an altitude of
1,650 m above sea level.
Darjeeling: It is the
dream land of the East, it has been a popular hill
station since the British period rich in natural
beauty and surrounded by lofty mountains and
Buddhist monasteries. The real fun in coming to
Darjeeling is on the toy train from Siliguri. It
takes six to seven hours to cover a distance of
82kms and the slow speed gives you enough time to
watch and appreciate the beauty which nature has
provided it. This train passes through the Forests,
waterfalls, over deep valleys and through the
mountains and tunnels.
Mirik: It is 52kms from Siliguri and 55kms from the
nearest Airfield of Bagdogra. Mirik is being
developed as a new hill station in the mountains.
Mirik is surrounded by tea estates, orange orchards
and cardamom plantations with all the facilities to
fulfill the needs of a tourist. This place is 5,800
feet above the sea level and has very thin
population of 10,000 people. Mirik has not yet
acquired the hustle and bustle of the a regular hill
station and is from pollution. Thus the little time
spend here is enough to refresh you.
Customized packages are
available on request based on
Individual needs/Budget/Interest and Time | <urn:uuid:d3aedeb7-60ad-4ab3-ac74-89a321ed2f44> | CC-MAIN-2015-18 | http://www.akshayaindia.com/inbound-hillstations.htm | s3://commoncrawl/crawl-data/CC-MAIN-2015-18/segments/1429246635639.11/warc/CC-MAIN-20150417045715-00186-ip-10-235-10-82.ec2.internal.warc.gz | en | 0.915524 | 3,934 | 2.546875 | 3 |
(IIT JEE 2009)
1) Internal energy
2) Reversible expansion work
3) Irreversible expansion work
4) Molar enthalpy
* Thermodynamics definition of state function is: any property that depends only on the state of the system and not on the path taken to reach that state.
The values of internal energy and Molar enthalpy depend only on the state and not on the path.
However work is a path function. It is something that we measure while a system changes its position from one state to another state and can have any value depending on the path that is taken by the system to reach the final state.
1 and 4 are correct options.
(IIT JEE 2001)
1) Work is a state function.
2) Work appears at the boundary of the system.
3) Temperature is a state function.
4) Change in the state is completely defined when the initial and final states are specified.
Logic & solution:
* Work appears only as change in the state at the boundary of the system. It is a path function. It can be defined as any quantity of energy that flows across the boundary between the system and surroundings which can be used to change the height of a mass in the surroundings.
Note: Think that how nonsense it is to say that a system at one point has this amount of work.
* Temperature is one of the variable that defines the state of a system.
Statement given in option '1' is false.
1) What is the thermodynamic definition of heat?
2) State whether entropy is a state function or not? | <urn:uuid:2f3aa4bf-588e-4a3d-aad7-1e83c8b8e9cb> | CC-MAIN-2017-17 | http://www.adichemistry.com/jee/qb/thermodynamics/1/q1.html | s3://commoncrawl/crawl-data/CC-MAIN-2017-17/segments/1492917121528.59/warc/CC-MAIN-20170423031201-00150-ip-10-145-167-34.ec2.internal.warc.gz | en | 0.908388 | 341 | 2.921875 | 3 |
What is the Net Literacy Alliance?
The year was 2008 and hundreds of trade associations across the United States helped organize their membership in the verticals that they served; facilitating communications, vetted good practices, and creating synergy among their members. However, organizations that shared a digital inclusion and digital literacy mission had no such association and the occasional digital inclusion forums and conferences that were conducted had a history of being unsustainable.
In 2009 when the FCC called on the public to provide input and comment as a National Broadband Plan was created, Net Literacy participated in many groups, co-authored several white papers, and served on adoption and use committees.
That year, Net Literacy also formed the Net Literacy Alliance, launching a website in May, 2009. The mission of Alliance is to serve as a destiny for the collaboration of organizations with a shared mission of digital inclusion to collaborate, discuss good practices, and work together with grantors and other funders that are committed to bridging the digital divide by promoting digital inclusion. The site provided the first comprehensive data based containing hundreds of U.S. digital inclusion and digital literacy nonprofits. It also served as a clearing house as dozens of nonprofits throughout the country and around the world sent emails each month, asking for information or programatic assistance.
The Net Literacy Alliance is the first part of the four-part approach to creating synergy within the Industry. To increase digital inclusion and digital literacy, Net Literacy:
i Created the Net Literacy Alliance;
ii Partnered with national trade associations with a shared mission, including the US Internet Industry Association, the National Telecommunications Cooperative Association, the Wireless ISP Association, Broadband for America, the Wireless Communications Association International, among others;
iii Partnered with socially-minded organizations that supported and advocated digital inclusion, including Intel, Bright House Networks, Dell, Microsoft, Cisco Systems, the “Computers For Youth” Network, among others; and
iv Innovated the Digital Literacy “best practices” site – where the digital literacy and digital inclusion good practices from around the country and around the world could be freely shared for all. Digital Literacy has been endorsed by Internet associations representing 250,000 Internet organizations on five continents. | <urn:uuid:dbe7116a-ad13-4fe0-becb-9d29c38e92b6> | CC-MAIN-2019-13 | https://www.netliteracy.org/net-literacy-alliance/ | s3://commoncrawl/crawl-data/CC-MAIN-2019-13/segments/1552912203991.44/warc/CC-MAIN-20190325133117-20190325155117-00414.warc.gz | en | 0.938861 | 451 | 2.546875 | 3 |
This is part 2 of a 2-part post on ad design and legibility. In this part, we’ll look at how to use basic reading concepts to get more people to read your advertising.
Meaningful sales messages are transmitted through language, not design. The goal of design, therefore, is to encourage and support readership. In general, a designer should strive to:
1. Draw attention to the copy and help the reader get started reading.
2. Make reading easy by applying the basic rules of layout and typography.
3. Help communicate the writer’s message (not produce a work of art).
Specifically, a designer should make every effort to work with the realities of how people read and make the process as easy and transparent as possible.
This is part 1 of a 2-part post on ad design and legibility. In this part, we take a look at how people read.
With no special instruction, people instinctively learn spoken language. In fact, within just three years, an infant will master a vocabulary of about 1,000 words. Reading, however, must be taught. It’s a difficult process, and even after years of instruction, most people remain relatively poor readers into adulthood.
Reading is literally an unnatural act.
This is crucial for you to understand, since so many marketing efforts, and most especially direct mail and print ads, depend on your getting people to READ. In fact, I would go as far to say:
Direct mail and print advertising is all about READING.
Reading envelope teasers. Reading letters. Reading brochures. Reading order forms. Reading headlines. Reading coupons. Without reading — easy, effortless reading — you have no sales.
Therefore, one of the most devastating response barriers is simple legibility. Can your prospects read your message? Can they read it effortlessly?
I was looking at some old ads for comic books recently. In addition to bringing back boyhood memories, it got me thinking about what’s often wrong with ad design these days.
Comic books (and the ads for them) are all about action and adventure. The design creates this feeling with vivid colors, imperfect hand lettering, perspective, and angles.
Imagine what a comic would look like if the colors were muted, the letters were small and perfect, the images were flat, and all the graphics were linear.
It would look like many ads you see today. Boring and aloof.
Direct response design is all about getting people to READ the text. If no one reads the words, why bother running the ad?
While flipping through some magazines recently, I came across this ad for a laser sighting device. I know what the ad is about because of the photo, but certainly not because of the text. This ad ignores virtually every convention for designing readable copy.
Is the woman turning to the right or to the left? That depends. Some will see her turning one way while others will see the opposite.
This animation is a visual trick, but it illustrates the idea that two people can look at the same thing and see something entirely different.
Selling is largely about perception. And everyone’s perception is a bit different. To be successful at writing or designing direct mail, ads, or other selling tools, you must grasp this simple idea.
Every person comes to your advertising with different experiences, knowledge, language skills, attitudes, preferences, and prejudices. Even something as simple as a headline can create a totally different response for two people. Read more
In a recent article on 37signals, a writer asked the question, “Can good design also be ugly?”
He’s referring to the Drudge Report, a news site that is loved (and hated) by millions. It’s one of the most popular and successful Web sites in the world. And it’s profoundly ugly.
The writer’s conclusion is that, yes, good design can be ugly. And I heartily agree.
He says that the ” … definition of design goes beyond aesthetic qualities and into areas of maintenance, cost, profitability, speed, and purpose.” Or, in architectural terms, we might say, “form follows function.”
He’s writing from the perspective of Web design, but his take on what makes for good design applies to anything, most especially to direct response advertising. Read more
Color is one of the most powerful elements of design for direct mail, ads, and other marketing materials.
Why? Because color is a form of nonverbal communication. Research has shown that color increases brand identity, assists in memory, increases a reader’s participation in ads, and improves readership, learning, and comprehension.
This is a complicated subject and is worthy of a dozen posts, but I’d like to cover just three important points about why color choice is so important.
Color carries meaning through association.
This meaning can be divided into two parts: natural associations and psychological or cultural associations.
By “natural association” I mean that colors bring to mind certain ideas that everyone understands. For example, green is associated with nature because that’s the primary color of plants everywhere in the world. Blue is associated with the sky. Yellow is associated with the sun. These associations are simple and universal.
Psychological or cultural associations are more tricky. In the U.S., orange is associated with Halloween because pumpkins are a big part of that holiday. But since many other cultures don’t celebrate this particular holiday, that association doesn’t exist. Likewise, while black is associated with death in the West, white is often the death color in other cultures. Read more
Good direct mail design is like good design in other fields. The best work results from a designer who understands how design is used to accomplish something.
In other words, form should follow function.
In the case of direct mail, the function is to deliver a sales message to a list of recipients to persuade them to take some kind of action, such as placing an order, requesting information, or going to a Web site.
The wrong way to design direct mail is to come up with a “creative concept,” then force fit the copy into the design.
The right way to design direct mail is to understand the selling message and the goal of the mailing, then allow the design to naturally flow from these ideas.
For example, if the goal is to build traffic for a Web site, it would be silly to create an elaborate envelope package. Since you’re not asking for money and the action you’re asking for is easy, all you need is a small piece, such as a postcard.
On the other hand, if you’re selling a product with a $500 price tag, you shouldn’t try it with a postcard because you’ll need a lot more room to convince your recipient to part with his money, provide a means of response that may include a reply form, and include other information such as instructions or your return policy. Read more
You’ve heard it a thousand times: “Copy is king.”
Sure. That’s because direct marketing is all about the message, and copy delivers the message. But … and this is a very important but … design is what delivers the copy.
Assuming that copy is the only important part of a printed direct marketing message is like thinking that the screenplay is the only important part of a movie. A movie starts with the script, but until it’s translated into visuals, there’s no movie.
It’s the same with advertising, direct response advertising in particular. The sales pitch starts with the copy, but the copy must be translated into visuals before you have a complete message that people can read and interact with.
Even a simple letter requires some design: page size, type, color, logo placement, underlines or highlights, signature in blue, and other elements. Get these items wrong and the design will obstruct the copy rather than enhance it.
How? Here are 5 of the most common ways design can kill your copy:
Start with a visual “concept.” There’s nothing wrong with concepts per se, but the message should guide the concept, not the other way around. I once had a client who would send a design and ask me to fill in the blanks with copy. This led to terrifically weak direct mail. Of course, starting with copy from a writer with no regard for design can be nearly as bad. Read more
My wife dragged me to a mall recently and I ran across a good example of why getting super creative with type endangers legibility.
Take a look. (Forgive the poor quality of the photo. I snapped this with my cell phone.)
Sure, you can tell that it reads “SALE.” But it takes a second for your brain to make it out, doesn’t it?
This sign violates two basic principles of legibility. It spells a word vertically rather than left to right, which is the standard in English. And it crams the letters together so that the familiar configuration of the word is damaged.
Now take a look at an example of good legibility just a few stores down in the same mall.
Same word, but it reads left to right and uses the natural shape of the word to make it instantly recognizable. The brain doesn’t need to read this sign, it recognizes and understands the word “sale” instantly.
From a designer’s perspective, the creative sign is more interesting. But that’s irrelevant, since the purpose of the sign is to announce a sale and bring people into the store. All things being equal, the less creative sign is more interesting to customers since they’re interested in the sale, not the sign.
By the way, you should also note that the less creative sign uses the colors red and yellow, which are more dramatic than the soft blue of the other sign. Plus it adds some copywriting savvy by calling the sale an “ultimate sale” and providing some detail on the number of styles marked down.
I recently referred to an article that provides a primer on reading and legibility in design. If you didn’t read it then, read it now. Even if you’re not a designer, you need to understand these ideas since most direct response advertising is about reading.
(Oh, and for the people out there who hate shopping but get suckered into malling anyway, this illustrates a great way to eat up time when a mall is about to close. Announce that you have an idea for your blog and take photos. Don’t take the pictures when you first see a good subject. Walk way past it, then say you have to go back. Then fiddle with your camera for a while. If you’re good, you should be able to reduce your shop time by 10 minutes or more.) | <urn:uuid:1d6d6cc7-b4c0-4690-bb50-f3eb79936b59> | CC-MAIN-2017-13 | http://www.directcreative.com/blog/category/design | s3://commoncrawl/crawl-data/CC-MAIN-2017-13/segments/1490218191444.45/warc/CC-MAIN-20170322212951-00529-ip-10-233-31-227.ec2.internal.warc.gz | en | 0.949369 | 2,296 | 2.578125 | 3 |
Community Participation for Girls and Women Living with Rett Syndrome
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OBJECTIVE: To describe the relationships between impairment and contextual factors and community participation for girls and women with Rett syndrome.METHODS: Data was collected from a questionnaire completed in 2009 by families participating in the Australian Rett Syndrome Database (n=214). Univariate and multivariate logistic regression were used to analyse relationships between impairment, personal and environmental factors and community participation.RESULTS: The mean age of the girls and women was 17.6 years (SD=7.95, range 3 to 34 years) with 114 (53.3%) girls still at school and 100 (46.7%) women post school. Frequency of activities was influenced by level of walking, community support and maternal education. For girls living at home, participation in activities was associated with greater functional independence and higher levels of maternal education. Participation in recreational (90.1%), physical/skill-based (67.6%) and/or social (70.3%) activities was commonly reported by families, while self-improvement (17.6%) activities were less reported. Younger girls participated in activities mainly with family members and older girls more frequently participated with carers.CONCLUSION: Participation for girls and women with Rett syndrome could be enhanced by stronger local community supports. There are also needs for the implementation of policies that ensure resources are available and accessible by those communities most in need.
Showing items related by title, author, creator and subject.
Downs, Jennepher; Leonard, H.; Hill, Kylie (2012)Purpose: In girls and women with Rett syndrome, we assessed the accuracy of the StepWatch Activity Monitor™ and investigated relationships between daily step counts, gross motor skills and age. Method: Twelve subjects ...
Lim, Faye; Downs, Jennepher; Li, Jianghong; Bao, Xinhua; Leonard, Helen (2013)Purpose: Rett syndrome is one of several genetic disorders known to cause severe intellectual and physical disability, mostly in girls. Girls affected by Rett syndrome appear to develop normally in the first 6 months of ...
Foley, K.; Downs, Jennepher; Bebbington, A.; Jacoby, P.; Girdler, S.; Kaufmann, W.; Leonard, H. (2011)Rett syndrome is a rare but severe neurological disorder typically associated with a mutation in the MECP2 gene. We describe change in gross motor function over 3 to 4 years for 70 subjects participating in the Australian ... | <urn:uuid:869b2632-1b72-4142-a912-fef77c8e9e6a> | CC-MAIN-2018-26 | https://espace.curtin.edu.au/handle/20.500.11937/29826 | s3://commoncrawl/crawl-data/CC-MAIN-2018-26/segments/1529267864940.31/warc/CC-MAIN-20180623035301-20180623055301-00214.warc.gz | en | 0.939751 | 528 | 2.625 | 3 |
The lottery is a game of chance where players pay money to have a chance at winning a cash prize. There are many different kinds of lotteries that are played all over the world. In the United States, the US National Lottery is available online and in person. These lotteries often have large cash prizes. They can be used to fund charitable organizations or public projects.
Lotteries have been around for over a century. Many cities and towns have held public lotteries in order to raise funds. Traditionally, the proceeds have been used for religious congregations and libraries. However, more and more people are using lotteries to raise money for public programs.
One of the oldest records of lottery is from the Roman Empire. Emperor Augustus is reputed to have run a lottery. He used the money from the lottery to help repair Rome. Another famous public project that was built with lotteries was the St. Pantheon. Other projects included 15 churches in Paris.
During the Han Dynasty, lottery slips were also used to fund major government projects. Today, a significant portion of the money raised by lottery is used for charity. It can be used for senior citizens, veterans, park services, and more. Despite the fact that many lottery winners go bankrupt within a few years of their victory, lottery is still one of the most popular ways to raise money for good causes.
A few of the most popular lottery games are Mega Millions, Pick 3, Toto, and Cash4Life. These games are designed to give low-income earners a chance at winning big. Buying a ticket for any of these lottery games is relatively inexpensive. Some lottos allow players to create their own games.
While there are a number of jurisdictions that allow the sale of tickets, a few have banned the use of lottery. As a result, the sales of lottery tickets have decreased. Most jurisdictions require adults to purchase a ticket.
In the United States, the state-run lottery generates billions of dollars in revenue every year. Two-thirds of that revenue goes to the pension and public school funds of the states. This money is then used to help build roads and other public projects.
Lotteries have become popular over the past fifty years. Currently, there are more than 100 countries in which people play the lottery. Each lottery has a different set of rules. Generally, the process of buying a ticket involves randomly selecting numbers from a selection of numbered sets. When a ticket is drawn, the winner is chosen from a smaller pool of winners. Depending on the game, the winner may receive a cash prize, a gift certificate, or a housing unit.
There are also some jurisdictions that will charge the winner a tax on the prize. Regardless of where a winner chooses to spend the prize, it is important to have an emergency fund. You never know when you might need to use the money. | <urn:uuid:7ba2db73-2582-4c13-8f62-d298cb7d3ee7> | CC-MAIN-2023-23 | https://channa-place.com/how-to-play-the-us-national-lottery-online-and-hong-kong-lottery-online/ | s3://commoncrawl/crawl-data/CC-MAIN-2023-23/segments/1685224657169.98/warc/CC-MAIN-20230610095459-20230610125459-00002.warc.gz | en | 0.975861 | 590 | 2.65625 | 3 |
In the last few years, Methacillin-resistant Staphylococcus Aureus (MRSA) has gotten just a bit more complicated. Now it is common for physicians to attempt to make a distinction as to how the infection was acquired. While the healthcare setting (hospitals and nursing homes in particular) have long been known to harbor Super Bugs like MRSA, this infection is now showing up in the community at large.
Healthcare-Associated MRSA is also called "healthcare acquired" and HA-MRSA. Super Bugs like MRSA live in the hospital setting for a lot of good reasons. There are plenty of vulnerable individuals--often with weakend immune systems--for the germs to infect. Patients with bacterial infections are routinely treated with strong antibiotics while in-hospital. But, not every germ is killed with the first dose of an antibiotic. That's why antibiotics are continued over a designated period of time--so that the reproducing generations of bacteria can be targeted at regular intervals until they are all gone. Meanwhile, some of the bacteria that survived the initial doses of antibiotics will be shed from the infected patient through body secretions (like mucus, urine, etc.) The bacteria that have survived have learned a thing or two from their near-fatal antibiotic exposure. They learned ways to dodge the effects of that antibiotic, and these bacteria are ready to reproduce into entire colonies of "strong bacteria" once they find a "host" to infect. The bacteria live on hard surfaces and can be easily passed from person to person. Patients with catheters in their bladders, breathing tubes, central IV lines, and fresh surgical incisions are particularly vulnerable to bacteria "walking in" to their bladder, airway, bloodstream, or wound if proper hygiene is not meticulously attended to. (When patients acquire an infection in the hospital setting--one that they didn't come in with--any infection, not just MRSA--it is called a nosocomial infection.)
Community-Associated MRSA: Also called "community-acquired" or CA-MRSA. MRSA that infects individuals who have not been hospitalized within the past a year and who haven't had a recent medical procedure is described as community-associated. CA-MRSA frequently causes skin infections like boils, pimples, or abcesses. Some patients initially mistake these skin lesions as a spider bite. (It's important to be skeptical of the spider bite theory and have any suspicious boils examined and treated.) CA-MRSA has resulted in outbreaks of skin infections among atheletes who share equipment and personal items.
Here is an excerpt of the CDC's guidelines for cleaning and disinfecting to reduce transmission of CA-MRSA:
"What can I do to keep surfaces free from staph and MRSA?
- Cover your infections. Covering infections with bandages or dressings is the best way to keep surfaces from becoming contaminated with staph and MRSA.
- Clean your hands often. Wash your hands often with soap and water or use an alcohol-based hand rub when a sink is not available. Always clean your hands after changing bandages or touching infected skin.
- Keep the environment clean. Regularly clean frequently touched surfaces and other items that come into direct contact with infected skin.
- In gyms, locker rooms, and other places where many people come and go, repair or throw out equipment and furniture with damaged surfaces that cannot be thoroughly cleaned.
Which disinfectants should I use against staph and MRSA?Disinfectants effective against Staphylococcus aureus or staph are most likely also effective against MRSA. These products are readily available from grocery stores and other retail stores . . . Most, if not all, disinfectant manufacturers will provide a list of germs on their label that their product can destroy . . .
How do I know if the surfaces or equipment are properly cleaned?Although in most situations you will not know if a surface has been cleaned, it’s important to remember that most surfaces do not pose a risk of spreading staph and MRSA. If cleaning procedures are unknown, taking the appropriate precautions such as:
- Using barriers like a towel or clothing between your skin and the surface.
- Showering immediately after activities where you have direct skin contact with people or shared surfaces such as after exercising at a health club.
- Cleaning your hands regularly.
- Keeping cuts and scrapes clean and covered with bandages or dressing until healed.
These precautions are especially important in settings such as in locker rooms, gyms, and health clubs.
Will routine laundry processes, detergents, and laundry additives remove staph and MRSA from towels, clothes, linens, and uniforms?Yes. Routine laundry procedures, detergents, and laundry additives will all help to make clothes, towels, and linens safe to wear or touch. If items have been contaminated by infectious material, these may be laundered separately, but this is not absolutely necessary."
Visit the CDC's MRSA site for an abundance of information on community and hospital-acquired infection.
Just in case I forget to post it elsewhere--a few more words of advice from me:
- don't share towels and washcloths (period)
- don't share razors--and replace your razor or blade if you have had a recent skin infection | <urn:uuid:21f9ec77-c049-491c-ac4c-30ab0de06652> | CC-MAIN-2018-22 | http://promotinghealthandpatienteducation.blogspot.com/2009/01/mrsa-healthcare-vs-community-acquired.html | s3://commoncrawl/crawl-data/CC-MAIN-2018-22/segments/1526794867311.83/warc/CC-MAIN-20180526053929-20180526073929-00543.warc.gz | en | 0.947973 | 1,105 | 3.09375 | 3 |
FARNESE, the name of one of the most illustrious and powerful Italian families, which besides including eminent prelates, statesmen and warriors among its members, ruled the duchy of Parma for two centuries. The early history of the family is involved in obscurity, but they are first heard of as lords of Farneto or Farnese, a castle near the lake of Bolsena, and they played an important part as consuls and signori of Orvieto. They seem to have always been Guelphs, and in the civil broils of Orvieto they sided with the Monaldeschi faction against the Ghibelline Filippeschi. One Pietro Farnese commanded the papal armies under Paschal II. (1099-1118); another Pietro led the Florentines to victory against the Pisans in 1363. Ranuccio Farnese served Eugene IV. so well that the pope endowed him with large fiefs, and is reported to have said, "The Church is ours because Farnese has given it back to us."
The family derived further advantages at the time of Pope Alexander VI., who was the lover of the beautiful Giulia Farnese, known as Giulia Bella, and created her brother Alessandro a cardinal (1493). The latter was elected pope as Paul III. in 1534, and it is from that moment that the great importance of the family dates. An unblushing nepotist, he alienated immense fiefs belonging to the Holy See in favour of his natural children. Of these the most famous was Pierluigi Farnese (1503-1547), who served in the papal army in various campaigns, but also took part in the sack of Rome in 1527. On his father's elevation to the papacy he was made captain-general of the Church, and received the duchy of Castro in the Maremma, besides Frascati, Nepi, Montalto and other fiefs. A shameless rake and a man of uncontrollable temper, his massacre of the people of Perugia after a rebellion in 1540 and the unspeakable outrage he committed on the bishop of Fano are typical of his character. In 1545 his father conferred on him the duchy of Parma and Piacenza, which likewise belonged to the Holy See, and his rule proved cruel and tyrannical. He deprived the nobles of their privileges, and forced them to dwell in the towns, but to some extent he improved the conditions of the lower classes. Pierluigi being an uncompromising opponent of the emperor Charles V., Don Ferrante Gonzaga, the imperial governor of Milan, was ever on the watch for a pretext to deprive him of Piacenza, which the emperor greatly coveted. When the duke proceeded to build a castle in that town in order to overawe its inhabitants, the nobles were furiously indignant, and a plot to murder him was organized by the marquis Anguissola and others with the support both of Gonzaga and of Andrea Doria (q.v.), Charles's admiral, who wished to be revenged on Pierluigi for the part he had played in the Fiesco conspiracy (see Fiesco). The deed was done while the duke was superintending the building of the above-mentioned citadel, and his corpse was flung into the street (December 10th, 1547). Piacenza was thereupon occupied by the imperialists.
Pierluigi had several children, for all of whom Paul made generous provision. One of them, Alessandro (1520-1589), was created cardinal at the age of fourteen; he was a man of learning and artistic tastes, and lived with great splendour surrounded by scholars and artists, among whom were Annibal Caro, Paolo Giovio, Mons. Della Casa, Bembo, Vasari, etc. It was he who completed the magnificent Farnese palace in Rome. He displayed diplomatic ability on various missions to foreign courts, but failed to get elected to the papacy.
Orazio, Pierluigi's third son, was made duke of Castro when his father became duke of Parma, and married Diane, a natural daughter of Henry II. of France. Ottavio, the second son (1521-1586), married Margaret, the natural daughter of Charles V. and widow of Alessandro de' Medici, at the age of fifteen, she being a year older; at first she disliked her youthful bridegroom, but when he returned wounded from the expedition to Algiers in 1541 her aversion was turned to affection (see Margaret of Austria). Ottavio had been made lord of Camerino in 1540, but he gave up that fief when his father became duke of Parma. When, on the murder of the latter in 1547, Piacenza was occupied by the imperialists, Paul determined to make an effort to regain the city; he set aside Ottavio's claims to the succession of Parma, where he appointed a papal legate, giving him back Camerino in exchange, and then claimed Piacenza of the emperor, not for the Farnesi, but for the Church. But Ottavio would not be put off; he attempted to seize Parma by force, and having failed, entered into negotiations with Gonzaga. This unnatural rebellion on the part of one grandson, combined with the fact that it was supported by the other grandson, Cardinal Alessandro, hastened the pope's death, which occurred on the 10th of November 1549. During the interregnum that followed Ottavio again tried to induce the governor of Parma to give up the city to him, but met with no better success; however, on the election of Giovan Maria Ciocchi (Julius III.) the duchy was conferred on him (1551). This did not end his quarrel with the emperor, for Gonzaga refused to give up Piacenza and even threatened to occupy Parma, so that Ottavio was driven into the arms of France. Julius, who was anxious to be on good terms with Charles on account of the council of Trent which was then sitting, ordered Farnese to hand Parma over to the papal authorities once more, and on his refusal hurled censures and admonitions at his head, and deprived him of his Roman fiefs, while Charles did the same with regard to those in Lombardy. A French army came to protect Parma, war broke out, and Gonzaga at once laid siege to the city. But the duke came to an arrangement with his father-in-law, by which he regained Piacenza and his other fiefs. The rest of his life was spent quietly at home, where the moderation and wisdom of his rule won for him the affection of his people. At his death in 1586 he was succeeded by his son Alessandro Farnese (1545-1592), the famous general of Philip II. of Spain, who spent the whole of his reign in the Flemish wars.
The first years of the reign of his son and successor Ranuccio I. (1569-1622), who had shown much spirit in a controversy with Pope Sixtus V., were uneventful, but in 1611 a conspiracy was formed against him by a group of discontented nobles supported by the dukes of Modena and Mantua. The plot was discovered and the conspirators were barbarously punished, many being tortured and put to death, and their estates confiscated. Ranuccio was a reserved and gloomy bigot; he instituted savage persecutions against supposed witches and heretics, and lived in perpetual terror of plots. His eldest son Alessandro being deaf and dumb, the succession devolved on his second son Odoardo (1612-1646), who fought on the French side in the war against Spain. His failure to pay the interest of the money borrowed in Rome, and the desire of Urban VIII. to obtain Castro for his relatives the Barberini (q.v.), resulted in a war between that pope and Odoardo. His son and successor Ranuccio II. (1630-1694) also had a war with the Holy See about Castro, which was eventually razed to the ground. His son Francesco Maria (1678-1727) suffered from the wars between Spain and Austria, the latter's troops devastating his territory; but although this obliged him to levy some burdensome taxes, he was a good ruler and practised economy in his administration. Having no children, the succession devolved at his death on his brother Antonio (1679-1731), who was also childless. The powers had agreed that at the death of the latter the duchy should pass to Don Carlos of Bourbon, son of King Philip V. of Spain by Elisabetta Farnese (1692-1766), granddaughter of Ranuccio II. Antonio died in 1731, and with him the line of Farnese came to an end.
The Palazzo Farnese in Rome, one of the finest specimens of Roman Renaissance architecture, was begun under Paul III., while he was cardinal, by Antonio da San Gallo, and completed by his nephew Cardinal Alessandro under the direction of Michelangelo (1526). It was inherited by Don Carlos, afterwards king of Naples and Spain, and most of the pictures were removed to Naples. It now contains the French embassy to the Italian court, as well as the French school of Rome.
Bibliography. - F. Odorici gives a detailed history of the family in P. Litta's Famiglie celebri italiane, vol. x. (Milan, 1868), to which an elaborate bibliography is appended, including manuscript sources; a more recent bibliography is S. Lottici and G. Sitti, Bibliografia generale per la storia parmense (Parma, 1904); much information will be found in A. von Reumont's Geschichte der Stadt Rom, vol. iii. (Berlin, 1868), and in F. Gregorovius's Geschichte der Stadt Rom (Stuttgart, 1872).
Note - this article incorporates content from Encyclopaedia Britannica, Eleventh Edition, (1910-1911) | <urn:uuid:44733430-f8db-407c-8199-349cb2144b63> | CC-MAIN-2018-51 | http://www.maximapedia.com/f/farnese.html | s3://commoncrawl/crawl-data/CC-MAIN-2018-51/segments/1544376825029.40/warc/CC-MAIN-20181213171808-20181213193308-00376.warc.gz | en | 0.980587 | 2,161 | 3.125 | 3 |
There will not be sufficient doses of a coronavirus vaccine to cover the wider EU population before 2022, officials said today in an internal meeting.
If an effective antidote does become available, only a share of the 450 million people who live in the European Union will receive it before the end of 2021.
The warning comes as governments remain split on vaccination plans.
The 27 member states in the EU have secured more than one billion doses of potential Covid-19 vaccines from three drugmakers.
The trade bloc is also negotiating the booking of another one billion vials with other companies.
As a global scramble to secure shots accelerates, experts caution that not every potential vaccine may prove to be effective.
“There will not be sufficient doses of Covid-19 vaccines for the entire population before the end of 2021,” a European Commission official told diplomats from EU states in a closed-door meeting, according to a report made to Reuters.
A second official confirmed the statement.
An EU Commission spokesman was not immediately available for comment.
There is still no effective Covid-19 vaccine, but the first shots could be available at the beginning of next year, the Commission said earlier in October. | <urn:uuid:e078e8c9-02a6-4a10-9529-f0e5a364f3d0> | CC-MAIN-2021-10 | https://e-virusnews.com/eu-news/2022-before-a-covid-vaccine-is-available-to-all-in-eu/ | s3://commoncrawl/crawl-data/CC-MAIN-2021-10/segments/1614178358956.39/warc/CC-MAIN-20210227114444-20210227144444-00540.warc.gz | en | 0.938023 | 247 | 2.578125 | 3 |
Note: This page contains sample records for the topic vesico vaginal fistula from Science.gov.
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This article discusses vesico-vaginalfistulae: their causes, prevention, and treatment. A vesico-vaginalfistula is an obstetric complication consisting of a hole in the vaginal wall connecting to the bladder or rectum, often resulting from prolonged and obstructed labor. Most women with fistulae are poor, young, malnourished from birth, chronically anemic, susceptible to disease, and often physically stunted. Incontinence is an immediate effect of fistulae. Nerves in the pelvic region may also be damaged, leading to difficulty in walking. Women with fistulae may smell strongly of urine, and thus are often abandoned by their husbands and considered outcasts in the community. A small proportion of fistulae may heal if the woman is hospitalized and the bladder is drained continuously. Surgical repair is also possible. Obstetric fistulae can be prevented through nutritional improvement, access to family planning, presence of a skilled attendant during childbirth, delaying marriage and first birth, use of a partograph, and use of maternity waiting homes. PMID:12322285
One hundred and thirteen patients with vesico-vaginalfistula were seen at the University of California Hospital from 1932 through 1959. The most common cause of fistula was trauma associated with pelvic operation, and the operation most often involved was total abdominal hysterectomy. Malignant disease of the pelvic organs was the second most common cause, while radiation therapy and obstetrical causes were next in the order of frequency. Three fistulas healed spontaneously. Twelve bladder by-pass operations were done and 54 repairs were carried out in 46 patients. Thirty-eight patients (82.6 per cent) were cured after one or more repair operations. A variety of operative approaches were used, selected in accordance with the needs of the individual case. Bladder distention postoperatively, due to a plugged catheter, was held responsible for failure of the repair in three cases, and this complication was considered preventable. Close attention to surgical technique, the recognition of bladder injury, and proper repair at the time of operation are prime factors in the prevention of vesico-vaginalfistula.
Obstetrical vesico-vaginalfistulas in Africa are very frequent and are correlated with the insufficiency or even the lack of health structures and sanitary conditions. They follow up a dystocic parturition, and their prevention requires a correct surveillance of pregnancy and parturition. Their pathogenesis consists in a durable compression of the pelvic cavity by the foetal head, inducing ischemia and later on necrosis. Their difficult treatment is based on clinical inspection which makes possible to distinguish several pathological types of fistulas. Surgical tactic will be selected according to the size of the fistula, the conservation or the destruction of the uretra with the vesico-uretral sphincters, the importance of perifistula sclerosis. BRACQUEHAYE'S operation is the basis of the conservatory treatment, associated or not with a technic restoring the urinary continence: either the INGELMAN-SUNDBERG operation of the LE GUYADER rectomyoplasty. When uretra is destroyed, the best palliative intervention is probably the building up of a rectal neobladder. These operations can be performed under conditions often prevailling in Africa. In most cases, they have restored normal social life for the women affected. But setbacks are not rare, and demonstrate the importance of prophylaxis. PMID:6999282
Foreign body is a rare cause of vesico-vaginalfistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginalfistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.
Foreign body is a rare cause of vesico-vaginalfistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginalfistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications. PMID:24116334
This was a case of Gishiri cut in a patient with Meyer-Rokitansky-Kuster-Hauser syndrome resulting in a vesico-vaginalfistula and urethral loss. This followed an attempt to enlarge and lengthen the vagina to enhance penile penetration. Few cases of MRKH syndrome presenting with complications after an attempt at treatment by traditional birth attendants have been reported. This report is particularly of essence as most urinary fistulae in Nigeria are obstetric fistulae following prolonged obstructed labour. PMID:20348986
Background and Aim: The urinary bladder becomes small, contracted and is associated with excess pelvic fat in long standing cases of vesico-vaginalfistulas (VVFs). The aim of this new technique was to use this excess pelvic fat for harvesting an interposition flap. Materials and Methods: An interposition flap of peri-vesical fat was raised from the anterior, superior and posterior surfaces of the urinary bladder and was interposed between the right angle closed vaginal vault and the urinary bladder to strengthen the repair. This technique was used in two patients of VVFs. Results: Both the patients had successful outcome and were able to retain sufficient quantity of urine at 3 months follow-up. Conclusions: Peri-vesical fat flap proved an effective interposition flap in the repairs of VVFs in selected cases.
Introduction We report a case of a vesico-vaginalfistula (VVF) post cold cup biopsy; to our knowledge this is the only reported case. We present the clinical history/presentation, investigation and the outcome of the treatment. VVFs are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing a VVF is more than 1% after radical surgery and radiotherapy for malignancies. Management of these fistulas has been better defined and standardized over the last decade. Methods and results A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder. In addition there was a long history of smoking with its effects on tissue integrity and healing. VVFs are very rare and are an unpleasant outcome post a cold cup biopsy, adding to the psychological and social effects of the surgical treatment. Conclusion Although cold cup biopsy is a normal day procedure performed by both residents and consultants, consensus should exist on how to treat a patient who has a bladder with defective integrity and small capacity. The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.
Mawhinney, Abigail; Hameed, Ammar; Thwaini, Ali; Mulholland, Colin
A 10% sample was drawn from 3000 records on vesicovaginal fistulae operations performed at the Addis Ababa Fistula Hospital for Poor Women with Childbirth Injuries and their content were analyzed. In 88% of the cases under review the operation was classified as successful. The results of this study underline the tremendous maternal health gains which can be achieved by appropriate obstetric care in case of obstructed labour. It also reinforced the need for early detection and referral of high risk births among the very young mothers who are likely to experience an obstructed labour, the loss of the child, vesico-vaginalfistulae and possibly a ruptured uterus. In the absence of likely increases in the availability of transport, the building of waiting homes at maternal clinics is encouraged so that women can await delivery in the vicinity of a referral centre. There is a need for increased attendance of delivery by trained personnel as well as for continuing education for both staff and traditional birth attendants. It is further recommended to train former patients as helpers for the dedicated care which needs to be extended to the unfortunate, and often stigmatized victims. PMID:7571703
The problem of maternal ill-health is growing all over the world, especially in developing countries. Data from the international workshop on vesico-vaginalfistulae cited that there are 2 million women suffering from fistulae, 200,000 of them in Nigeria. In response to this crisis, fistula-treating hospitals have been set up and training of doctors is taking place in several countries in Africa. However, maternal morbidity and mortality rates in sub-Saharan Africa are not decreasing. This situation is mainly attributed to poverty, wherein the basic essentials such as food, water, and sanitation are lacking. Yet, a number of health care providers are doing their job very well. Noteworthy, for instance, is the introduction of well supervised, trained traditional birth attendants, which resulted in a decline in maternal mortality in a rural area in Nigeria; clinics that have been staffed by trained midwives and follow strict protocol guidelines; health care programs that have provided better education, better antenatal care, and better use of community health workers in Ethiopia; and the building of maternity waiting homes near maternity hospitals for women considered to be at risk. PMID:12322286
Vaginalfistula (VF) is a devastating complication following restorative proctocolectomy. PURPOSE: This study was designed to examine the perioperative factors influencing the outcome and management of vaginalfistula. METHOD: Between October 1983 and September 1994, 526 women underwent restorative proctocolectomy. Nineteen develop VF (3.6 percent), and six were referred from other institutions with this complication. These 25 women were followed
Patrick Y. Lee; Victor W. Fazio; James M. Church; Tracy L. Hull; Kong-Weng Eu; Ian C. Lavery
We present the case of a vesicouterine fistula secondary to a caesarean section indicated due to the disproportion the pelvis and the head of the baby. This kind of fistula is due fundamentally to obstetric causes, especially to caesarean sections in developed countries and to prolonged labour in developing countries. The commonest clinical presentation is urinary incontinence in the form of continuous or intermittent urinary leaks. Surgical treatment is generally the therapy of choice, although, in the case of small fistulas, conservative treatment is feasible. The best form of prevention is correct indication of caesarean section and careful surgical technique. PMID:12812125
Medina Ramos, N; Cerezuela Requena, J F; Martín Martínez, A; García Hernández, J A; Chesa Ponce, N
Objective: To determine the appropriateness of vaginal approach for gynecological supratrigonal vesicovaginal fistulae. Patients and Methods: Retrospective review of consecutive women with gynecological supratrigonal VesicoVaginalFistulae (VVF) repaired at the fistula unit of Urogynecology department between 1996 and 2011 was done.Out of 48 cases of supratrigonal VVF of gynecological origin identified; 34 (70.8%) cases were repaired vaginally and 14 (36.8%) abdominally with a mean follow-up period of 52.8 (2-132) months. Results: Overall 95.8% were successfully cured at first attempt. The success rate of vaginal repair (94.8%) at first attempt was comparable to that of abdominal repair (100%) (P value = 0.8946). Amongst two failed vaginal repairs, one was successfully cured by subsequent vaginal repair and other by abdominal repair. Conclusion: Three fourth gynecological supratrigonal VVF can be repaired vaginally in first attempt with success rate comparable to abdominal approach. On the basis of this study we postulate that vaginal approach should be preferred over abdominal approach for repair of all vaginally accessible supratrigonal VVF of gynecological origin.
Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction.
Sarhan, Osama M.; Al-Ghanbar, Mustafa S.; Nakshabandi, Ziad M.
Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction. PMID:24311916
Sarhan, Osama M; Al-Ghanbar, Mustafa S; Nakshabandi, Ziad M
The authors report a series of 22 cases of post-obstetrical genito-urinary lesions. In addition, they analyse the cases of 12 patients suffering of vesico-vaginalfistulae (9) or uretero-vaginalfistulae (3). They point out evident regression of these fistulae in this country which become of simple type and also emphasize on preventive measures which should be taken to reduce even more its frequency. PMID:8514995
Vagino-vesico-cutaneous fistula is a rare condition characterised by continuous dribbling of urine and secondary infection of the involved areas with poor self-esteem. Osteomyelitis is delayed complication of radiotherapy treatment for cervical cancer. Treatment of these conditions is a challenging entity especially after previous surgery and irradiation. We present a case of vesicocutaneous - vesicovaginalfistula with osteomyelits of the right pubic bone which was a late complication of post-cervical cancer radiotherapy.
Contemporary literature regarding the management of neobladder-vaginalfistula and stress urinary incontinence following radical cystectomy and neobladder reconstruction in women is reviewed in this article. Neobladder-vaginalfistula is uncommon but mandates meticulous repair. Compared to the native bladder, the wall of the neobladder is much thinner that may render it vulnerable to fistulization. Preservation of the anterior vaginal wall during radical cystectomy decreases the likelihood of pouch-vaginalfistula. Omental flap interposition between the vaginal stump and neobladder at cystectomy may not always prevent fistulization if anterior vaginal wall is violated or overlapping suture lines are not avoided. Surgery for intractable stress incontinence following neobladder reconstruction is fraught with severe complications and requires judicious use of allograft pubovaginal slingplasty possibly with bone anchors. Martius flap interposition appears to play a crucial role in improving the outcome following transvaginal repair of the neobladder-vaginalfistula in multiple non-overlapping layers. PMID:16160880
Tunuguntla, Hari S G R; Manoharan, Murugesan; Gousse, Angelo E
We present a case of a thick transverse vaginal septum with a vesicovaginal fistula treated with vaginal expansion using dilators, followed by surgery. A 27-year-old woman was admitted to our hospital with vaginal atresia and cyclical hematuria. Urethroscopy and cystography showed a vesicovaginal fistula between the proximal vagina and bladder. The vaginal septum was 4 cm thick. Over a 6-month period, the distal vagina was expanded with the use of dilators and the septum was sufficiently thinned. Reconstruction using a transvaginal and transabdominal approach created a direct anastomosis between the proximal and distal vagina. No vaginal strictures or contractures in the anastomotic region have been observed during the 12 months following surgery. The combination of expansion and subsequent reconstructive surgery for the treatment of a thick transverse vaginal septum with a vesicovaginal fistula was less invasive than alternative surgical approaches and provided the desired outcome. PMID:22109703
Menouria due to congenital vesicovaginal fistula is rare entity. We report a case of a 22-year-old female who presented with\\u000a menouria. On evaluation, she had congenital vesicovaginal fistula and obstructing complete vaginal septum. McIndoe vaginoplasty\\u000a and fistula repair through vaginal route was performed.
Menouria due to congenital vesicovaginal fistula is rare entity. We report a case of a 22-year-old female who presented with menouria. On evaluation, she had congenital vesicovaginal fistula and obstructing complete vaginal septum. McIndoe vaginoplasty and fistula repair through vaginal route was performed. PMID:20737136
Congenital vesicovaginal fistula is an extreme rarity. We report on a case of a 22-year-old lady who presented with menouria and infertility. On evaluation, she was found to have congenital vesicovaginal fistula, a nonfunctioning right kidney with ectopic ureter and transverse vaginal septum. Abdominal repair of the fistula, right nephroureterectomy, and excision of the vaginal septum was performed. PMID:17143654
We present a case of iatrogenic urethrovaginal fistula with transverse vaginal septum. The patient presented with cyclical hematuria and infertility. The vagina was blind-ending. The magnetic resonance imaging (MRI) showed normal uterus with transverse vaginal septum. The cystoscopic examination during cyclical hematuria revealed bloody efflux through a small fistula below the internal urethral sphincter. Vaginoplasty and repair of the urethrovaginal fistula was done. The vagina was reconstructed using an amniotic mould. The report emphasizes the importance of MRI and cystoscopy in diagnosing such rare and complex anomalies. PMID:22279328
Vesicovaginal fistula (VVF) is a very commonly encountered urogynaecological entity in developing countries such as India. The most common cause of VVF in developing counties is secondary to obstructive labour. We report a very unusual case of VVF in a young woman that developed due to insertion of an unknown vaginal herb for treatment of primary infertility. Cystoscopy showed a single trigonal fistula measuring 3×2 cm just near the bladder neck. Vaginoscopy revealed cicatrised less capacious vagina and unhealthy vaginal mucosa. She was treated with transvaginal VVF repair using Martius flap interposition which leaked on 10th postoperative day. She underwent re-evaluation and another transvaginal fistula repair for small trigonal residual fistula after 3 months. She is doing well during the follow-up of 2 years. She attained sexual activity after 3 months of surgical repair but could not conceive. PMID:24092608
Background: Urinary–vaginalfistula is one of the most common and dreaded complications of obstetric trauma in developing countries. Management of these fistulas is complicated by the presence of substantial urethral loss and the tendency of the repair to break down.Study Design: We retrospectively studied 46 patients with urinary–vaginalfistulas operated on in our institution over 5 years. Most of the
N. P Rangnekar; N Imdad Ali; S. A Kaul; H. R Pathak
Congenital vesicovaginal fistula is an extreme rarity. We report on a case of a 22-year-old lady who presented with menouria\\u000a and infertility. On evaluation, she was found to have congenital vesicovaginal fistula, a nonfunctioning right kidney with\\u000a ectopic ureter and transverse vaginal septum. Abdominal repair of the fistula, right nephroureterectomy, and excision of the\\u000a vaginal septum was performed.
An 18-year-old woman presented with history of cyclic hematuria, abdominal pain, and a mass in the hypogastrium. She was found\\u000a to have transverse vaginal septum in the lower one-third of her vagina with congenital vesicovaginal fistula (VVF) and a dead\\u000a fetus of approximately 20 weeks gestation. She underwent vaginotomy and removal of the dead fetus. Vaginal repair of VVF was\\u000a carried
An 18-year-old woman presented with history of cyclic hematuria, abdominal pain, and a mass in the hypogastrium. She was found to have transverse vaginal septum in the lower one-third of her vagina with congenital vesicovaginal fistula (VVF) and a dead fetus of approximately 20 weeks gestation. She underwent vaginotomy and removal of the dead fetus. Vaginal repair of VVF was carried out 3 months later. PMID:16897124
Surgical treatment of female stress urinary incontinence (SUI) has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF) plus inguinal abcess after tension-free vaginal tape (TVT). A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT. PMID:23820661
?ahin, Ali Feyzullah; ?lbey, Yusuf Özlem; ?ahin, Nur
A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginalfistula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fistulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fistula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on.
Sivarajah, Vernon; Bello, Sean OZ; Yiu, Chu Yiu; Oke, Olatokunbo
Background: Recto-vaginalfistula is primarily one of the co-morbidities of vaginal delivery. These patients suffer from persistent malodor vaginal discharge. Various surgical techniques have been employed by surgeons in the course of time. This is the first trial of applying Human Amniotic Membrane (HAM) as a bio-prosthesis in repairing recto-vaginalfistula. Materials and Methods: In a prospective animal study, 8 mixed-breed female dogs weighing 23-27 kg with the age of 12-18 months were selected. They were randomly divided into two groups for standard recto-vaginalfistula repair and fistula repair with human amniotic membrane. The Kruskal-Wallis and Mann Whitney tests were performed to indicate statistical differences. Results: After 6 weeks, fistulas were evaluated both grossly and microscopically. In gross examination, there were no difference between the two groups and healing of fistula seemed to have been occurred in all dogs expect for one which had a persistent patent fistulous tract. Microscopic healing was scored according to epithelialization, collagenization inflammation, ulcer and necrosis of samples. Healing score was significantly higher in the HAM group than the standard group (P = 0.029). Conclusion: Our findings revealed that using HAM as a bio-prosthesis to repair recto-vaginalfistula would result in better surgical and histological outcomes comparing to simple repair.
Roshanravan, Reza; Ghahramani, Leila; Hosseinzadeh, Massood; Mohammadipour, Mastoureh; Moslemi, Sam; Rezaianzadeh, Abbas; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid
An 18-year-old female presented with primary amenorrhea and progressive cyclic abdominal pain, which prompted emergency exploratory laparotomy. Intraoperative findings revealed absent cervix and vagina, partial bicornuate uterus, hematometra, left tubal endometriosis, ruptured left endometrioma and left renal agenesis. Left salpingectomy, left oophorocystectomy, hysterotomy, evacuation of menstrual blood and transverse loop colostomy were performed. Depo-medroxyprogesterone acetate was administered to suppress menses. On re-exploration, utero-rectovestibular fistula anastomosis was described with the distal rectovestibular fistula functioning as a neovagina. Cyclic menses occurred thereafter. Endorectal pull-through with anoplasty was performed after the fistulous tract healed. To the best of our knowledge, this is the first reported case of cervico-vaginal agenesis associated with imperforate anus and rectovestibular fistula. Early diagnosis and surgery are necessary to avoid complications such as endometriosis. The aim was to preserve fertility with conservative management. PMID:18588621
A 13-year-old patient with a complaint of worsening lower abdominal pain during the past 4 months was admitted to the emergency department. An abdominopelvic ultrasound scan revealed a distended uterocervical cavity suggestive of hematometrocolpos. Imperforate hymen was observed on examination of the external genitalia. MRI scan revealed an air-fluid level representing pyometrocolpos within a distended vagina. Posterior vaginal extraperitoneal leakage as the sign of a fistula between the vagina and the rectovaginal space was detected. Although laparoscopic approach was planned, malodorous pus expelled after the insertion of the Veress needle, it was decided to proceed to laparotomy. Pus with peritoneal microabscess formations was observed at laparotomy. The imperforate hymen and TVS were excised vaginally. A more complex anomaly should be suspected in cases with hematometra and concomitant imperforated hymen without any bulging and thorough evaluation using radiological imaging techniques should be performed before surgical approach. PMID:24660080
A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between ... two arteries. Some people are born with a fistula. Other common causes of fistulas include Complications from ...
AIM: To communicate our findings on successful treatment of recto-vaginalfistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 1998 and 2008 was performed. A total of 80 patients with RVF were identified, of which five patients (6%), with a mean age of 65 years (range: 52-73), had undergone previous surgery for POP with prosthetic reinforcement. RESULTS: All patients complained about ongoing vaginal infections and febrile episodes. These symptoms were reported after a mean period of 18 mo after POP repair. As a first intervention, three patients underwent ablation of the prosthetic material (PM). As a second intervention, open proctectomy with a primary anastomosis, an omental patch, and a protective ileostomy were performed in two patients. One patient required a terminal colostomy due to complete destruction of the anal sphincters. In two other patients, ablation of the PM and proctectomy was performed as a one-step procedure. The postoperative course in all patients was uneventful, with a mean length of hospitalization of 20 d (range: 15-30). Closure of the ileostomy was achieved in all four patients within four months. After a mean period of 35 mo (range: 4-60) of follow-up, no recurrence was observed with normal continence in four patients. CONCLUSION: In our experience, the definitive treatment of high RVFs after PM repair for POP necessitates ablation of the PM, proctectomy with a primary colo-rectal anastomosis, an omental patch interposition, and a temporary ileostomy.
Objective. In irreparable or recurrent vesicovaginal fistulas and cloacal defects following high-dose irradiation therapy for gynecological malignancies, urinary diversion is the last resort to achieve a socially acceptable solution. In a select group of young and tumor-free patients, additional vaginal reconstruction may be indicated. Multiple operative procedures are available, but the results are often disappointing in the previously irradiated area.Materials
Joachim Leissner; Peter Black; Dragana Filipas; Margit Fisch; Rudolf Hohenfellner
Recto-urinary, recto-vaginal and ileo-anal pouch-associated fistulae are rare yet a significant clinical problem due to their profound impact on patients' quality of life and are a challenge to repair. In this report, we describe repair of these complex fistulae using a modified trans-sphincteric posterior sagittal approach with Surgisis™ mesh and fibrin sealant and review our repair outcomes. PMID:23095950
We report a case of grade III pseudomyxoma peritonei revealed by mucusuria and abdominal mass. These symptoms are unusual; the most frequent clinical presentation is acute appendicitis or progressively increasing abdominal diameter. PMID:24462837
Magnetic resonance imaging (MRI) has become an important part of the assessment of suspected vaginal pathology. This pictorial review demonstrates the MRI features and some of the histopathological findings of a variety of vaginal conditions. These may be congenital (total vaginal agenesis, partial vaginal agenesis, longitudinal vaginal septum, transverse vaginal septum), benign (Bartholin's cyst, diffuse vaginal inflammation, invasive endometriosis, ureterovaginal fistula, post-surgical appearances with the formation of a neovagina and adhesions) or malignant, usually due to extension or recurrence from another pelvic malignancy. In this paper, examples of the above are described and illustrated together with examples of the much rarer primary vaginal malignancies. PMID:16038691
\\u000a Urogenital fistulae are a rare condition in western countries. Due to the wide variety and individuality of the clinical manifestations\\u000a of these injuries, it is practically impossible to find and create common guidelines for treatment. Prevention of urogenital\\u000a fistulae can be achieved through both improvements in obstetric care and profound training in vaginal surgery. The success\\u000a of any surgical treatment
Background Rectovaginal fistulas (RVFs) have multiple causes, size and location on which the surgical treatment depends. Description The Authors consider different approaches to RVFs and describe a clinical case of recurrent high RVF. Conclusions Most RVFs can be successfully repaired, although many interventions may be necessary. A colostomy with delayed repair may improve RVFs outcome. Moreover, several authors indicate Mucosal Advancement Flap and Babcock-Bacon technique as the treatments of choice respectively for low and high RVFs (complex and recurrent) and emphasize the placement of endoscopic prothesis in cases of difficult healing of the anastomosis.
To our knowledge, peritoneovaginal fistula is a complication of cystectomy that has not been reported before. We describe 2 patients in whom a transvaginal approach using a Martius flap was utilized to repair persistent vaginal leakage after cystectomy. At a mean follow-up of 20 months, both patients are free from vaginal leakage and have no evidence of recurrent fistula. This approach offers a safe and effective way to repair a peritoneovaginal fistula in a cystectomy patient. PMID:10925104
Blander, D S; Zimmern, P E; Lemack, G E; Sagalowsky, A I
Objective The abdominal route of genitourinary fistula repair may be associated with longer term hospitalisation, hospital-associated infection and increased resource requirements. We examined: (1) the factors influencing the route of repair; (2) the influence of the route of repair on fistula closure 3 months following surgery; and (3) whether the influence of the route of repair on repair outcome varied by whether or not women met the published indications for abdominal repair. Design Prospective cohort study. Setting Eleven health facilities in sub-Saharan Africa and Asia. Population The 1274 women with genitourinary fistula presenting for surgical repair services. Methods Risk ratios (RRs) and 95% confidence intervals (95% CIs) were generated using log-binomial and Poisson (log-link) regression. Multivariable regression and propensity score matching were employed to adjust for confounding. Main outcome measures Abdominal route of repair and fistula closure at 3 months following fistula repair surgery. Results Published indications for abdominal route of repair (extensive scarring or tissue loss, genital infibulation, ureteric involvement, trigonal, supratrigonal, vesico-uterine or intracervical location or other abdominal pathology) predicted the abdominal route [adjusted risk ratio (ARR), 15.56; 95% CI, 2.12–114.00]. A vaginal route of repair was associated with increased risk of failed closure (ARR, 1.41; 95% CI, 1.05–1.88); stratified analyses suggested elevated risk among women meeting indications for the abdominal route. Conclusions Additional studies powered to test effect modification hypotheses are warranted to confirm whether the abdominal route of repair is beneficial for certain women.
Frajzyngier, V; Ruminjo, J; Asiimwe, F; Barry, TH; Bello, A; Danladi, D; Ganda, SO; Idris, S; Inoussa, M; Lynch, M; Mussell, F; Podder, DC; Barone, MA
Vesicovaginal fistulas are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing vesicovaginal fistula is more than 1% after radical surgery and radiotherapy for gynecologic malignancies. Management of these fistulas has been better defined and standardized over the last decade. We describe in this paper the success rate reported in the literature by treatment modality and the guidelines used at our teaching hospitals, University of Rome Campus Biomedico and University of Miami School of Medicine. In general, our preferred approach is a trans-vaginal repair. To the performance of the surgical treatment, we recommend a minimum of a 4-6 week's wait from the onset of the fistula. The vaginal repair techniques can be categorized as to those that are modifications of the Latzko procedure or a layered closure with or without a Martius flap. The most frequently used abdominal approaches are the bivalve technique or the fistula excision. Radiated fistulas usually require a more individualized management and complex surgical procedures. The rate of successful fistula repair reported in the literature varies between 70 and 100% in non-radiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91 and 97%, respectively. Fistulas in radiated patients are less frequently repaired and the success rate varies between 40 and 100%. In this setting many institutions prefer to perform a urinary diversion. In conclusion, the vaginal approach of vesicovaginal fistulas repair should be the preferred one. Transvaginal repairs achieve comparable success rates, while minimizing operative complications, hospital stay, blood loss, and post surgical pain. We recommend waiting at least 4-6 weeks prior to attempting repair of a vesicovaginal fistula. It is acceptable to repeat the repair through a vaginal approach even after a first vaginal approach failure. In the more individualized management of fistulas associated with radiation, the vaginal approach should still be considered. PMID:14693342
Entero-enteral fistula; Enterocutaneous fistula; Fistula - gastrointestinal ... Most gastrointestinal fistulas occur after surgery. Other causes include: Gastrointestinal obstruction Inflammatory processes, such as infection or inflammatory bowel disease (most ...
To improve surgical outcomes in patients with complicated recurrent, radiation-induced, giant and multiple vesicovaginal fistulas, we have developed a new combined method of fistuloplasty (patent 21350999). The method was used in 12 of 32 operations made in 1997-2007 in the urological clinic of the Kazan Medical University for vesicovaginal fistula in patients aged 19 to 72 years. The technique was applied in women with vesicovaginal fistula located close to the ureteral orifice. Good results of the operation were achieved due to leak-proof sutures, accurate dissection of the bladder from the vagina and intact blood supply of the tissues. Two surgical approaches were used: transvesical and vaginal. Neither complications nor relapses occurred in all 12 patients operated by the proposed technique of combined fistuloplasty which proved to be effective in recurrent, complicated, combined fistulas and is a method of choice in complicated, recurrent, radiation-induced, giant and multiple fistulas. PMID:20973131
Management of vaginal prolapse in the elderly lacks a uniform consensus and continues to remain challenging. The authors report a case of an elderly lady who presented with a spontaneous vaginal evisceration. She had a long-standing vaginal prolapse being controlled by a shelf pessary, which, in her case became displaced 2 weeks prior to admission. The patient underwent a laparotomy with an intent to replace the bowel back within the peritoneal cavity and repair the vault. During the pelvic floor repair, she sustained an inadvertent button-hole injury to the rectum, which was oversewn. She went on to develop a rectovaginal fistula requiring a de-functioning colostomy. The patient made good recovery subsequently.
I, Siddiqui; A, Samee; C, Hall; J, Cooper; F, O'Mahony
Vaginal dryness is present when the tissues of the vagina are no longer well-lubricated and healthy. When ... sexual intercourse more comfortable. It also helps decrease vaginal dryness. If estrogen levels drop off, the vaginal tissue ...
... symptoms. Common causes are bacterial infections, trichomoniasis, and yeast infections. Some other causes of vaginal symptoms include sexually transmitted diseases, vaginal cancer, and vulvar cancer. Treatment of vaginal problems depends ...
Colovesical fistulas were identified in 42 patients. Diverticulitis was the underlying cause in 40 per cent of the patients. Carcinoma of the colon or cervix caused 33 per cent of the fistulas. Cystoscopy was the most effective procedure in diagnosing the fistulas. Surgical therapy had to be individualized to the patient's condition. Fistulas secondary to radiation were associated with a high complication rate.
Leiomyomas are common benign tumors in the uterus. However, vaginal leiomyomas remain an uncommon entity with only about 300 reported cases. Here, we report a case of a 38-year-old multigravida who presented with lower abdominal pain and vaginal bleeding. A physical examination and ultrasonography were performed, and a diagnosis of cervical fibroid was made. Pervaginal removal of the tumor was performed and subsequent histopathology revealed a vaginal leiomyoma. Although a rare tumor, vaginal leiomyomas may present with a variety of clinical features and may be mistaken preoperatively for cervical fibroid. Removal of tumor by vaginal route, wherever possible, with subsequent histopathological examination appears to be the optimum management plan.
Chakrabarti, Indranil; De, Anuradha; Pati, Shyamapada
Colouterine fistula complicating diverticulitis is rare. Our experience with two patients, one with chronic vaginal discharge\\u000a and the other with acute overwhelming sepsis, emphasizes the wide spectrum of clinical presentations that may accompany this\\u000a entity. In patients with chronic symptoms, surgery is indicated to forestall further local infectious complications, and a\\u000a single-stage sigmoid resection without hysterectomy may be adequate. If
Elliot L. Chaikof; Richard P. Cambria; Andrew L. Warshaw
The cholecystocolonic fistula is an atypical variant of biliary disease. When presenting with symptomatic disease, surgical treatment with cholecystectomy, fistula takedown and possible colonic resection are indicated, however the role of surgery in asymptomatic patients, especially those deemed higher risk is less clear. Herein we present a case of an incidentially discovered asymptomatic cholecystocolonic fistula in a higher risk surgical patient managed nonoperatively. The presentation and treatment options for this disease are discussed in relation to their application to this patient.
Vesicovaginal fistula (VVF) formation represents a condition with devastating consequences for the patient and continues to pose a significant challenge to the surgeon. Quick and accurate diagnosis, followed by timely repair is essential to the successful management of these cases. A thorough understanding of the pathophysiology and anatomy of the fistula, potential factors that may compromise healing and experience in the fundamental principles of fistula repair are the vital tools of the fistula surgeon. This review was undertaken to provide an overview of the key areas in VVF investigation and management.
Forty women presenting with mammillary fistulas over a 6 year period have been reviewed. The events preceding the fistula were incision of a periareolar breast abscess (n = 24), breast biopsy (n = 13) and spontaneous discharge of an inflammatory mass (n = 3). Only two of the women with abscesses were lactating. Two patients had granulomatous mastitis. The remaining 36 patients were all considered to have periductal mastitis/mammary duct ectasia as the cause of their fistulas. The two mammillary fistulas associated with lactation healed spontaneously. Nine patients had the fistula excised and the wound packed; this resulted in satisfactory healing in all but one patient. Twenty-one patients had excision of the fistula and primary closure, without antibiotic cover, but only ten healed without complications and six patients required further surgical procedures for a recurrent fistula. Six patients had primary excision and closure under antibiotic cover with a penicillin and metronidazole; all healed. Mammillary fistulas are complications of the periductal mastitis/duct ectasia syndrome. They should be treated by excision and primary closure under appropriate antibiotic cover or alternatively excised and left open to granulate. PMID:3607398
Vesicovaginal fistulas are often the result of obstetric trauma in third world countries or gynaecologic surgery in developed countries. The incidence of obstetric trauma is approximately 3-4/1000 births in West Africa. The incidence of fistulas as a result of surgery has remained relatively unchanged for years; 75% occur during gynaecologic procedures. The main clinical symptom of a vesicovaginal fistula is urine loss. Different surgical techniques with similar repair results are available: transvaginal approach, transvesical approach and transperitoneal approach. Irrespective of the approach used, requirements for successful repair include adequate surgical exposure, wide mobilization of the bladder and vagina, excision of the fistula tract, tension-free closure of the bladder and vagina, and placement of an interposition flap, i.e. Martius flap, omentum, peritoneum, when indicated. Using these surgical techniques, around 85% of women can be cured from their vesicovaginal fistula with a single operation. PMID:15702304
Vaginal leiomyomas are rare benign tumors. This is a case report with menstrual and urinary difficulties and vaginal mass with inner urethral meatus and hymen displacement. Miccional cystourethrography showed a posterior displaced, comprised and elongated urethra. Excretory urography and pelvic sonogram were normal. Preurethral enucleation extirpation with no complications was practiced. Current literature is reviewed. PMID:16972526
Leiomyomas are common benign tumors in the uterus. However, vaginal leiomyomas remain an uncommon entity with only about 300 reported cases. Here, we report a case of a 38-year-old multigravida who presented with lower abdominal pain and vaginal bleeding. A physical examination and ultrasonography were performed, and a diagnosis of cervical fibroid was made. Pervaginal removal of the tumor was performed and subsequent histopathology revealed a vaginal leiomyoma. Although a rare tumor, vaginal leiomyomas may present with a variety of clinical features and may be mistaken preoperatively for cervical fibroid. Removal of tumor by vaginal route, wherever possible, with subsequent histopathological examination appears to be the optimum management plan. PMID:21897740
Chakrabarti, Indranil; De, Anuradha; Pati, Shyamapada
INTRODUCTION Rectovaginal fistulas have a multitude of causes and it is well known that obstetric and gynecological problems form a large part of these causes such as our case. PRESENTATION OF CASE We present a 45-year-old female that presented with complaints of stool per vagina and was found to have a rectal vaginalfistula near the vaginal cuff from her previous uncomplicated vaginal hysterectomy. The patient was originally scheduled for a complex open abdominal surgery based on examination but underwent a sigmoidoscopy with vaginal examination and identified a small opening with minimal inflammation. The patient was treated with Bioglue® and had complete resolution of the fistula at follow-up. DISCUSSION There are numerous cases presented in the literature on the use of bioglue for anal fistulas and rectovaginal fistulas with multiple cases of success. However, in looking at the literature failure appears to be due to ongoing inflammation from the previous disease process. CONCLUSION Although the use of Bioglue® may not be suitable for all patients with rectovaginal fistulas, it offers yet another treatment modality for select patients.
Opinion statement External and internal pancreatic fistulas have a different etiology and natural history. Approximately 50% of internal and\\u000a 70% to 90% of external pancreatic fistulas can be expected to heal with nonoperative management. Nonclosure is predicted by\\u000a anatomic factors, which may be defined at endoscopic retrograde cholangiopancreatography or by CT if disconnected pancreatic\\u000a segments are seen. Enteral nutrition beyond the
The management of a postoperative rectovaginal fistula after low anterior resection for rectal cancer is difficult and requires reconstruction of the anastomotic site and fistula. The results of reconstructive operation are often unsatisfactory. Herein, we describe our reconstruction technique using the posterior approach through the vaginal lumen for a high rectovaginal fistula repair. This reconstructive operation is useful for postoperative rectovaginal fistulas accompanied by severe stenosis of the anastomotic site following low anterior resection for rectal cancer. PMID:12162534
... who is infected. What about other infections? Two sexually transmitted infections, chlamydia and gonorrhea, can also cause vaginal discharge. ... I need any tests, such as tests for sexually transmitted infections? What do my test results mean? Based on ...
... your vagina). A pessary can also help many women who have stress urinary incontinence (the leaking of urine when you cough, strain or exercise). Pregnant women who have incontinence can also use a vaginal ...
... estradiol vaginal ring is also used to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) ... mild soap and warm water. Do not use hot water or boil the applicator. Ask your pharmacist ...
... Female infants are normally born with a thin membrane ( hymen ) that surrounds the vaginal opening. In rare ... specific physiological purpose. high transverse septum: A thin membrane up high in an organism that lies crosswise. ...
Preauricular fistulae and their relapses are not exceptional in ENT practice. Simple topographic and anatomical relations in this area tempt us to underrate the surgical risk which is mainly the danger of incomplete removal and subsequent relapses. The elimination of nonidentifiable remnants of branchiomas in the granulation and scar tissue calls for resection extending to sound neighbouring structures which require more pretentious knowledge of clinical and anatomical conditions in this region. The authors operated successfully during the past 10 years 10 preauricular fistulae (primary operations) and two relapses. They outline the principles of surgery which were formulated with regard to their own experience, data in the literature and based on the most recent embryological findings; they emphasize preventive aspects of surgical treatment of preauricular fistulae. PMID:2713931
Vaginal leiomyoma is a very rare condition. The earliest reference made to such a tumor is attributed to Denys De Leyden in 1773, and the first review of the literature concerning such tumors was published in 1882. It is estimated approximately 300 leiomyomas of the vagina have been reported in the world literature. The case of a 39-year-old female with large vaginal leiomyoma illustrates the diagnostic difficulties in such cases. In leiomyoma of the vagina surgical treatment is recommended. PMID:12916261
We present a case in which there was optimal management of recurrent cervicovesical fistula. The patient sustained a fistula shortly after a cesarean for cephalopelvic disproportion in the second stage. She underwent an unsuccessful attempt at vaginal repair 3 months postpartum and continued experiencing intermittent urinary leakage through the vagina. She expressed a wish for further childbearing and was counseled to undergo fistula repair at the time of repeat cesarean section. Twenty-seven months after her first delivery, she had a second healthy pregnancy and the repair of her cervicovesical fistula was performed with collagen graft interposition at the time of her elective cesarean section. This case report highlights the importance of surgical timing and comments on various factors that possibly enhance the success of the fistula repair. PMID:24522933
An 18-year-old female patient with Crohn's disease had abdominal pain secondary to a retained pill camera. After several weeks of medical management, the camera spontaneously passed. However, the patient also had an intra-abdominal abscess that worsened, despite medical therapy. Surgical therapy was recommended and a 5cm infected urachal cyst with entero-urachal and vesico-urachal fistulas was discovered. An en-bloc resection of the entire area was performed to include the urachal cyst, the adherent portion of the dome of the bladder, and 15cm of associated ileum. The bladder was repaired, a suprapubic catheter was placed, and an ileo-ileal anastamosis was performed. Microscopic findings were consistent with active Crohn's disease and fistula formation. The entero-uracho-vesical fistula site was likely the site of the retained pill camera. The patient did well postoperatively and was discharged on postoperative day six without complications. PMID:23795327
Yheulon, Christopher G; Derosa, Daniel C; Gagliano, Ronald A
An 18-year-old female patient with Crohn's disease had abdominal pain secondary to a retained pill camera. After several weeks of medical management, the camera spontaneously passed. However, the patient also had an intra-abdominal abscess that worsened, despite medical therapy. Surgical therapy was recommended and a 5cm infected urachal cyst with entero-urachal and vesico-urachal fistulas was discovered. An en-bloc resection of the entire area was performed to include the urachal cyst, the adherent portion of the dome of the bladder, and 15cm of associated ileum. The bladder was repaired, a suprapubic catheter was placed, and an ileo-ileal anastamosis was performed. Microscopic findings were consistent with active Crohn's disease and fistula formation. The entero-uracho-vesical fistula site was likely the site of the retained pill camera. The patient did well postoperatively and was discharged on postoperative day six without complications.
Objective: To establish the efficacy of Macroplastique® in treating vesico-ureteric reflux (VUR) in adults with neuropathic bladder dysfunction.Patients and methods: Fifteen patients (12 male and three female), age range 19 to 80 years (mean age 38) were included in this study. Diagnosis was confirmed by videourodynamics. In seven patients reflux was present bilaterally. Twenty-two refluxing ureters were treated. Twelve patients
Urachal anomalies are uncommon defects arising either by incomplete obliteration of the urachus during the foetal period or by its reopening after postnatal regression. Five anomalies have been described: congenital patent urachus, urachal cyst, umbilical-urachal sinus, vesico-urachal diverticulum, and alternating sinus. Only congenital patent urachus is present at childbirth. The other forms are usually acquired disorders. Nevertheless, they commonly appear in children, being less common in the adult. Colic-urachal fistulas are quite uncommon findings. Only three cases have been reported thus far. The aim of this study is to report the fourth case of sigmoid-urachal fistula, and the first one appearing without an urachal cyst. PMID:12432840
We report on a patient who underwent total vaginal hysterectomy for urinary incontinence 8 years previously with a sling operation using transobturator tape (TOT). She was admitted to our hospital after complaints of vaginal discharge, foul odor, and bleeding, left thigh pain, and edema. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a fistula tract from the vagina or urethra with remnant sling tape. We removed the remnant tape using intraoperative ultrasonography. This case exemplifies the rare occurrence of a vaginalfistula extending to the obturator, adductor, and pectineus muscles combined with myositis after TOT placement. It is important that urogynecologists recognize that TOT procedures may result in complications accompanied by common recurrent vaginal symptoms, such as vaginal odor and spotting, which can be identified by MRI or CT. PMID:24085145
This patient education program reviews female reproductive anatomy and explains vaginal birth. It also discusses the stages of labor and delivery, as well as potential risks and complications. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.
A coronary artery fistula generally occurs when one of the coronary arteries fails to form properly during the development of the baby. Coronary artery fistula is an abnormal connection between one of ...
PURPOSE: This study was undertaken to assess results of surgery for fistula-in-ano and identify risk factors for fistula recurrence and impaired continence. METHODS: We reviewed the records of 624 patients who underwent surgery for fistula-in-ano between 1988 and 1992. Follow-up was by mailed questionnaire, with 375 patients (60 percent) responding. Mean follow-up was 29 months. Fistulas were intersphincteric in 180
Julio Garcia-Aguilar; Carlos Belmonte; W. Douglas Wong; Stanley M. Goldberg; Robert D. Madoff
This article reviews the mechanisms by which vaginal surgery affects female sexual function and related pathophysiology to potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed as they apply to vaginal surgery. Methods to avoid neurovascular damage during pelvic floor surgery have been corroborated by supporting literature. The incidence of female sexual dysfunction after various transvaginal procedures for indications such as stress urinary incontinence and pelvic organ prolapse, anterior/posterior colporrhaphy, perineoplasty, and vaginal vault prolapse has been discussed. Current literature regarding female sexual dysfunction following other procedures such as vaginal hysterectomy, Martius flap interposition, and vesicovaginal and rectovaginal fistula repair also are reviewed. PMID:15461920
Most external small bowel fistulas follow surgical operation, but a few develop spontaneously. Seventy percent will close with conservative treatment including vigorous nutritional support and elimination of sepsis. Internal fistulas involving the small bowel always result from extension of disease in the bowel or in adjacent viscera, and they virtually never close spontaneously. Our 11-year experience of 71 Crohn's fistulas
PurposeCongenital anterior urethrocutaneous fistula is a rare anomaly that may present in an isolated fashion or in association with other penile abnormalities, such as chordee or hypospadias. There have been 18 cases of congenital anterior urethrocutaneous fistula reported in the literature. We present 14 additional cases of congenital anterior urethrocutaneous fistula.
ANTHONY A. CALDAMONE; SHYH-CHYAN CHEN; JACK S. ELDER; MICHAEL L. RITCHEY; DAVID A. DIAMOND; MARTIN A. KOYLE
Congenital vesicovaginal fistula (CVVF) is a rare, complex female genital malformation that is difficult to diagnose, classify and treat. Symptoms include menouria, cyclical haematuria and urinary incontinence from birth. The aim of this review was to highlight the importance of correct diagnosis and treatment of this congenital anomaly. A comprehensive literature review was conducted to identify articles on CVVF with and without menouria. Forty-one articles were found, of which 31 described 37 original cases of congenital fistula (30 CVVF, six uterovesical fistula and one urethrovaginal fistula): 14 in girls and 23 in adults. The cases were classified according to clinical, diagnostic and therapeutic parameters in order to unify concepts and terms. Menouria occurred in 21 of the 23 adults: 14 cases were CVVF, six cases were congenital uterovesical fistula, and one case was congenital urethrovaginal fistula in a young woman without congenital adrenal hyperplasia. Sixteen (53%) of the 30 patients with CVVF had urinary incontinence or hydrocolpometra, and 14 (47%) had menouria. There were associated anomalies in 91% of cases, 29 (48%) of which involved the urinary tract. Various diagnostic and therapeutic methods were used, and there was confusion surrounding the aetiopathogenesis in most cases. CVVF should be suspected in any girl with urinary incontinence, urinary tract infections from birth, vaginal swelling or hydrocolpometras, as well as in adults with menouria. Diagnosis should be based on physical examination and imaging (cystoscopy during menouria, ultrasound and magnetic resonance imaging). Surgical treatment should be based on correction of the vaginal defects (obstructive problem opening or vaginal reconstruction) and CVVF closure. The embryological origin of CVVF lies in the abnormal persistence of the urogenital sinus due to lack of formation and caudal growth of the urogenital wedge, combined with distinct degrees of agenesis or hypoplasia of the entire urogenital ridge or the mesonephric ducts (which affects development of the Müllerian ducts). PMID:24560718
Martínez Escoriza, J C; Palacios Marqués, A M; López Fernández, J A; Feliu Rey, E; Martín Medina, P; Herráiz Romero, I; Delgado García, S; Oliva García, A B; Oliver Sánchez, C
A transverse vaginal septum is the most common congenital anomaly of the vagina. Vaginal atresia is seen less frequently. There have been some variations in cases of transverse vaginal septum and vaginal atresia. This is the first report of a patient with retrohymenal vaginal atresia and perforate transverse vaginal septum. PMID:1427424
Oga, M; Anai, T; Yoshimatsu, J; Kawano, Y; Hayata, T; Miyakawa, I
The Martius pedicle adipose flap can be used as an interposition flap during complex vaginal operations. It is a simple, rapid technique allowing raising of a well vascularized adipose flap with a mean length of 8 to 12 cm. It can be used in certain forms of vaginal repair, such as high supratrigonal vesicovaginal fistula, after bladder perforation, for obstructed urethra after colposuspension, after urethral destruction following prolonged bladder catheterization in a neurological patient, during repair of a complex urethral diverticulum or during transvaginal insertion of an artificial sphincter. After describing the flap raising operative technique, the various operative indications are presented. PMID:9116729
Localization of leiomyomas in the vaginal wall is very rare. We report about a case of a vaginal leiomyoma in the anterior vaginal wall, preoperatively identified with sonography and CT. Surgical enucleation was performed. Surgical removal in these cases is safe and usually with minimal bleeding. PMID:18317784
Theodoridis, T D; Zepiridis, L; Chatzigeorgiou, K N; Papanicolaou, A; Bontis, J N
Background: Congenital vesicovaginal fistula (VVF) is a very uncommon condition rarely suspected at initial presentation. It is usually seen in association with complex malformations of the genitourinary tract. Case: A bifid insertion of the solitary ureter causing an uretero-VVF was associated with an obstructing transverse vaginal septum manifesting as menouria. Also seen were solitary crossed renal ectopia, bicornuate uterus and skeletal anomalies. Conclusion: In women with menouria without vaginal menstruation, pre-operative evaluation to detect an obstructive vaginal anomaly and unusual uretero-vesicovaginal fistulous communications is necessary before surgical intervention. PMID:19955683
Background: Congenital vesicovaginal fistula (VVF) is a very uncommon condition rarely suspected at initial presentation. It is usually seen in association with complex malformations of the genitourinary tract. Case: A bifid insertion of the solitary ureter causing an uretero–VVF was associated with an obstructing transverse vaginal septum manifesting as menouria. Also seen were solitary crossed renal ectopia, bicornuate uterus and skeletal anomalies. Conclusion: In women with menouria without vaginal menstruation, pre-operative evaluation to detect an obstructive vaginal anomaly and unusual uretero–vesicovaginal fistulous communications is necessary before surgical intervention.
Mammillary fistulae develop between the lactiferous ducts of the breast and areolar skin. Over a 14-year period 41 fistulae were treated in 36 patients (34 women, 2 men). In 24 women at least one subareolar abscess (mean 2.5) had been incised and drained previously. Fourteen fistulae developed after discharge of an inflammatory mass and three after surgical biopsy. Twelve women underwent 13 fistulectomies, two of which required reoperation. The remaining 24 patients with complicated fistulae (n = 28) had previously undergone multiple surgical procedures; 12 patients had 13 fistulae treated by total duct excision and primary closure without antibiotic cover and six fistulae required reoperation. Fifteen fistulae in 12 women were treated by duct excision with either primary closure under antibiotic cover (n = 7) or packing with healing by granulation (n = 8) and only one recurred (P less than 0.05). Operations for mammillary fistulae should be treated as contaminated procedures. In simple cases where no previous surgery has taken place, fistulectomy is appropriate. In complicated cases, treatment should be duct excision with the wound either closed primarily under antibiotic cover or left open to heal by secondary intention. PMID:1774706
Vaginal ageneses are by no means rare anomalies. Complete Mullerian agenesis is the most common reason for vaginal agenesis requiring reconstruction. Patients usually present with pain, hematocolpos, or hematometra in puberty, and later with amenorrhea and dyspareunia. Detailed information is given here regarding etiologies, timing of surgery, and current treatment options for vaginal agenesis. Outcomes and short- and long-term complications of recent treatment options are also discussed. PMID:21372677
Ozkan, Ozlenen; Erman Akar, Münire; Ozkan, Omer; Do?an, N Utku
Introduction: The aim of this study is to verify the predictive role of transrectal ultrasound (TRUS) of prostatic fossa, digital rectal examination (DRE), prostate specific antigen (PSA) and pathological stage after radical prostectomy in the detection of a prostate tumor recurrence at the level of the vesico-urethral anastomosis by means of multiple TRUS biopsies (6–8 cores).Material and Methods: From October
Vincenzo Scattoni; Marco Roscigno; Marco Raber; Francesco Montorsi; Luigi Da Pozzo; Giorgio Guazzoni; Massimo Freschi; Patrizio Rigatti
Objectives: Dextranomer\\/hyaluronic acid (Dx\\/HA) copolymer has favorable properties for endoscopic treatment of vesico-ureteral reflux (VUR). This open, randomized study was performed to compare the efficacy and safety of Dx\\/HA copolymer with antibiotic prophylaxis in children with VUR. Methods: Children >1 year of age with VUR grade II to IV (confirmed by voiding cysto-urethrogram) received endoscopic treatment with Dx\\/HA copolymer (n
Objective To present our experience of treating supratrigonal vesicovaginal fistulae by laparoscopic technique and their long-term follow-up. Material and Methods Between January 2008 and June 2012, 28 cases of supratrigonal fistulas were repaired by laparoscopic transperitoneal transvesical technique with interposition flap. The obstetric fistula was present in 18 and gynecologic fistula in 10 patients. Single supratrigonal fistula was present in 26 patients and in 2 patients there were 2 fistulae lying side to side. The vaginal opening was closed as single layer interrupted suture and cystotomy closed as single layer continuous suture by 3-0 polygalactin. The omentum was used as interposition flap in all except 2 cases in whom postero-superior vesical fold of peritoneum was used. The open conversion was required in 2 cases. The urethral catheter was removed in 4 weeks following a micturating cystogram. Result The mean fistula size was 1.2 cm (range 0.8-2.5 cm). Open conversion was performed in 2 cases of whom one had excess carbon-dioxide retention and cardiac arrhythmia and in another case the needle of 3-0 polygalactin was avulsed and lost in peritoneal cavity which was recovered following laparotomy. All patients were continent following the catheter removal. The median follow-up is 24 months. None developed any complication related to laparoscopic repair till last follow-up. Conclusion Laparoscopic repair of supratrigonal vesicovaginal fistulae is an effective and safe minimally invasive treatment with excellent result.
Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. The literature review revealed various procedures for the closure of oroantral fistulas. These procedures may be subdivided into local flap, distant flap and grafting. Procedures involving local flaps are usually adequate to close minor to moderate size defects. Those procedures utilizing the buccal mucoperiosteal flap as the tissue closure include straight-advancement, rotated, sliding and transversal flap procedures; while those involving the palatal mucoperiosteum are straight advancement, rotational-advancement, hinged and island flap procedures. The combinations of various local flaps to strengthen the tissue closure are also being advocated. The advantages and the limitations of these procedures are discussed. Distant flaps and bone grafts are usually indicated in the closure of larger defects in view of their greater tissue bulks. Tongue flaps have superseded extra-oral flaps from extremities and forehead for aesthetic reasons and also in view of their similar tissue replacement. Various tongue flap procedures are described. At present, various alloplastic materials such as gold, tantalum and polymethylmethacrylate are infrequently reported in the closure of oroantral fistulas. However, in the light of successful reports over the use of biological materials, collagen and fibrin, in the closure of oroantral fistulas, there seems to be another simple alternative technique for treating oroantral fistulas. PMID:3133418
Vaginal erotic sensitivity was investigated in a group of 48 coitally experienced volunteers by means of systematic digital stimulation of both vaginal walls. It was found that 45 subjects reported erotic sensitivity located in most cases on the upper anterior wall, and of those, 30 (66. 7%) either reached orgasm or requested to stop stimulation short of orgasm. This study
Vesicovaginal fistula (VVF) has been a social and a surgical problem for centuries and remains a challenge to surgeons. Though advances have been made in the understanding of the etiology, diagnostic procedures and management of these fistulae, controversies still exist over the ideal approach and time to repair. This review was undertaken to look into the recent literature with regard to the timing and surgical approach to VVF repair. The literature search was done using the Medline database with keywords: vesicovaginal fistula, laparoscopy and robotic repair filtered for the last 5 years.
Background: Mayer-Rokitansky-Küster-Hauser syndrome is defined as Müllerian aplasia with vaginal agenesis and uterine remnants. It is commonly associated with renal and sometimes vertebral anomalies. MRKH syndrome or distal vaginal atresia is sometimes associated with anorectal malformations. The purpose of this study was to describe seven females with vaginal agenesis or distal vaginal atresia and an anorectal malformation and review the
Objective The objective was to evaluate the feasibility and complication rate of vaginal hysterectomy with or without adnexectomy in women with enlarged uteri and\\/or other considered contraindications to the vaginal route. Study design Over a period of 2 years, a total of 204 women underwent vaginal hysterectomy for benign pathology. Normally considered contraindications to the vaginal route were: moderate to excessive
Pierluigi Paparella; Ornella Sizzi; Alfonso Rossetti; Franco De Benedittis; Raffaele Paparella
The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment.
Seventeen patients with dimples, fistulae and cysts in the region of the cheek and the preauricular field are reported. All are located in the neighborhood of the dorsal end of the first visceral arch. Both the fistulae of the ascending helix and the upper preauricular fistulae must be regarded as relics of the dorsal end of the first branchial cleft. This interpretation supports the theory of Wood-Jones and I-Chuan according to which the tragus is formed from the material of the mandibular arch, and the remaining part of the auricle from the mesoderm of the second visceral arch. Similar anomalies in the neighborhood of the angle of the mouth, the extraoral opening of an accessory duct of Stensen and the inferior preauricular fistula are sufficiently explained by the incomplete closure or tearing of the embryonal oral aperture. PMID:267575
A small-bowel enteroatmospheric fistula (EAF) is an especially challenging complication for patients with open abdomens (OAs) and their surgeons. Manipulation of the bowel during treatment (e.g. dressing changes) is one of the risk factors for developing these openings between the atmosphere and the gastrointestinal tract. Unlike enterocutaneous fistulae, EAFs have neither overlying soft tissue nor a real fistula tract, which reduces the likelihood of their spontaneous closure. Surgical closure is necessary but not always easy to do in the OA environment. Negative pressure wound therapy (NPWT) has been used successfully as an adjunct therapy to heal the wound around EAFs. This review discusses many aspects of managing EAFs in patients with OAs, and presents techniques that have been developed to isolate the fistula and divert effluent while applying NPWT to the surrounding wound bed. PMID:24851732
Terzi, Cem; Egeli, Tufan; Canda, Aras E; Arslan, Naciye C
Vaginal vault dehiscence (VVD) may occur rarely after hysterectomy. Although mostly, a vaginal cuff dehiscence is seen after robotic or laparoscopic hysterectomy, it may also be observed as a complication of abdominal or vaginal hysterectomy. Vaginal repair is one of the techniques used for VVD. Here, we will describe a case of vaginally repaired VVD, associated with intra-abdominal hematoma after postpartum hysterectomy. PMID:24876366
The records of 93 patients with colocutaneous fistulas associated with diverticulitis treated at the Cleveland Clinic between\\u000a 1965 and 1983 were reviewed. There were 56 males and 37 females with an age range of 19 to 80 years (median, 57 years). Eighty-eight\\u000a fistulas followed surgery for diverticulitis while five developed spontaneously. The presence of a diverting stoma in 34 patients
Victor W. Fazio; James M. Church; David G. Jagelman; Frank L. Weakley; Ian C. Lavery; Riyad Tarazi; Maurice VanHillo
This study was undertaken to assess the appropriate management of patients with diverticulitis complicated by fistula formation.\\u000a A retrospective chart review was conducted on patients with symptoms of a fistula who presented between 1975 to 1995. There\\u000a were 42 patients (32 women, 76%; 10 men, 24%) who ranged in age from 46 to 89 years (mean 69.8±9.8). Six patients had
C.-A. Vasilevsky; P. Belliveau; J. L. Trudel; B. L. Stein; P. H. Gordon
Benign anorectal diseases, such as anal abscesses and fistula, are commonly seen by primary care physicians, gastroenterologists, emergency physicians, general surgeons, and colorectal surgeons. It is important to have a thorough understanding of the complexity of these 2 disease processes so as to provide appropriate and timely treatment. We review the pathophysiology, presentation, diagnosis, and treatment options for both anal abscesses and fistulas. PMID:24280399
To evaluate the presence of vesico ureteric reflux (VUR) and renal scarring in children with documented symptomatic urinary tract infection (UTI), and the importance of age at time of presentation, we studied 29 patients with UTI. Nineteen patients were females and 10 were males. Three patients were below one year of age, 13 were between one and five years, and 13 were above five years. None of the patients had systemic hypertension or renal insufficiency. All patients had renal ultrasound and renal scintigraphy with dimercapto succinic acid (DMSA). Micturating cystourethrogram was done in all children below age of five, and in patients above age of five if renal scintigraphy showed evidence of scarring. Of the 29 UTI patients 10 (34%) had VUR. Of the patients with VUR, seven were below age of five while three were above five. Renal scarring was found in 3/7 patients with VUR below age of five years, but was in all patients with VUR above age of five years. All patients with grade 3 and 4 reflux nephropathy had renal scarring, while it was found in half of the patients with grade 1 and 2 reflux. We conclude that in UTI patients VUR is not uncommon finding, which needs further investigations and follow-up. PMID:18417912
... IUD use (may cause occasional spotting) Ectopic pregnancy Miscarriage Other pregnancy complications Vaginal dryness due to lack ... information Are you pregnant? Have you had a miscarriage or abortion? Have you had a D and ...
Adisruption of the dynamic equilibrium of the healthy vagina may have significant sequelae, leading to chronic or serious conditions. Therefore, all cases of vaginitis should be accurately diagnosed and appropriately treated.
The MR appearances of two cases of vaginal leiomyoma are described. Both patients presented with a periurethral mass; one patient presented during pregnancy. MRI allowed precise anatomic localization of the masses and confident preoperative characterization in both cases. PMID:11351183
Shadbolt, C L; Coakley, F V; Qayyum, A; Donat, S M
A case of a vaginal fibroma in a 50-year-old woman is presented. The tumor presented as a solid mass in the upper third of the anterior vaginal wall. Intravenous pyelography (IVP) and cystoscopy excluded any association of the mass with the urinary tract. Surgical excision of the tumor was easily accomplished and histopathological examination established the diagnosis of a fibroid tumor of the vagina. PMID:12556111
Daskalakis, G J; Karabinas, C D; Papantoniou, N E; Papaspyrou, I A; Antsaklis, A J; Michalas, S
Aims: To study the outcome of endoscopic hyaluronic acid/dextranomer injection in patients with vesico-ureteric reflux (VUR). Materials and Methods: Sixty-three children were evaluated with a median follow up of 18 months (12-55 months) before injecting hyaluronic acid/dextranomer in a total of 99 ureteric moieties. Median age at presentation was 24 months (6-72 months). Primary VUR was the main presenting diagnosis in 60%. Patients were monitored for urinary tract infection (UTI), glomerular filtration rate (GFR), renal scarring, persistence, or appearance of contra-lateral reflux. Results: Grade III VUR was the most common (38%) followed by Grade IV (24%), Grade V (17%), Grade II (14%), and Grade I (7%). Most common cause for VUR was Primary (60%), followed by posterior urethral valve (PUV) (19%), bladder exstrophy (5%), anorectal malformation (ARM), epispadias, and duplex system. Analysis of patients characteristics at presentation revealed renal scarring (40%), split renal functions <35% (35%), recurrent UTI (15%), GFR <50 ml/min/1.73 m2 (15%), serum creatinine >1.4 mg/dL (10%). Complete resolution (100%) of Grade I and Grade II VUR was achieved after single injection. For Grade III VUR, single injection resolved reflux in 85.5% ureters, 100% resolution was seen after 2nd injection. In Grade IV VUR, 1st injection resolved VUR in 83.3% ureters, 95.8% ureters were reflux free after 2nd injection, and 100% resolution was seen after 3rd injection. In Grade V VUR, 94% ureters showed absent reflux after three injections. Conclusion: Hyaluronic acid/dextranomer injection holds promise even in higher grades of VUR.
Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms. PMID:24501660
Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen any time from conception ( ... out of every 10 pregnant women have vaginal bleeding during their first 20 weeks of pregnancy.
... dolor sit amet, consectetur adipiscing elit. Vaginal Abnormalities: Fusion and Duplication Having two of everything may be ... if your child's doctor diagnoses an "anomaly of fusion and duplication." What causes vaginal fusion and duplication? ...
Changes in the elasticity of the vaginal walls, connective support tissues, and muscles are thought to be significant factors in the development of pelvic organ prolapse, a highly prevalent condition affecting at least 50% of women in the United States during their lifetimes. It creates two predominant concerns specific to the biomechanical properties of pelvic support tissues: how does tissue elasticity affect the development of pelvic organ prolapse and how can functional elasticity be maintained through reconstructive surgery. We designed a prototype of vaginal tactile imager (VTI) for visualization and assessment of elastic properties of pelvic floor tissues. In this paper, we analyze applicability of tactile imaging for evaluation of reconstructive surgery results and characterization of normal and pelvic organ prolapse conditions. A pilot clinical study with 13 patients demonstrated that VTI allows imaging of vaginal walls with increased rigidity due to implanted mesh grafts following reconstructive pelvic surgery and VTI has the potential for prolapse characterization and detection.
The arteriovenous fistula (AVF) has been a mainstay of hemodialysis treatments and the preferred access route since its inception in the 1960s, due to its longevity and resistance to infection. However, the AVF is not benign. There is significant primary failure, as well as cardiac, vascular, and other, less well recognized, complications. Together, they represent toxicity, to which considerable morbidity
Richard Amerling; Claudio Ronco; Martin Kuhlman; James F. Winchester
A radiotelemetric method for measurements of vaginal temperature in the home milieu is presented. Registrations from two subjects show that vaginal temperatures vary up to and about 1°C nighttime. Initially, on going to bed, vaginal temperature drops. A further distinct drop occurs with any kind of experienced sexual arousal, reaching a minimum when and if orgasm is achieved. At rest,
Axel R. Fugl-Meyer; Kerstin Sjögren; Kenneth Johansson
Objective To report two cases of desquamative inflammatory vaginitis (DIV) associated with toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus strains. Materials and Methods Case report of two patients, one with an acute and one with a chronic presentation, diagnosed with DIV on the basis of clinical findings and wet mount microscopy. Pre- and posttreatment vaginal bacterial and yeast cultures were obtained. Results Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial cultures following oral antibiotic therapy were negative. Conclusions DIV may be triggered through TSST-1-mediated vaginal toxic shock reaction.
Pereira, Nigel; Edlind, Thomas D.; Schlievert, Patrick M.; Nyirjesy, Paul
A case of paraurethral vaginal leiomyoma becoming clinically apparent in the postpartum period is presented. As is frequently the case, the diagnosis was not apparent. Urinary tract origin is commonly suspected, since the majority of these tumors occur in the midline of the anterior vaginal wall. The tumors are often asymptomatic, but can cause dysuria, urinary frequency, urinary retention, and dyspareunia. Pathologically, they are well circumscribed and have the typical microscopic features of leiomyomas found elsewhere. Simple excision is usually adequate treatment. PMID:3603914
In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0.31). At V2, the percentage improvement rates were 84 and 89 % (p = 0.13), respectively. Improvement rates for vaginal itching, burning, and dyspareunia at V2 were about 86, 85, and 57 % for hyaluronic acid vaginal gel, and 82, 87, and 62 % for estriol vaginal cream (p[0.05), respectively. After treatment, vaginal pH was significantly lower in estriol-treated women compared to those having received hyaluronic acid. Endometrial thickness did not differ between groups. In the majority of women, the vaginal microenvironment remained unaffected by treatment. However, the proportion of women whose abnormal vaginal microecological results became normal was higher in women using estriol vaginal cream. Adverse events (suspected to be) related to the investigational compounds were minor and included vaginal infection and genital itching. The authors concluded that hyaluronic acid vaginal gel was not inferior to estriol vaginal cream in women presenting with vaginal dryness. They suggest using hyaluronic acid vaginal gel not only as an alternative treatment to vaginal estrogens, but also to consider its general use in women presenting with vaginal dryness of any cause. PMID:24178484
Purpose Anal fistulas that involve a significant amount of sphincter may be difficult to treat without compromising continence function.\\u000a In this study, we evaluated our experience with the Surgisis® anal fistula plug, which was recently reported to be successful\\u000a in >80 percent of patients with complex fistulas.\\u000a \\u000a \\u000a \\u000a Methods We retrospectively collected patient and fistula characteristics, procedure details, and follow-up information for all
Dimitrios Christoforidis; David A. Etzioni; Stanley M. Goldberg; Robert D. Madoff; Anders Mellgren
Vaginitis is a common complaint of adolescent females. It can cause extreme distress for some patients, especially those with recurrent symptoms. Thus, it is important to take care when evaluating these patients and to acknowledge their frustration when appropriate. A thoughtful and thorough history will determine most causes, with the most common being yeast, trichomoniasis, and BV. PMID:15449843
PURPOSE: Long-term results of cutting seton in the treatment of anal fistulas were studied. METHODS: Of the 44 patients with anal fistulas, mainly of the high variety, managed with this method, 35 (25 men) attended a clinical and manometric follow-up examination on average 70 (range, 28–184) months after operation. Fistula distribution was high transsphincteric (25), low transsphincteric (5), extrasphincteric (3),
Cholecystocolic fistula is a rare billiary-enteric fistula with variable clinical presentation. Despite modern diagnostic tool a high degree of suspicion is required to diagnose it preoperatively. These fistulae are treated by open as well as laparoscopic surgery, with no difference in intraoperative and postoperative complications. We are describing a 50-year-old female patient with the diagnosis of chronic cholecystitis with cholelithiasis, which was investigated with routine lab investigations, and abdominal ultrasonography but none of these gave us any clue to the presence of fistula, were discovered incidentally during an open surgery and were appropriately treated. PMID:24783121
Cholecystocolic fistula is a rare billiary-enteric fistula with variable clinical presentation. Despite modern diagnostic tool a high degree of suspicion is required to diagnose it preoperatively. These fistulae are treated by open as well as laparoscopic surgery, with no difference in intraoperative and postoperative complications. We are describing a 50-year-old female patient with the diagnosis of chronic cholecystitis with cholelithiasis, which was investigated with routine lab investigations, and abdominal ultrasonography but none of these gave us any clue to the presence of fistula, were discovered incidentally during an open surgery and were appropriately treated.
Gastrocutaneous fistula is an infrequent but serious surgical complication which has received little attention in the recent literature. The current report analyzes 13 patients with this complication. The fistula most commonly occurs in the fundic portion of the greater curvature of the stomach and is usually a result of unrecognized iatrogenic injury or associated with severe left upper quadrant inflammation and external drainage. Clinical recognition occurs when the patient develops left subphrenic sepsis or drains gastric content. The fistula is best documented by upper gastrointestinal contrast studies and usually responds to wide drainage and supportive treatment in the presence of benign disease. Oral alimentation apparently need not be delayed until complete fistula closure.
Thoracic aortic dissection (TAD) with aorto-oesophageal fistula formation is an uncommon but fatal cause of haematemesis. A case is presented of a previously healthy 63-year-old man who presented to the emergency department with syncope and haematemesis. He had no history of heavy alcohol intake and was previously well. Bedside portable chest x ray revealed a widened mediastinum and, while awaiting
Summary We have presented two examples of difficulties encountered in making a diagnosis, and have shown how improper medical or surgical\\u000a therapy may hinder correct treatment of cancer.\\u000a \\u000a Over a period of 13 years, two patients have been treated for neoplastic anal fistula. The lesson to be learned is that an\\u000a early diagnosis is seldom reached and consequently correct treatment is
Arturo Heidenreich; Hector A. Collarini; Alberto Mario Paladino; José María Fernandez; Teófilo Oscar Calvo
Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour. PMID:23223657
Background Treatment and care for female genital fistula have become increasingly available over the last decade in countries across Africa and South Asia. Before the International Federation of Gynaecology and Obstetrics (FIGO) and partners published a global fistula training manual in 2011 there was no internationally recognized, standardized training curriculum, including perioperative care. The community of fistula care practitioners and advocates lacks data about the prevalence of various perioperative clinical procedures and practices and their potential programmatic implications are lacking. Methods Data presented here are from a prospective cohort study conducted between September 2007 and September 2010 at 11 fistula repair facilities supported by Fistula Care in five countries. Clinical procedures and practices used in the routine perioperative management of over 1300 women are described. Results More than two dozen clinical procedures and practices were tabulated. Some of them were commonly used at all sites (e.g., vaginal route of repair, 95.3% of cases); others were rare (e.g., flaps/grafts, 3.4%) or varied widely depending on site (e.g. for women with urinary fistula, the inter-quartile range for median duration of post-repair bladder catheterization was 14 to 29 days). Conclusions These findings show a wide range of clinical procedures and practices with different program implications for safety, efficacy, and cost-effectiveness. The variability indicates the need for further research so as to strengthen the evidence base for fistula treatment in developing countries.
OBJETIVE: To assess efficacy and tolerability of a isoflavone (Glycine max L. Merr.) vaginal gel to the treatment of vaginal atrophy in postmenopausal women. METHODS: The double-blind, randomized, placebo-controlled, clinical trial. Ninety women were treated for 12 weeks with isoflavone vaginal gel 4% (1g/day) and a placebo gel and conjugated equine estrogen cream (0.3mg/day). After 4 and 12 weeks, the vaginal atrophy symptoms were classified at none, mild, moderate and severe and the vaginal cytology were taken to determine the maturation value. The endometrial safety (by transvaginal ultrasonography) was evaluated through at screening and the end of the trial. RESULTS: Isoflavone vaginal gel appears to be effective for relief of vaginal dryness and dyspareunia symptons and an increase in the intermediate and superficial cells was noted. These results were similar to the effects with use of conjugated equine estrogens and superior to placebo gel. No changes in endometrial thickness, sera FSH and estradiol levels were observed at study endpoint. CONCLUSION: Glycine max (L.) Merr. at 4% vaginal gel on a daily basis in postmenopausal women led to improvements in vaginal atrophy symptoms and a significant increase in cell maturation values. Isoflavones proved good treatment options for relief of vulvovaginal symptoms especially in women who do not wish to use hormonal therapy or have contra-indications for this treatment. PMID:23312487
Lima, Sonia M Rolim Rosa; Yamada, Silvia Saito; Reis, Benedito Fabiano; Postigo, Sostenes; Galvão da Silva, Maria Antonieta L; Aoki, Tsutomu
Introduction. Vaginal vault prolapse is a common complication following vaginal hysterectomy with negative impact on women's quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanism for the uterus and vagina is important in making the right choice of corrective procedure. Management should be individualised, taking into consideration the surgeon's experience, patients age, comorbidities, previous surgery and sex life. Result. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced at hysterectomy to prevent vault prolapse. Studies have shown the McCall's culdoplasty under direct visualisation to be superior. Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future.
Anomalies of the urethra are uncommon. Urethrorectal fistula in horses has only been reported in foals and only in conjunction with other congenital anomalies. This report describes the diagnosis, surgical management, and possible etiologies of a unique case of urethrorectal fistula in a mature gelding.
Cruz, A M; Barber, S M; Kaestner, S B; Townsend, H G
Over a recent 4-year period, 823 neck dissections that included the lower jugular lymph nodes were performed. Of the 823, 14 (1.9%) patients developed chyle fistulas. Two other patients developed fistulas, one after undergoing a gastric transposition, and the other after a scalene node biopsy. All 16 patients were initially managed conservatively with closed-wound drainage and low-fat nutritional support; this was successful in only 4 patients, 3 of whom had peak 24-hour chyle drainage of less than 600 cc. The remaining 10 patients required open-wound management, which included operative ligation in 4 instances. Continued conservative treatment with an open neck wound resulted in significant additional hospitalization. Our experience indicates that closed-wound management of a chyle fistula is likely to fail when peak 24-hour fistula output exceeds 600 cc. Considering the cost and morbidity of conservative treatment, early reoperation may be appropriate in those patients with high fistula output. PMID:2362537
CRYPTOGLANDULAR ANAL FISTULA: Perianal abscesses are caused by cryptoglandular infections. Not every abscess will end in a fistula. The formation of a fistula is determined by the anatomy of the anal sphincter and perianal fistulas will not heal on their own. The therapy of a fistula is oriented between a more aggressive approach (operation) and a conservative treatment with fibrin glue or a plug. Definitive healing and the development of incontinence are the most important key points. ANAL FISSURES: Acute anal fissures should be treated conservatively by topical ointments, consisting of nitrates, calcium channel blockers and if all else fails by botulinum toxin. Treatment of chronic fissures will start conservatively but operative options are necessary in many cases. Operation of first choice is fissurectomy, including excision of fibrotic margins, curettage of the base and excision of the sentinel pile and anal polyps. Lateral internal sphincterotomy is associated with a certain degree of incontinence and needs critical long-term observation. PMID:23179514
Three cases of hereditary lateral cervical fistulas are reported. The patients had lateral cervical fistulas bilaterally and different types of auricular malformations. The mothers of the patients also had lateral cervical fistulas. Moreover, one mother had bilateral microtias and the other mothers bilateral preauricular fistulas. The literature is reviewed and discussed. PMID:3377420
A 41-year-old amenorrheic woman started taking venlafaxine 37.5 mg/day for treatment of depression; 7 days later, she experienced vaginal bleeding, which ceased 1 day after she stopped taking the drug. On rechallenge with venlafaxine, she again experienced vaginal bleeding that resolved after discontinuation. We found no published reports describing vaginal bleeding associated with venlafaxine. However, premarketing and postmarketing data report similar adverse effects in patients taking the agent. In addition, several cases of menstrual irregularities have occurred with two other antidepressants: fluoxetine and bupropion. This case report supports previous surveillance data indicating that venlafaxine may cause vaginal bleeding. PMID:12013367
Linnebur, Sunny A; Saseen, Joseph J; Pace, Wilson D
During a 15 year period, 18 patients with 28 mamillary fistulas were treated. In eight women, periareolar abscess had preceded recognition of a fistula. Ten patients were primarily diagnosed as having mamillary fistula. In six patients, when the underlying fistula tract was not identified and excised at the time of operation, discharging sinus reoccurred. Twenty-two fistulas were completely excised together with an extensive lactiferous duct system. Operative wound was primarily closed using antibiotic cover. Periareolar abscess and mamillary fistula should be treated primarily by complete excision of the fistula tract and extensive duct system of the breast. PMID:1411885
Background A vaginalfistula is a devastating condition, affecting an estimated 2 million girls and women across Africa and Asia. There are numerous challenges associated with providing fistula repair services in developing countries, including limited availability of operating rooms, equipment, surgeons with specialized skills, and funding from local or international donors to support surgeries and subsequent post-operative care. Finding ways of providing services in a more efficient and cost-effective manner, without compromising surgical outcomes and the overall health of the patient, is paramount. Shortening the duration of urethral catheterization following fistula repair surgery would increase treatment capacity, lower costs of services, and potentially lower risk of healthcare-associated infections among fistula patients. There is a lack of empirical evidence supporting any particular length of time for urethral catheterization following fistula repair surgery. This study will examine whether short-term (7 day) urethral catheterization is not worse by more than a minimal relevant difference to longer-term (14 day) urethral catheterization in terms of incidence of fistula repair breakdown among women with simple fistula presenting at study sites for fistula repair service. Methods/Design This study is a facility-based, multicenter, non-inferiority randomized controlled trial (RCT) comparing the new proposed short-term (7 day) urethral catheterization to longer-term (14 day) urethral catheterization in terms of predicting fistula repair breakdown. The primary outcome is fistula repair breakdown up to three months following fistula repair surgery as assessed by a urinary dye test. Secondary outcomes will include repair breakdown one week following catheter removal, intermittent catheterization due to urinary retention and the occurrence of septic or febrile episodes, prolonged hospitalization for medical reasons, catheter blockage, and self-reported residual incontinence. This trial will be conducted among 512 women with simple fistula presenting at 8 study sites for fistula repair surgery over the course of 24 months at each site. Discussion If no major safety issues are identified, the data from this trial may facilitate adoption of short-term urethral catheterization following repair of simple fistula in sub-Saharan Africa and Asia. Trial registration ClinicalTrials.gov Identifier NCT01428830.
PURPOSE This study was designed to evaluate the efficacy of the Surgisis® (Anal Fistula Plug™) in multiple patients at our institution\\u000a and present early clinical results along with notable clinical observations from our experience.\\u000a \\u000a \\u000a \\u000a METHODS This was a prospective analysis of all patients who received the Anal Fistula Plug™ for treatment of anorectal fistulas between\\u000a April 2006 and February 2007. All tracts
Alex J. Ky; Patricia Sylla; Randolph Steinhagen; Emily Steinhagen; Sergei Khaitov; Erin K. Ly
\\u000a Purpose Complex high and recurrent fistulas remain a surgical challenge. Simple division, i.e., fistulotomy, will likely result in fecal incontinence. Various surgical treatment options for these fistulas have shown disappointing\\u000a results. Recently a biologic anal fistula plug was developed to treat these high transsphincteric fistulas. To assess the\\u000a results of the anal fistula plug in patients with complex high perianal fistulas,
Paul J. van Koperen; Andre D’Hoore; Albert M. Wolthuis; Willem A. Bemelman; J. Frederik M. Slors
The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future. PMID:12340621
Summary Dural arteriovenous fistulas are most probably acquired lesions. However, they have been rarely encountered de novo. We present a unique case of a 71-year-old woman who initially presented with right-sided dural arteriovenous fistula (DAVF), which spontaneously resolved after diagnostic arteriography. She later developed asymptomatic occlusion of the left transverse sinus. Five years after her initial presentation she developed left-sided pulse-synchronous tinnitus. MRA and catheter angiography showed a complex type IV DAVF between the left transverse sinus and multiple dural branches arising from both left and right external carotid arteries. The left transverse sinus was isolated from the torcula herophili, with stenosis of the sigmoid sinus. Extensive cortical venous drainage was demonstrated. Endovascular cure was effected by polyvinyl alcohol particle and absolute alcohol occlusion of the dominant dural supply, and transvenous coil occlusion of the left transverse sinus. The patient's symptoms resolved almost immediately. This unique case demonstrates that dural sinus occlusion and DAVFs may co-exist, but there may not be a causal relationship. It is likely that both DAVFs and sinus occlusion are manifestations of the same disease process characterised by a pro-thrombotic state and secondary angiogenesis. It is important to recognise that changes in symptomatology, even long after apparent disappearance of a lesion may indicate recurrence, and careful follow up is advocated.
Purpose: We aim to present our experience for the repair of vesicovaginal fistula (VVF) with special reference to surgical approach. Materials and Methods: From January 1999 to June 2005, 52 VVF patients with mean age of 32 years underwent operative treatment. Fistulas were divided into two groups, simple and complex, depending on site, size, etiology and associated anomalies. Simple VVFs were approached through the vaginal route and complex VVFs via the transabdominal route. Patients were evaluated at two to three weeks initially, three-monthly twice and later depending on symptoms. Results: Thirty-two (61.5%) had simple fistulas and 20 (38.5%) complex fistulas. The most common etiology was obstetric trauma in 31 (59.6%) patients, while the second most common cause was post hysterectomy VVF. Thirty-two (61.5%) patients were managed by transvaginal route, of which 17 had supratrigonal and 15 trigonal fistulas. Twenty (38.5%) patients with complex fistulas were managed by abdominal route. The mean blood loss, postoperative pain and mean hospital stay were shorter in transvaginal repair. Eleven (21.2%) patients required ancillary procedures for various other associated anomalies at the time of fistula repair. Three patients failed repair giving a success rate of 94.2%. At a mean follow-up of three years 48 women were sexually active, of these 10 (19.2%) complained of mild to moderate dyspareunia. Conclusion: Most of the simple fistulas irrespective their locations are easily accessible transvaginally while in complex fistulas we recommend the transabdominal approach. Depending on the clinical context both the approaches achieved comparable success rates.
Vaginal eroticism was investigated in a group of 27 coitally experienced volunteers by means of systematic digital stimulation of both vaginal walls. Erogenous zones were found in all subjects, mainly located on the upper anterior wall and the lower posterior one. An orgasmic response was elicited by stimulation of these zones in 89% of the subjects.
A quantitative method of culture, based on a weighed sample and with results expressed as colony forming units (cfu)\\/g was assessed and used to investigate the vaginal flora of normal women and that of women with vaginal disease. Samples were collected by means of disposable plastic loops into modified proteose peptone water transport medium in preweighed bottles. Counts expressed as
Vaginal or vulvovaginal atrophy is a widespread but poorly recognized condition of peri- and post-menopausal women. It causes urogenital symptoms of dryness, reduced lubrication, itching, burning, irritable bladder symptoms and painful intercourse. This impacts quality of life and sexual health, but increases with time rather than reduces, as with most other menopausal symptoms. With early identification, treatments can improve these symptoms and reverse the physical changes. However, when embedded, bladder and sexual changes have occurred and these may be more difficult to remedy. Therefore, it is important to educate both healthcare professionals and women about these symptoms and advise on the range of interventions available. PMID:24601810
Labial hair tourniquet syndrome is a rare condition that can be easily misdiagnosed and ultimately lead to irreversible damage. An 11-year-old premenarche girl presented with a 5-day history of pain and swelling in the labia with associated vaginal discharge. The general practitioner treated her with clotrimazole without improvement. On examination, there was an oedematous swelling of the right labia with a proximal hair tourniquet. Local anaesthetic was applied and the hair removed with forceps. There was instant relief of pain and the discharge stopped within 24 h. The patient was sent home with a course of antibiotics. PMID:24049092
Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal microbial populations have not been investigated using molecular methods. Here, we evaluated site-specific microbial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S rRNA gene clone libraries were prepared from samples obtained from different locations (cervix, fornix, outer vaginal canal) and by different methods (swabbing, scraping, lavaging) from the vaginal tracts of eight clinically healthy, asymptomatic women. The data reveal that the vaginal microbiota is not homogenous throughout the vaginal tract but differs significantly within an individual with regard to anatomical site and sampling method used. Thus, this study illuminates the complex structure of the vaginal ecosystem and calls for the consideration of microenvironments when sampling vaginal microbiota as a clinical predictor of vaginal health.
Kim, Tae Kyung; Thomas, Susan M.; Ho, Mengfei; Sharma, Shobha; Reich, Claudia I.; Frank, Jeremy A.; Yeater, Kathleen M.; Biggs, Diana R.; Nakamura, Noriko; Stumpf, Rebecca; Leigh, Steven R.; Tapping, Richard I.; Blanke, Steven R.; Slauch, James M.; Gaskins, H. Rex; Weisbaum, Jon S.; Olsen, Gary J.; Hoyer, Lois L.; Wilson, Brenda A.
An esophagorespiratory fistula (ERF) is an often fatal consequence of esophageal or bronchogenic carcinomas. The preferred treatment is placement of esophageal and/or airway stents. Stent placement must be performed as quickly as possible since patients with ERFs are at a high risk for aspiration pneumonia. In this review, choice of stents and stenting area, fistula reopening and its management, and the long-term outcome in the interventional management of malignant ERFs are considered. Lastly, a review of esophagopulmonary fistulas will also be provided.
Bronchio biliary fistula in adults is a rare event defined by the passage of bile into the bronchus and the sputum (biloptysis).Typically these lesions occur in the congenital form, as a result of thoracoabdominal trauma, or in rare instances as a result of iatrogenic injury or long-standing biliary tract disease and obstruction. In this paper, we report a novel case of a fatal bronchobiliary fistula that developed in a 67-year-old Chinese male with Oriental cholangiohepatitis. To our knowledge, this is the first case report of a bronchobiliary fistula complicating the clinical management of a patient with this disease.
Forty-two patients with 43 mammary duct fistulae, including 23 with a history of at least one previous unsuccessful operation, were treated by excision of the involved duct and fistula alone (15 fistulae) or excision of the fistula combined with total duct excision (28 fistulae). The wounds were closed primarily with antibiotic cover. Two patients had a minor wound infection which settled within 1 month of surgery; one patient developed superficial necrosis of the nipple and one patient required a second operation to excise a discharging sinus. No fistula recurrence has been identified after a median follow-up of 2.5 years. Excision of the involved duct and fistula alone, or excision of the fistula combined with total duct excision performed with antibiotic cover, is probably the treatment of choice for mammary duct fistula. PMID:1958980
Patient: Female, 16 Final Diagnosis: Malrotation and cholecystoduodenal fistula Symptoms: Abdominal pain • anorexia • fever • nausea • vomiting Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Anatomical anomaly/variation Background: Cholecystoduodenal fistula (CDF) is the most common cholecystenteric fistula. It is a late complication of gallbladder disease with calculus and is mainly encountered in the elderly and females. Case Report: We report the case of a teenage patient with cholecystoduodenal fistula and malrotation. Direct plain abdominal x-ray demonstrated air in the biliary system. Computed tomography revealed CDF-associated with an anomaly of intestinal malrotation. She had gallstones (with a few stones in the gallbladder) and cholecystitis. CDF is caused by malrotation, and cholecystitis has not been reported before. In this regard our patient is the first and youngest reported case. Conclusions: We suggest that CDF is probably a consequence of malrotation. The patient’s clinical features and operative management are presented and discussed with current literature.
Ozkan, Aybars; Ozaydin, Ismet; Kaya, Murat; Kucuk, Adem; Katranci, Ali Osman
In the clinic, 56 patients with an external pancreatic fistula was treated. After conservative treatment, a fistula closed in 43 patients, and was functioning in 13. Fistuloenterostomy was performed in 6 patients, resection of the left lobe of the pancreas--in 7. There were no complications and lethal outcomes. The method for return of the pancreatic juice into the duodenum has been suggested. PMID:1296060
Vecherko, V N; Konoplia, P P; Tiurin, I V; Iurév, V V
A case of aortocaval fistula complicating a ruptured infrarenal aortic aneurysm is reported. As the length of the defect and the thickness of the aortic wall made repair from within the aorta unsafe, the defect was repaired from within the vena cava. The details of the technique are reported. It can be a useful alternative to inferior vena cava ligation, when standard repair of aortocaval fistulae from within the aorta is risky or difficult to attempt. PMID:9128225
Illuminati, G; Calió, F G; Bertagni, A; Caratozzolo, M; Vietri, F
PURPOSE: The aim of this study was to evaluate the long-term success and complication rate of fibrin-glue treatment of anal fistulas. METHODS: Patients with an anal fistula presenting to a single surgeon over a three-year period were enrolled in this study. At their first operation, all 48 patients (26–72 years old) underwent anoscopy, biopsy, destruction of the internal gland, and
Arteriovenous fistulas (AVF)--a rare inborn disease of respiratory system. During 32 yrs 19 observations of pulmonary AVF were made. There were 13 (68.4%) men and 6 (31.6%) women. The patients' age was 25 yrs at average. In 4 (21.1%) patients there was Rendu-Weber-Osler disease diagnosed. Characteristic complaints were acrocyanosis, dyspnea while on loading, rapid fatigue. In accordance to laboratory investigation performed, polycytemia and hypoxemia were revealed. All the patients were operated on, most frequent operation was lobectomy--in 14 (73.6%). Multiple AVF were revealed in 4 (21.1%) patients. The postoperative period course was without complications in 15 (78.9%) patients. One patient (5.3%) died, aged 24 yrs old, suffering bilateral AVF, in 24 days after right-sided lower lobectomy from the bleeding, occurring in contralateral lung and asphyxia. PMID:24501988
Opanasenko, M S; Klymenko, V I; Demus, R S; Konik, B M; Tereshkovych, O V; Kalenychenko, M I; Bychkovs'ky?, V B; Obrems'ka, O K; Levanda, L I; Kononenko, V A; Kshanovs'ky?, O E; Mykytenko, I Iu
Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP) or magnetic resonance cholangiopancreaticography (MRCP) may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.
We report the resection of a vaginal septum while preserving the virginity of a 12-year-old girl with Herlyn-Werner-Wunderlich Syndrome (HWWS) having a didelphys uterus, obstructed hemivagina, and an ipsilateral renal agenesis with follow-up at 18 months. Successful resection of the vaginal septum with conservation of the hymenal ring and complete drainage of both the hematocolpos and the hematometra were achieved. Cyclic dysmenorrhea and pelvic pain were completely resolved on follow-up visits at 4, 6, and 18 months. Office hysteroscopy performed during the last follow-up visit revealed a patent vaginal vault without evidence of adenosis or recurrence of the vaginal septum. Vaginoscopy is a safe, convenient, and efficient diagnostic and therapeutic modality that can be used in the management of patients with an obstructed hemivagina. It maintains the patient's virginity and it is useful in patients with a restrictive vaginal opening or narrow vaginal canal. Furthermore, the hysteroscopic excision of the vaginal septum offers minimal risk of recurrence of the septal defect. PMID:23315718
Nassif, Joseph; Al Chami, Ali; Abu Musa, Antoine; Nassar, Anwar H; Kurdi, Ahmad; Ghulmiyyah, Labib
The surgical treatment of vaginal leiomyoma in a seven year old Blue Heeler bitch is described. A smooth, 12 cm diameter submucosal, intraluminal, firm mass was found on vaginal examination. It appeared to arise from the left ventral vaginal wall, cranial to the clitoris but caudal to the cervix. There was no history of urinary problems and the dog was normal in all other aspects. The treatment was surgical excision of the mass via an episiotomy. Histological examination indicated a leiomyoma. The differential diagnoses, possible etiologies and control or prevention of the condition by ovariohysterectomy are also discussed. PMID:17422296
The surgical treatment of vaginal leiomyoma in a seven year old Blue Heeler bitch is described. A smooth, 12 cm diameter submucosal, intraluminal, firm mass was found on vaginal examination. It appeared to arise from the left ventral vaginal wall, cranial to the clitoris but caudal to the cervix. There was no history of urinary problems and the dog was normal in all other aspects. The treatment was surgical excision of the mass via an episiotomy. Histological examination indicated a leiomyoma. The differential diagnoses, possible etiologies and control or prevention of the condition by ovariohysterectomy are also discussed. ImagesFigure 1.Figure 2.
Vesico-ureteric reflux (VUR) is one the most common inherited disorder in humans. Even though this defect is common among siblings and parents of index patients (27-40%), the mode of inheritance is not well defined. Parents and siblings (three female and two male) of a 13-year-old girl with end-stage renal failure (ESRF) due to reflux nephropathy were screened for VUR although they had not presented episodes of urinary tract infection. VUR was identified in the father (44 years old) and in all the three sisters (aged 15 years, 16 years and 18 years) while the two brothers (aged 5 years and 8 years) had normal renal ultrasonograms and cystograms. A technetium-99m di-mercapto-succinic acid ((99m)Tc-DMSA) scan demonstrated renal scars in the father and in two of the sisters with VUR. No episodes of urinary infection had been documented for any relatives. Haplotype analysis on the X-chromosome confirmed paternity. This is the first description of VUR compatible with an X-dominant trait. This mode of inheritance must be added to what is already known on familial VUR, and future studies should also consider this possibility. PMID:19705159
Naseri, Mitra; Ghiggeri, Gian Marco; Caridi, Gianluca; Abbaszadegan, Mohammad R
The C825T polymorphism in the GNB3 gene encoding a beta3 subunit from heterotrimeric G-proteins correlates strongly with the variation in activity of the G-proteins. It has so far been associated with a variety of medical conditions, but has not been tested for association with vesico-ureteric reflux (VUR). Primary VUR is a condition of genetic origin that appears to be inherited in an autosomal dominant mode, but with reduced penetrance. The constitutional change in G-protein-mediated cell signaling associated with the C825T polymorphism might be one of the factors that participate in the development of VUR by modifying the effect of still unknown mutated gene(s). A significant difference in genotype frequencies (chi(2) = 7.38, P = 0.025, df = 2) was observed between patients with primary VUR (33 CC homozygotes, 40 CT heterozygotes, 12 TT homozygotes) and healthy controls with no medical record of reflux (114 CC homozygotes, 88 CT heterozygotes, 18 TT homozygotes). This result suggests that the C825T polymorphism of the GNB3 gene might be associated with the development of VUR. PMID:15337465
Congenital vaginal agenesis, with a prevalence of 1 in 4000 females, occurs mainly as a feature of the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Management of patients with MRKH syndrome includes, along with the proper psychological support, the creation of a neovagina to give them the opportunity to have a normal sexual life. Both surgical and non-surgical techniques have been suggested during the past century, for neovagina creation. Among them, the most widespread non-surgical techniques performed are the Frank technique and its modification by Ingram, while the surgical techniques include the McIndoe operation, the Vechietti procedure and its laparoscopic modification and the Williams vaginoplasty and its Creatsas modification. The Creatsas vaginoplasty is a simple, fast and safe technique that has been performed in 178 patients in our Institution over the past 22 years and has provided excellent results in the vast majority of patients. PMID:20089458
Cyclical hematuria is an unusual presentation of a müllerian fusion anomaly. We report a patient with transverse vaginal septum and menstruation by way of the lower urinary tract because of a vesical-vaginal communication. A defect of vertical fusion, transverse vaginal septum results from failure of canalization of the vaginal plate. Reconstruction using a transvaginal and transabdominal approach created a direct anastomosis between the proximal vaginal segment and the distal vaginal pouch. Previously described cases are reviewed. PMID:17382175
One out of 10 women will have vaginal bleeding during their third trimester. At times, it may ... few months of pregnancy, you should always report bleeding to your health care provider right away. You ...
Serum antibody titers to Candida albicans were estimated in 37 women with recurrent vaginal candidiasis and in 148 normal American and Finnish subjects, using the passive-hemagglutination technique. The antibody titers ranged from 0 to 16 in normal individuals and 4 to 256 in vaginal candidiasis patients. Antibodies to C. albicans in the sera of vaginal candidiasis patients were found to be the secretory immunoglobulin A type, as determined by gel filtration and double-diffusion tests. The results were confirmed by the indir-ct fluorescent-antibody technique. Our findings suggest that, in vaginal candidiasis, the antibody response is mainly local, consisting of secretory immunoglobulin A, some of which finds its way into systemic circulation. Images
Mathur, S; Koistinen, G V; Horger, E O; Mahvi, T A; Fudenberg, H H
... tumors, it may be used to biopsy possible metastasis. Magnetic resonance imaging (MRI) Magnetic resonance imaging (MRI) ... in detecting cancer that has spread to the brain or spinal cord. This rarely occurs in vaginal ...
Objective: The purpose of this study was to determine the effectiveness of passive vaginal dilation and McIndoe vaginoplasty in the creation of a neovagina for patients with müllerian agenesis. Study Design: Fifty-one patients with Mayer-Rokitansky-Kuster-Hauser syndrome were treated for vaginal agenesis at either Johns Hopkins Hospital or Emory University. These historic prospective data were obtained by a review of medical
\\u000a Vaginal bleeding during gestation is an ominous sign indicating an adverse pregnancy outcome. Bleeding can occur during all\\u000a stages of gestation. It complicates up to 20% of pregnancies during the first trimester and is regarded as a sign of threatened\\u000a abortion. During the second and third trimesters, vaginal bleeding was found to be a risk factor for adverse maternal and
Background: Enterocutaneous fistula has traditionally been associated with substantial morbidity and mortality, related to fluid, electrolyte and metabolic disturbance, sepsis and malnutrition. Methods: A retrospective review of enterocutaneous fistula in 277 consecutive patients treated over an 11-year period in a major tertiary referral centre was undertaken to evaluate current management practice and outcome. Results: Most fistulas occurred secondary to abdominal
P. Hollington; J. Mawdsley; W. Lim; S. M. Gabe; A. Forbes; A. J. Windsor
Aggressive treatment of early fistula failure.BackgroundFistula failure has been classified as early and late. Early failure refers to those cases in which the arteriovenous (AV) fistula never develops to the point that it can be used or fails within the first 3 months of usage. It has been common practice to abandon these early failures; however, aggressive evaluation and treatment
Gerald A. Beathard; Perry Arnold; Jerry Jackson; Terry Litchfield
Dural arteriovenous fistulas are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Digital subtraction angiography remains the gold standard for diagnosing these fistulas. Endovascular treatment is one of the first line options available for their management. This review article reviews the etiopathogenesis, natural history, common classification systems and various available treatment options.
Background Several techniques have been described for the management of fistula-in-ano, but all carry their own risks of recurrence and incontinence. We conducted a prospective study to assess type of presentation, treatment strategy and outcome over a 5-year period. Methods Between 1st January 2005 and 31st March 2011 247 patients presenting with anal fistulas were treated at the University Hospital Tor Vergata and were included in the present prospective study. Mean age was 47 years (range 16-76 years); minimum follow-up period was 6 months (mean 40, range 6-74 months). Patients were treated using 4 operative approaches: fistulotomy, fistulectomy, seton placement and rectal advancement flap. Data analyzed included: age, gender, type of fistula, operative intervention, healing rate, postoperative complications, reinterventions and recurrence. Results Etiologies of fistulas were cryptoglandular (n = 218), Crohn's disease (n = 26) and Ulcerative Colitis (n = 3). Fistulae were classified as simple -intersphincteric 57 (23%), low transphincteric 28 (11%) and complex -high transphicteric 122 (49%), suprasphincteric 2 (0.8%), extrasphinteric 2 (0.8%), recto-vaginal 7 (2.8%) Crohn 26 (10%) and UC 3 (1.2%). The most common surgical procedure was the placement of seton (62%), usually applied in case of complex fistulae and Crohn's patients. Eighty-five patients (34%) underwent fistulotomy, mainly for intersphincteric and mid/low transphincteric tracts. Crohn's patients were submitted to placement of one or more loose setons. The main treatment successfully eradicated the primary fistula tract in 151/247 patients (61%). Three cases of major incontinence (1.3%) were detected during the follow-up period; Furthermore, three patients complained minor incontinence that was successfully treated by biofeedback and permacol injection into the internal anal sphincter. Conclusions This prospective audit demonstrates an high proportion of complex anal fistulae treated by seton placement that was the most common surgical technique adopted to treat our patients as a first line. Nevertheless, a good outcome was achieved in the majority of patients with a limited rate of faecal incontinence (6/247 = 2.4%). New technologies provide promising alternatives to traditional methods of management particularly in case of complex fistulas. There is, however, a real need for high-quality randomized control trials to evaluate the different surgical and non surgical treatment options.
Multiple superficial veins in different anatomical configurations exist in the elbow. The resulting variety of elbow arteriovenous fistulae (AVFs) is described in this paper. A classification of elbow AVF in nontransposed AVF, transposed AVF and multiple outflow AVF is proposed. The nontransposed brachiocephalic AVF has the lowest primary failure rate and a good medium-term survival particularly in the elderly. The simplest technique is an end-to-side anastomosis of the median cubital vein to the brachial artery. In cases of small upper arm veins, a perforating vein AVF, using multiple outflow tracts, may be helpful to lower primary failure risk. In the era of vein mapping with portable ultrasound elbow AVF should be made when forearm veins are exhausted or too small. A side-to-side AVF in order to enhance retrograde flow in the median forearm vein seems rarely indicated, in particular considering the greater risk of steal and venous hypertension. A transposed brachiobasilic AVF is a tertiary access procedure after the simpler alternatives have been exhausted. There is conflicting evidence of the benefits of one-stage versus two-stage procedures. Therefore, the type of operation should be tailored to the individual patient. PMID:24817455
Enteroatmospheric fistulae (EAFs), a rare condition that develops in patients treated with an open abdomen, present serious problems for the surgeon. There are no fixed algorithms for treatment of EAF, and treatment options are determined based on the experience of the surgeon and status of the patient. We developed a 'suspended silicone fistula plug' for treating a patient who developed an EAF after undergoing multiple operations in a short period of time. Used in conjunction with negative pressure wound therapy, application of this novel therapy resulted in EAF closure and patient discharge. PMID:24851733
Ozer, M Tahir; Sinan, Hüseyin; Zeybek, Nazif; Peker, Yusuf
Background Thoracobiliary fistulas are pathological communications between the biliary tract and the bronchial tree (bronchobiliary fistulas) or the biliary tract and the pleural space (pleurobiliary fistulas). Review of the literature We have reviewed aetiology, pathogenesis, predilection formation points, the clinical picture, diagnostic possibilities, and therapeutic options for thoracobiliary fistulas. Case report A patient with an iatrogenic bronchobiliary fistula which developed after radiofrequency ablation of a colorectal carcinoma metastasis of the liver is present. We also describe the closure of the bronchobiliary fistula with the greater omentum as a possible manner of fistula closure, which was not reported previously according to the knowledge of the authors. Conclusions Newer papers report of successful non-surgical therapy, although the bulk of the literature advocates surgical therapy. Fistula closure with the greater omentum is a possible method of the thoracobiliary fistula treatment.
We present a complex case of a splanchnic arterioportal vein fistula in a patient who presented with weight loss, abdominal pain, diarrhea, and pancreatitis. We report successful use of the Guglielmi Detachable Coil (GDC) and N-butyl cyanoacrylate glue for the therapeutic embolization of the fistula between the superior mesenteric artery, the common hepatic artery, and the portal vein. On the day following the procedure, the patient reported total remission of the abdominal pain and diarrhea. These results were maintained at 3 months follow-up.
Chen, Qi, E-mail: [email protected]; Tack, Carl; Morcos, Morcos; Ruggiero, Mary Ann; Schlossberg, Peter; Fogel, Joshua [Maimonides Medical Center, Department of Radiology (United States); Weng Lijun [New York Methodist Hospital, Department of Radiology (United States); Farkas, Jeffrey [Maimonides Medical Center, Department of Radiology (United States)
Objective: The purpose of this study was to review retrospectively the functional and anatomic outcomes of women who underwent vaginal repair of enterocele and vault prolapse with the use of an intraperitoneal suspension of the vaginal vault to the uterosacral ligaments in conjunction with fascial reconstruction of the anterior and posterior vaginal wall. Study Design: Two hundred two women with
M. Karram; S. Goldwasser; S. Kleeman; A. Steele; B. Vassallo; P. Walsh
PURPOSE: This prospective study was done to analyze the efficacy of autologous fibrin glue application in the healing or closure of recurrent anorectal fistulas. Autologous cryoprecipitate was used as fibrin glue in all patients. This group included complex anorectal fistulas, rectovaginal fistulas, and urethrovesicorectal fistulas. METHODS: Patients were given bowel preparation and intravenous antibiotics before the procedure. Fistulas were curetted
... contact us Vaginitis Questions to Discuss with Your Doctor: How long have you had this vaginal discomfort? ... abdominal pain, joint pain, or a rash? Your Doctor Might Examine the Following Body Structures or Functions: ...
... and low estrogen levels, which may lead to vaginal dryness and other symptoms ( Atrophic vaginitis ). Forgotten tampon or foreign body, which may cause a foul odor. Chemicals found in ... irritate the vagina or the skin around the vagina Less common ...
...3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II...
...3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II...
Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal micro- bial populations have not been investigated using molecular methods. Here, we evaluated site-specific micro- bial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S
Tae Kyung Kim; Susan M. Thomas; Mengfei Ho; Shobha Sharma; Claudia I. Reich; Jeremy A. Frank; Kathleen M. Yeater; Diana R. Biggs; Noriko Nakamura; Rebecca Stumpf; Steven R. Leigh; Richard I. Tapping; Steven R. Blanke; James M. Slauch; H. Rex Gaskins; Jon S. Weisbaum; Gary J. Olsen; Lois L. Hoyer; Brenda A. Wilson
The appearance of a new intrafascial technique for vaginal hysterectomy serves to remind us that in spite of well-standardized techniques, gynecologists perform this less often than formerly. The described technique is an intrafascial variation of the extrafascial vaginal hysterectomy beginning at the fundus uteri. We mobilize the anterior vaginal wall using Strassmann's incision. The body of the uterus should be delivered through the anterior fornix. Then follows the ligation of the broad ligaments and careful dissection of the fibroareolar space of the posterior cervical wall. The cardinal ligament requires intrafascial clamping and ligation. This technique is simple and avoids injury to the ureters. If this operation is successfully performed, postoperative pain is minimal, and hospitalization could be greatly reduced. PMID:15459520
We report on a 32-year-old man with a history of chronic lower abdominal pain and urogenital symptoms, leading to the diagnosis of coloseminal fistula complicating diverticular disease. We reviewed the literature on this rare clinical entity and would like to stress the role of pelvic imaging with rectal contrast to investigate complicated forms of diverticular disease. PMID:24457980
Barret, Maximilien; Cuenod, Charles-André; Jian, Raymond; Cellier, Christophe; Berger, Anne
OBJECTIVE: To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits. DESIGN: A longitudinal surveillance of the vaginal flora over an eight week period. SUBJECTS: 26 female health care workers in local genitourinary medicine clinics. METHODS: The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gram staining. The swabs were also cultured for Candida spp, Gardnerella vaginalis, anaerobes, Mycoplasma hominis and Ureaplasma urealyticum. RESULTS: Of 26 subjects, only four had normal vaginal microbiology throughout. One woman, who was not sexually active, had bacterial vaginosis (BV) throughout and nine (35%) had intermittent BV. Candidiasis was found intermittently in eight women (31%), and eight had normal microscopy. U urealyticum was isolated intermittently in 40% of women with BV, 25% with candida, and 50% with normal microscopy. Many women were symptomatic, but symptoms correlated poorly with microbiological findings. All but two women were sexually active; however, more women with BV were exposed to semen. BV seemed to be related to frequent use of scented soap, and there appeared to be an additive effect of clothing and hygiene factors. CONCLUSIONS: Our study raises doubts about what should be regarded as normal vaginal flora. It calls into question the significance of finding BV or U urealyticum on a single occasion in asymptomatic women, or of finding normal flora in symptomatic women. The effect of external factors on the vaginal flora deserve further study.
Background and Study Objectives. Enterovesical fistula (EVF) is a devastating complication of a variety of inflammatory and neoplastic diseases. Radiological imaging plays a vital role in the diagnosis of EVF and is indispensable to gastroenterologists and surgeons for choosing the correct therapeutic option. This paper provides an overview of the diagnosis of enterovesical fistulae. The treatment of fistulae is also briefly discussed. Material and Methods. We performed a literature review by searching the Medline database for articles published from its inception until September 2013 based on clinical relevance. Electronic searches were limited to the keywords: “enterovesical fistula,” “colovesical fistula” (CVF), “pelvic fistula”, and “urinary fistula”. Results. EVF is a rare pathology. Diverticulitis is the commonest aetiology. Over two-thirds of affected patients describe pathognomonic features of pneumaturia, fecaluria, and recurrent urinary tract infections. Computed tomography is the modality of choice for the diagnosis of enterovesical fistulae as not only does it detect a fistula, but it also provides information about the surrounding anatomical structures. Conclusions. In the vast majority of cases, this condition is diagnosed because of unremitting urinary symptoms after gastroenterologist follow-up procedures for a diverticulitis or bowel inflammatory disease. Computed tomography is the most sensitive test for enterovesical fistula.
IntroductionHigh transsphincteric fistulas are difficult to treat because fistulotomy of involved sphincter muscle results in incontinence. We compare our outcomes for anal fistula plug, fibrin glue, advancement flap closure, and seton drain insertion.
Wiley Chung; Pooya Kazemi; David Ko; Clare Sun; Carl J. Brown; Manoj Raval; Terry Phang
Infections of the vaginal tract result from perturbations in the complex interactions between the microbiome and the host vaginal ecosystem. Recent data have linked specific vaginal microbes and urogenital infection with pre-term birth. Here we discuss how next generation sequencing-based approaches to study the vaginal microbiome will be important for defining what constitutes an imbalance of the microbiome and the associated host conditions that lead to subsequent infection and disease states. These studies will provide clinicians reliable diagnostic tools and treatments for women who are at increased risk for vaginal infections, preterm birth, HIV and other sexually acquired diseases, and will provide opportunities for intervention.
White, Bryan A.; Creedon, Douglas J.; Nelson, Karen E.; Wilson, Brenda A.
Vaginitis can be a frustrating entity to treat, since the incidence of recurrence is high. This paper examines evidence from the literature concerning diagnosis and treatment of Candida albicans, Trichomonas vaginalis, Corynebacterium vaginale, herpes simplex type 2 and gonorrhea. A protocol based on these readings is outlined.
Vaginal infections, affecting half of all women, are more severe in women with AIDS. The infection vulva vaginitis, caused by candida, may require medical attention. The doctor performs a pelvic exam and examines vaginal fluids under a microscope. Antibiotics, diet, or a suppressed immune system can increase candida yeast presence. Sweets should be avoided, as well as foods high in leavening, such as bread, cheese, fruit, or alcoholic beverages. Vegetables, grains, rice and wheat can be added to the diet. Eating a half-cup of yogurt daily will help maintain a proper level of yeast. Acidophilus capsules can be taken two or three times daily to relieve digestive problems. Raw or cooked garlic can be used as a vaginal suppository at night. Pau D'arco, the bark of a South American tree, is also anti-yeast. Boil for ten to twenty minutes, and take a teaspoon two or three times a day. Tea, or vinegar and water, can be used as a douche. Some women get relief by adding a half-cup of white vinegar to their bath. Do not wash genitals with soap and do not use sanitary napkins or tampons. Visit a doctor if the condition persists. PMID:11362438
The aim of this study was to determine if a new sphincter muscle-sparing technique that uses fibrin glue was effective in\\u000a closing all types of anal fistulas. All patients with anal fistulas who were seen by a single surgeon over a 2-year period\\u000a were treated with fibrin glue. Six to 8 weeks after a seton was placed in the fistula
Background: Rectovaginal fistulas are rare, and the majority is of traumatic origin. The most common causes are obstetric trauma, local infection, and rectal surgery. This guideline does not cover rectovaginal fistulas that are caused by chronic inflammatory bowel disease. Methods: A systematic review of the literature was undertaken. Results: Rectovaginal fistula is diagnosed on the basis of the patient history and the clinical examination. Other pathologies should be ruled out by endoscopy, endosonography or tomography. The assessment of sphincter function is valuable for surgical planning (potential simultaneous sphincter reconstruction). Persistent rectovaginal fistulas generally require surgical treatment. Various surgical procedures have been described. The most common procedure involves a transrectal approach with endorectal suture. The transperineal approach is primarily used in case of simultaneous sphincter reconstruction. In recurrent fistulas. Closure can be achieved by the interposition of autologous tissue (Martius flap, gracilis muscle) or biologically degradable materials. In higher fistulas, abdominal approaches are used as well. Stoma creation is more frequently required in rectovaginal fistulas than in anal fistulas. The decision regarding stoma creation should be primarily based on the extent of the local defect and the resulting burden on the patient. Conclusion: In this clinical S3-Guideline, instructions for diagnosis and treatment of rectovaginal fistulas are described for the first time in Germany. Given the low evidence level, this guideline is to be considered of descriptive character only. Recommendations for diagnostics and treatment are primarily based the clinical experience of the guideline group and cannot be fully supported by the literature.
Summary A high flow pial arteriovenous fistula in a twenty-years-old girl is described. The arteriovenous communication corresponds to a single hole fistula on the right rolandic area, with a giant venous ectasia. The patient presented seizures and left hemiparesis as symptoms. The fistula was embolized with glue obtaining total occlusion of the shunt. Hypotension was induced and valsalva manoeuver was done during the glue injection to reduce the flow into the fistula,however 26 hours after the procedure the patient bled resulting in a fatal outcome. The purpose of this paper is discuss the presentation of Rendu-Osler-Weber (ROW) in children and the therapeutic guidelines.
Enterovesical fistula (EVF) is an abnormal communication between the intestine and the bladder. It represents a rare complication\\u000a of inflammatory or neoplastic disease, and traumatic or iatrogenic injuries. The most common aetiologies are diverticular\\u000a disease and colorectal carcinoma. Over 75% of affected patients describe pathognomonic features of pneumaturia, faecaluria\\u000a and recurrent urinary tract infections. The diagnosis of EVF can be
This is the case of a 56-year-old male who presented at our Emergency Room complaining of severe epigastric pain that radiated towards the left shoulder and neck. Pneumopericardium was diagnosed with plain chest X-rays, which indicated a gastropericardial fistula. A contrast X-ray film was taken using a water-soluble contrast. A full gastrectomy was performed with esophagojejunostomy reconstruction and pericardial drainage, which resulted in a favourable patient outcome. PMID:17516832
Ruano Poblador, A; Gay Fernández, A M; García Martínez, M T; Galán Raposo, L; Maruri Chimeno, I; Carracedo Iglesias, R; Casal Núñez, J E
Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient's signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.
Chaudhry, Imtiaz A.; Elkhamry, Sahar M.; Al-Rashed, Waleed; Bosley, Thomas M.
Purpose The long-term efficacy of Surgisis anal fistula plug in closure of cryptoglandular anorectal fistulas was studied.\\u000a \\u000a \\u000a \\u000a Methods Patients with high cryptoglandular anorectal fistulas were prospectively studied. Additional variables recorded were: number\\u000a of fistula tracts, and presence of setons. Under general anesthesia and in prone jackknife position, patients underwent irrigation\\u000a of the fistula tract by using hydrogen peroxide. Each primary opening was
Bradley J. Champagne; Lynn M. O’Connor; Martha Ferguson; Guy R. Orangio; Marion E. Schertzer; David N. Armstrong
Background and Objective: We conducted this study to evaluate the feasibility and efficacy of immediate laparoscopic nontransvesical repair without omental interposition for vesicovaginal fistula (VVF) developing after total abdominal hysterectomy (TAH), which causes not only social and economic misery for the patient but also considerable stress to the physicians who perform the surgery. Methods: We performed a retrospective review of 5 women who underwent immediate laparoscopic nontransvesical repair without omental interposition for VVFs, developing after TAH from October 2007 to March 2009. In terms of laparoscopic procedure, cystoscopy was performed to confirm the location of fistula and ureteral openings, initially. Without opening the bladder, the fistula tract was identified, and the bladder was dissected from the vagina. The bladder defect was closed by using intracorporeal, continuous, and double-layer suturing, laparoscopically. The vaginal defect was closed using interrupted and single-layer suturing, vaginally. A Foley catheter was inserted for 2 weeks and removed after bladder integrity was confirmed with a retrograde cystogram. Results: The median age and body mass index of the patients were 47 years and 22.3 kg/m2, respectively. Operating time, hemoglobin change, and hospital stay were 95 minutes, 1.1 g/dL, and 5 days, respectively. There were no complications or laparoconversions. During follow-up (median 56.1 weeks; range 26.6 to 74.0), there was no evidence of recurrence. Conclusions: Immediate laparoscopic nontransvesical repair without omental interposition might be an effective, feasible alternative to the traditional methods in select patients with small sized (<1 cm) VVF developing after TAH.
Malignant melanoma is predominantly a skin disease but in rare instances it may occur at other sites. A vaginal melanoma is a rare clinical entity and the round cell type is an uncommon variant. Although the present case was clinically diagnosed as a urethral caruncle, on histopathological examination and immunostaining it was diagnosed as a round cell pigmented malignant melanoma. The patient refused radical surgery and was given a full course radiotherapy treatment but died a year later. Malignant vaginal melanoma carries a very poor prognosis even when lesion is localised at the time of presentation. The five-year survival rate ranges from 10–20% with the prognosis being influenced by tumour size. A tumour size ?3cm has a poor prognosis. Age, mitotic count, stage, and location of the lesion do not influence survival rates.
Objective To determine the cost-effectiveness of in-utero percutaneous Vesico Amniotic Shunt (VAS) in the management of fetal lower urinary tract obstruction (LUTO) Design Model based economic analysis using data from the randomised controlled arm of the PLUTO (percutaneous vesico-amniotic shunting for lower urinary tract obstruction) trial. Setting Fetal medicine departments in United Kingdom, Ireland and Netherlands. Population or Sample Pregnant women with a male, singleton fetus with LUTO. Methods Costs and outcomes were prospectively collected in the trial; three separate base case analyses were performed using the intention to treat (ITT), per protocol and uniform prior methods. Deterministic and probabilistic sensitivity analyses were performed to explore data uncertainty. Main Outcome Measures Survival at 28 days, 1 year and disease free survival at 1 year. Results VAS was more expensive but appeared to result in higher rates of survival compared with conservative management in patients with LUTO. Using ITT analysis the incremental cost effectiveness ratios based on outcomes of survival at 28 days, 1 year, or 1 morbidity-free year on the VAS arm were £15,506, £15,545, and £43,932, respectively. Conclusions VAS is a more expensive option compared to the conservative approach in the management of individuals with LUTO. Data from the RCT suggest that VAS improves neonatal survival but does not result in significant improvements in morbidity. Our analysis concludes that VAS is not likely to be cost effective in the management of these patients given the NICE (National Institute of Health and Clinical Excellence) cost threshold of £20,000 per QALY.
Diwakar, Lavanya; Morris, Rachel K.; Barton, Pelham; Middleton, Lee J.; Kilby, Mark D.; Roberts, Tracy E.
OBJECTIVE To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections, and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting. DATA SOURCES Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997 were reviewed. DATA SYNTHESIS Techniques that enable the identification of the various strains of candida have helped lead to a better understanding of the mechanisms of recurrent candida infection. From this information a rationale for the treatment of recurrent disease can be developed. Bacterial vaginosis has been associated with complications, including upper genital tract infection, preterm delivery, and wound infection. Women undergoing pelvic surgery, procedures in pregnancy, or pregnant women at risk of preterm delivery should be evaluated for bacterial vaginosis to decrease the rate of complications associated with this condition. New, more standardized criteria for the diagnosis of bacterial vaginosis may improve diagnostic consistency among clinicians and comparability of study results. Use of topical therapies in the treatment of bacterial vaginosis are effective and associated with fewer side effects than systemic medication. Trichomonas vaginalis, although decreasing in incidence, has been associated with upper genital tract infection. Therapy of T. vaginalis infection has been complicated by an increasing incidence of resistance to metronidazole. CONCLUSIONS Vaginitis is a common medical problem in women that is associated with significant morbidity and previously unrecognized complications. Research in recent years has improved diagnostic tools as well as treatment modalities for all forms of vaginitis.
Carr, Phyllis L; Felsenstein, Donna; Friedman, Robert H
A total of 132 pregnant women with average gestational age of 14.2 weeks (range 11–22 weeks) undergoing legal abortion volunteered for a trial utilizing vaginal administration of misoprostol. In 106 women a dose of 800 ?g was utilized, whilst in 26 women 1,200-1,600 ?g were given. Nonsurgical expulsion of the fetus was successful in 117 cases (88.6%). Four cases had
Antonio Bugalho; Cassimo Bique; Luisa Almeida; Staffan Bergström
Objective: To document a 15 year experience of fistula in ano surgery. Design: Retropective audit of patients. Subjects: All patients referred with fistula in ano between 1975 and 1990. Setting: Colorectal Service, University Department of Surgery, Wellington School of Medicine. Main outcome measures: Resolution of symptoms and morbidity of surgery. Results: 92 operations were performed in 88 patients. There were
Six among 60 arterial injuries at the 18th Surgical Hospital (MA) and 71st Evacuation Hospital, Vietnam, were treated for arteriovenous fistulas. Five of six fistulas caused by war injuries were acute, and one was chronic. All injuries were caused by frag...
Summary Bronchobiliary fistula is a rare condition, defined by the presence of a passage between the biliary tract and the bronchial tree. Many conditions can give raise to the development of such a communication. Biliary lithiasis is one of those and is perhaps the one most amenable to endoscopic management. We describe a case of bronchobiliary fistula secondary to the
V. F. Moreira; C. Arocena; F. Cruz; M. Alvarez; A. L. San Roman
Duodenocaval fistulae are rare but may well be the source of gastrointestinal hemorrhage with associated sepsis in patients undergoing surgery and subsequently receiving radiation to the right upper abdomen. Management of these fistulae may be challenging. Diagnosis usually requires a high index of suspicion, particularly in post irradiated patients.
Arterio-ureteric fistulae are rare but can be associated with significant morbidity and mortality. We describe a novel case in which an arterio-ureteric fistula occurred as a complication following external iliac artery angioplasty and stenting, in a patient who had undergone previous pelvic surgery, radiotherapy, ureteric stenting, and urinary diversion surgery. Prompt recognition enabled successful endovascular management using a covered stent.
Aarvold, Alexander; Wales, Lucy, E-mail: [email protected]; Papadakos, Nikolaos; Munneke, Graham; Loftus, Ian; Thompson, Matt [St. George's Vascular Institute (United Kingdom)
Aortoesophageal and aortobronchial fistulas constitute a problem in therapy because of the high rates of morbidity and mortality associated with operation. From May 1996 to March 2000, we treated by an endovascular procedure one aortoesophageal and three aortobronchial fistulas. There was no postoperative death. We noted one peripheral vascular complication that required a surgical procedure, one postoperative confusion, and one
Bertrand Léobon; Daniel Roux; Antoine Mugniot; Hervé Rousseau; Alain Cérene; Yves Glock; Gérard Fournial
Vaginal leiomyoma is a rare tumor with a variable clinical presentation and broad differential diagnosis that can lead to preoperative misdiagnosis. We present a case of vaginal leiomyoma with a symptom complex of prolapse, urinary urgency and urge incontinence. A 50-year-old woman presented with a 4-year history of deteriorating sensation of prolapse, significant complex urinary complaints and prolonged vaginal bleeding. Clinical examination revealed a mobile 6 x 8 cm mass arising from the anterior vaginal wall. She underwent hysteroscopy, curettage, urethrocystoscopy (normal findings) and mass enucleation through a vertical incision. Histology showed a benign leiomyoma. Ultrasonography, MRI, positive-pressure urethrography and urethrocystoscopy should be considered in the evaluation of an anterior wall vaginal mass. Surgical enucleation via a vaginal approach is the treatment of choice. If this surgical procedure results in skeletonization of the urethral and bladder support, a colporrhaphy/pubourethral ligament plication is required. PMID:11484748
Vaginal microbiota form a mutually beneficial relationship with their host and have major impact on health and disease. In recent years our understanding of vaginal bacterial community composition and structure has significantly broadened as a result of investigators using cultivation-independent methods based on the analysis of 16S ribosomal RNA (rRNA) gene sequences. In asymptomatic, otherwise healthy women, several kinds of vaginal microbiota exist, the majority often dominated by species of Lactobacillus, while others comprise a diverse array of anaerobic microorganisms. Bacterial vaginosis is the most common vaginal conditions and is vaguely characterized as the disruption of the equilibrium of the ‘normal’ vaginal microbiots. A better understanding of ‘normal’ and ‘healthy’ vaginal ecosystems that is based on its ‘true’ function and not simply on its composition would help better define health and further improve disease diagnostics as well as the development of more personalized regimens to promote health and treat diseases.
The increased number of vaginal yeast infections in the past few years has been a disturbing trend, and the scientific community has been searching for its etiology. Several theories have been put forth to explain the apparent increase. First, the recent widespread availability of low-dosage, azole-based over-the-counter antifungal medications for vaginal yeast infections encourages women to self-diagnose and treat, and women may be misdiagnosing themselves. Their vaginitis may be caused by bacteria, parasites or may be a symptom of another underlying health condition. As a result, they may be unnecessarily and chronically expose themselves to antifungal medications and encourage fungal resistance. Second, medical technology has increased the life span of seriously immune compromised individuals, yet these individuals are frequently plagued by opportunistic fungal infections. Long-term and intense azole-based antifungal treatment has been linked to an increase in resistant Candida and non-Candida species. Thus, the future of limiting antifungal resistance lies in identifying the factors promoting resistance and implementing policies to prevent it.
Background: The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS). Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.
Using McIndoe's vaginal reconstruction with the ORFIT "S" vaginal stent, we achieved good results in 5 patients with congenital vaginal absence over the past 3 years. The ORFIT "S" vaginal stent is a semirigid, porous, and inexpensive stent. The application is easy intraoperatively, and minimal daily care is required for long-term postoperative dilatation. The stent keeps the neovagina in full acceptance of the speculum after long-term follow-up. PMID:8041835
The incidence of vaginal septum is rare. The infrequency of this anomaly makes accurate estimates of the true incidence very difficult to obtain. Diagnosis is based on careful historyand examination. This is the case of a patient who presented with transverse vaginal septum in labour and breech presentation. The septum was resected and the foetus delivered normally. Careful vaginal examination should be performed in pregnant women at term before labour to detect such manageable abnormalities. PMID:24397081
The pulmonary hypoplasia with bronchoesophageal fistula is a rarely-seen disease which can be confused with total pulmonary agenesis. This case study concerns to one day old male newborn which was hospitalized in our hospital with respiratory difficulties, accompanied by pulmonary opacity of the right side. After having carried out diagnosis studies, including bronchography, we concluded that it was a case of pulmonary agenesis. The patient died from persistent pulmonary hypertension. The anatomopathologic diagnosis, was right pulmonary hypoplasia with bronchoesophageal fistula. This pathology originated during early embryonic stage when the bronchoplastic and esophagoplastic tissue are incompletely separated an thus a fistula between the esophagus and the principal bronchus is formed. The presence of a fistula could not be proven by bronchography. However, esophagography or esophagoscopy would have proven the presence of the fistula. PMID:1466775
De León-Cantú, R E; Rodríguez-Balderrama, I; Tijerina-Carrillo, E L; Villarreal-Castellanos, E; Rodríguez-Bonito, R; Barbosa-Quintana, A; Abrego-Moya, V
Three cases of the rare condition of congenital cheek fistulae are presented. These differ from preauricular fistulae in terms of their location and the direction in which the fistula is lying. Each cheek fistula seemed to be situated along the line of the junction between the mandibular and maxillary processes of the first branchial arch. PMID:10624301
Colocutaneous fistula caused by diverticulitis is relatively rare, and a delayed recrudescent case of colocutaneous fistula is very uncommon. We herein report a rare case of a Japanese 56-year-old male with delayed recrudescent sigmoidocutaneous fistula due to diverticulitis. A colocutaneous fistula was formed after a drainage operation against a perforation of the sigmoid colon diverticulum. After 5 years from treatment,
Aim: Anal fistula is usually treated by either fistulotomy or fistulectomy. We described the routine use of setons to treat anal fistula without any surgery. Method: Forty-seven consecutive patients with diagnosed anal fistulae were treated using setons alone. Results: The median age of the patients was 41 (range: 18-70). Of the 47 patients, 15 had surgery previously for fistula and
This study compares the outcomes of laparoscopic uterosacral ligament uterine suspension (LUSUS) to those of vaginal vault suspension with total vaginal hysterectomy (TVH) for the treatment of symptomatic uterovaginal prolapse. We compared the outcomes of 25 LUSUS to those of 25 TVH with vaginal vault suspension among age-matched controls. No significant complications occurred in either group. EBL and hospitalization duration
Aparna Diwan; Charles R. Rardin; William C. Strohsnitter; Alexandra Weld; Peter Rosenblatt; Neeraj Kohli
Objectives: To determine if the efficacy of continuous low dose estradiol released from a vaginal ring is equivalent to estriol vaginal cream regarding improvement of the patient's subjective feeling of vaginal dryness and to determine if there is a preference for either of the two study treatments. Methods: Open-label randomized parallel group trial with active control with a blind evaluation
Ronald Barentsen; Peter H. M. van de Weijer; Jan H. N. Schram
Severe vaginal stenosis is a potentially disabling complication of transverse vaginal septum resection due to the constriction of the resulting circular scar. We describe a vaginal mold that can be easily created by an occupational therapist, and used as a long-term stent of the vagina in young girls. PMID:17418828
Lacy, Judith; Correll, Gretchen R; Walmer, David K; Price, Thomas M
Objectives: To evaluate whether an elevated vaginal leucocyte count in women with bacterial vaginosis (BV) predicts the presence of vaginal or cervical infections, and to assess the relation of vaginal WBC counts to clinical manifestations. Methods: We retrospectively analysed the relation of vaginal leucocyte counts to vaginal and cervical infections and to clinical manifestations in non-pregnant women diagnosed with BV at an STD clinic visit. Results: Of 296 women with BV studied, the median age was 24 years and 81% were African-American. Elevated vaginal leucocyte counts were associated with objective signs of vaginitis and cervicitis and also predicted candidiasis (OR 7.9, 95% CI 2.2 to 28.9), chlamydia (OR 3.1, 95% CI 1.4 to 6.7), gonorrhoea (OR 2.7, 95% CI 1.3 to 5.4), or trichomoniasis (OR 3.4, 95% CI 1.6 to 7.3). In general, as a screening test for vaginal or cervical infections, vaginal leucocyte count had moderate sensitivities and specificities, low positive predictive values, and high negative predictive values. Conclusions: An elevated vaginal leucocyte count in women with BV was a strong predictor of vaginal or cervical infections. Vaginal leucocyte quantification may provide an alternative approach to assessing need for empirical therapy for chlamydia and gonorrhoea, particularly in resource-limited high STD risk settings that provide syndromic management.
... factors for vaginal cancer? What are the key statistics about vaginal cancer? Vaginal cancer is rare. Only ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...
Vaginal contraception is enjoying a revival among women who fear the side effects of the pill or of the IUD. Vaginal contraception by vaginal diaphragm or by cervical cap is totally reversible and never causes complications; there may be short term reversible side effects with the diaphragm, such as cystitis, uretritis, and hemorroids; no side effects are associated with the use of cervical caps. Vaginal contraception has the added advantage of exercising a notable prophylactic actions on the diffusion of verereal diseases and of other vaginal infections such as trichomoniasis and candidosis. It is also possible that vaginal contraception offers protection against cervical neoplasia. Failure rate of diaphragm use is an average 10/100 women years, and for the cervical cap it is about 7.6/100 women years, when both devices are properly used. Vaginal contraception needs to be used in conjunction with spermicidal agents. Spermicidal agents can be used alone and can be very effective; they are, however, not well accepted by most couples, who resent the interruption of the sexual act. Two experimental models of vaginal sponge are now under study; vaginal sponges can be left in place for some time, and insertion is very easy. PMID:12336893
Vesico-vaginalfistula (VVF) is a major public health issue in Nigeria. This study focused on VVF patients seeking treatment. Hospital records were used to sample 30 respondents. Three focus group discussions were conducted and analyzed in themes. Results reveal that most of the respondents did not know what brought about their condition, whereas some felt it was a curse from the gods. Respondents reported discrimination and stigmatization by relatives. Findings suggest the need to have trained social workers working in all fistula centers in the country. They will help in the counseling, rehabilitation, and reintegration of these women. PMID:25068607
Emma-Echiegu, Nkechi; Okoye, Uzoma O; Odey, Ering S
A 44-year-old woman underwent uncomplicated uterine fibroid embolization (UFE) for menstrual and bulk-related symptoms in an enlarged, myomatous uterus. After surgery, she spontaneously sloughed a large mass of fibroids that arrested in the cervical canal during passage. Four days after gynecological extraction, she developed copious vaginal discharge that contained enteric contents. Contrast-enhanced computed tomography (CT) demonstrated a fistula between the small bowel and the uterus. She subsequently underwent hysterectomy, left oophorectomy, and small-bowel resection. Her postoperative recovery was uneventful.
Gutierrez, Luis B., E-mail: [email protected] [Stanford University, School of Medicine (United States); Bansal, Anshuman K., E-mail: [email protected] [University of California at Los Angeles, Department of Radiology (United States); Hovsepian, David M., E-mail: [email protected] [Stanford University, School of Medicine (United States)
The key to the treatment of anal fistula lies in scavenging the infected anal gland thoroughly, which is the source of anal fistula infection. The fistula tract at the internal orifice of the anal fistula is cut 1 cm using laser with the infectious source completely degenerated and the wound gassified and scanned. The residual distal fistula softens and disappears upon the action of organic fibrinolysin.
We report on a clinicopathologic study in an animal model of treatment with a new bioabsorbable polymer plug (BAPP). Over a 2-week period, 6 porcine models, which each had 4 anal fistulae, were created using Blake drains. The pigs were divided into 2 groups: the BAPP-treatment group (n = 12 fistulae) and the control group (n = 12 fistulae). Two weeks later, the pigs were humanely killed, and the perianal sites were excised and examined with gross and pathologic studies. Each fistula in the BAPP group was completely cured. In the pathologic study, the treatment sites had little disarray, few defects in the muscular layer, and small numbers of inflammatory cells. The control group had a significantly greater number of inflammatory cells and microabscesses than the BAPP group. The newly developed BAPP reduced the infection and induced good healing in anal fistulae. The BAPP may be a useful new device for the clinical treatment of anal fistulae.
Personal experience with the treatment cryptogenic complex anal fistulas over the 10-year period from 1993 to 2002 is reported. Such fistulas accounted for 54 out of 255 fistulas observed (21.1%). Accurate anatomo-pathological classification, based on the connections between the fistulas and the sphincter and the musculature of the pelvic floor, is mandatory, as is thorough preoperative evaluation of ano-rectal function and of the risk of faecal incontinence. The surgical strategies used, in relation to the different kinds of complex fistulas treated, are schematically reported. A mixed technique consisting in fistulectomy-fistulotomy with setons was particularly preferred, because of the risk related to immediate dissection of the sphincter, especially when concurrent risk factors are present. As regards the results obtained, the surgical outcome consisted in healing in 49/54 cases (90.7%) as against recurrence or persistence of the fistula in 5/54 (9.3%). Minor complications occurred in 6/54 (11.1%); no major complications were observed and no cases of permanent faecal incontinence were reported. In conclusion, the surgical choice in cases of complex fistulas must lead to definitive, radical treatment of the lesion, at the same time avoiding irreversible anal incontinence due to severe lesions to the sphincter. PMID:15452991
Obstetric fistula is one of the most severe childbirth-related complications. The small size and physical weakness of many young pregnant girls makes it extremely difficult for them to give birth to a child. Delivery is therefore often prolonged. During childbirth, girls' perineum often tears, leaving holes between the bladder and/or the rectum and the vagina. The young mothers from then on lose control over their bladder and bowels, are unable to bear more children, and find sexual intercourse painful. Such fistula are common in Somalia, Ethiopia, most Sahelian countries, Zambia, and Zimbabwe, but particularly so in Niger. 23,000 girls and women in Niger have the condition, or 1% of all women of child-bearing age. Obstetric fistula can, however, be cured by a simple operation. France recently announced a $400,000 aid project to help teenage girls in Niger with fistula and to discourage parents, village elders, and women's groups from marrying girls at too young ages. Doctors in Niger will be trained to surgically repair fistula, cured women will be helped to reintegrate into society, local health workers will be trained to recognize the early signs of fistula, and female genital mutilation will be discouraged because of its role in increasing the likelihood of fistula development. PMID:12290458
Postmenopausal estrogen deficiency can lead to symptoms of urogenital atrophy. Individuals with urogenital atrophy have symptoms that include vaginal dryness, vaginal and vulval irritation, vaginal soreness, pain and burning during urination (dysuria), increased vaginal discharge, vaginal odour, vaginal infections, recurrent urinary tract infections, pain associated with sexual activity (dyspareunia) and vaginal bleeding associated with sexual activity. Despite the frequency and effects of vaginal atrophy symptoms, they are often under-reported and, consequently, under-treated. Therefore, care of a menopausal woman should include a physical assessment of vaginal atrophy and a dialogue between the physician and the patient that explores existing symptoms and their effect on vulvovaginal health, sexuality and quality-of-life issues. The development of the ultra-low-dose 10-µg estradiol vaginal tablets is in line with the requirements of regulatory agencies and women's health societies regarding the use of the lowest effective hormonal dose. Because of its effectiveness and safety profiles, in addition to its minimal systemic absorption, the 10-µg estradiol vaginal tablet can offer greater reassurance to health-care providers and postmenopausal women with an annual estradiol administration of only 1.14 mg. PMID:22393176
Introduction. Vesicovaginal fistula has been a social and surgical problem for centuries. Many surgical techniques have been developed to correct this abnormality, including transabdominal, transvaginal, and endoscopic approaches. The best approach is probably the one with which the surgeon feels most experienced and comfortable. Laparoscopy has become increasingly popular in urology, reducing the invasiveness of treatment and shortening the period of convalescence. We report our results of transvesicoscopic approach for VVF repair. Materials and Methods. Patients with VVF were offered repair using the transvesicoscopic route. With the patient under general anaesthesia and in modified lithotomy position cystoscopy was performed with gas insufflation. Under cystoscopic guidance the bladder was fixed to anterior abdominal wall and ports inserted into the bladder. The fistula was repaired under endoscopic vision. Results. Four women, who had VVF following abdominal hysterectomy, underwent this procedure. The operating time ranged from 175 to 235 minutes. There was minimal bleeding. Post operative complications included ileus in one and fever in another. No recurrence of VVF was noted in any patient. Conclusions. Transvesicoscopic repair of VVF is feasible, safe, and results in lower morbidity and quicker recovery time.
The objective of this study was to demonstrate the applicability of laser doppler flowmetry to pre- and posthysterectomy vaginal blood flow assessment. We used laser Doppler flowmetry to measure pre-and postoperational vaginal blood flow in 8 premenopausal women undergoing benign hysterectomies; we also measured serum E2, FSH, FT and administered a brief sexual function questionnaire. We analyzed data using two
A group of 120 women with gestations from 64 to 84 days received 800 ?g of vaginal misoprostol every 24 h for a maximum of three doses without performing postexpulsion systematic preventive curettage. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side effects, and mean time of expulsion and vaginal bleeding. Complete abortion occurred in 104
J. L Carbonell Esteve; L Varela; A Velazco; E Cabezas; R Tanda; C Sánchez
Relatively simple and rapid procedures have been developed for evaluating the local efficacy of vaginal antifungal agents in vivo in a vaginal candidiasis model in ovariectomized rats. The results of this investigation indicate that the model and methods described are quite suitable for screening potential antifungal substances and for assessing the chemotherapeutic effectiveness of new antifungal agents and formulations before carrying out clinical studies.
McRipley, R. J.; Erhard, P. J.; Schwind, R. A.; Whitney, R. R.
Introduction Transverse vaginal septum occurs because there is a defect in vertical fusion during embryological development of the vagina.\\u000a It is quite rare and is infrequently encountered by most obstetricians and gynecologists in their practice.\\u000a \\u000a \\u000a \\u000a \\u000a Case report A 14-year-old unmarried student, Miss AUX, presented to a private gynecologist complaining of absent menses. Initial examination\\u000a and investigation revealed intact hymen, normal uterus but
Fahed Al-Abdulhadi; Michael Fidelis Diejomaoh; Assem El Biaa; Jiri Jirous; Mona Al-Qenae
Over 2 million women worldwide have an obstetric fistula, with the majority of cases occurring in resource-poor countries. Afflicted women tend to be young, primiparous, impoverished, and have little or no access to medical care. Incontinent of urine and/or stool, these women become ostracized and shunned by their community. Most obstetric fistulas are surgically correctible, although surgical outcomes have been poorly studied. Programs that improve nutrition, delay the age of marriage, improve family planning, and increase access to maternal and obstetric care are necessary to prevent obstetric fistula.
Gastropleural fistula is a rare condition, most frequently reported as a result of trauma, peptic ulcer disease or malignancy. We report a case of gastropleural fistula in a patient with metastatic ovarian cancer who presented with hydropneumothorax and mediastinal shift. She was successfully managed with an open partial gastrectomy, repair of diaphragmatic defect, and thoracoscopic washout and decortication. Based on our case and review of the literature, surgical repair of gastropleural fistula should be considered as a palliative procedure even in patients with end-stage cancer. PMID:24876505
Six cases of full spontaneous closure of congenital coronary artery fistulas, and one case of near closure, as seen by colour Doppler echocardiography, are presented. It is worth reconsidering the classical view that nearly all cases of spontaneous closure are eligible for surgical or percutaneous correction to prevent the development of significant and potentially fatal complications. As the natural course of coronary artery fistulas is still poorly defined, asymptomatic patients, especially those under 7 years old with small shunts, should be periodically followed up by echocardiography rather than be subjected to operative closure, even by catheterisation.???Keywords: congenital heart disease; coronary artery disease; coronary artery fistula; spontaneous closure
Cases of cholecystocutaneous fistulas are now a rare occurrence as a result of rapid diagnosis and treatment. We present a case of cholecystocutaneous fistula developing after the removal of a percutaneous drain for the treatment of acute cholecystitis. Re-occurring infection and presence of gallstones led to fistulization of the gallbladder fundus and the development of a tract along the path created by the drain. The patient presented with re-occurring right upper quadrant abdominal pain, purulent discharge from the fistulous opening and expulsion of multiple gallstones. She underwent laparoscopic cholecystectomy and fistula excision.
Gastropleural fistula is a rare condition, most frequently reported as a result of trauma, peptic ulcer disease or malignancy. We report a case of gastropleural fistula in a patient with metastatic ovarian cancer who presented with hydropneumothorax and mediastinal shift. She was successfully managed with an open partial gastrectomy, repair of diaphragmatic defect, and thoracoscopic washout and decortication. Based on our case and review of the literature, surgical repair of gastropleural fistula should be considered as a palliative procedure even in patients with end-stage cancer.
Summary We report a case of a 68-year-old woman with an acute paraplegia due to venous congestion of the spinal cord caused by an exclusive epidural arteriovenous fistula. Diagnosed by MRI and selective spinal angiography the fistula was embolized during emergency treatment via transarterial access. Immediately after the intervention the paraplegia declined and the patient recovered completely. Epidural AV fistulae are a very rare and therefore relatively unknown cause of vascular myelopathy. They may require emergency management to avoid permanent neurological deficits.
\\u000a Purpose Long-term closure rates of anorectal fistulas using fibrin glue have been disappointing, possibly because of the liquid consistency\\u000a of the glue. A suturable bioprosthetic plug (Surgisis, Cook Surgical, Inc.) was fashioned to close the primary opening of fistula tracts. A prospective cohort study was performed\\u000a to compare fibrin glue vs. the anal fistula plug.\\u000a \\u000a \\u000a \\u000a Methods Patients with high transsphincteric fistulas, or
Eric K. Johnson; Janette U. Gaw; David N. Armstrong
\\u000a Purpose The efficacy of Surgisis anal fistula plug in closure of Crohn’s anorectal fistula was studied.\\u000a \\u000a \\u000a \\u000a Methods Patients with Crohn’s anorectal fistulas were prospectively studied. Diagnosis was made by histologic, radiographic, or endoscopic\\u000a criteria. Variables recorded were: number of fistula tracts (primary openings), presence of setons, and current antitumor\\u000a necrosis factor therapy. Under general anesthesia and in prone jackknife position, patients underwent
Lynn O’Connor; Bradley J. Champagne; Martha A. Ferguson; Guy R. Orangio; Marion E. Schertzer; David N. Armstrong
A total of 132 pregnant women with average gestational age of 14.2 weeks (range 11-22 weeks) undergoing legal abortion volunteered for a trial utilizing vaginal administration of misoprostol. In 106 women a dose of 800 micrograms was utilized, whilst in 26 women 1,200-1,600 micrograms were given. Nonsurgical expulsion of the fetus was successful in 117 cases (88.6%). Four cases had to be excluded for various social reasons. A total of 11 did not achieve fetal expulsion within 56 h after application of misoprostol. These cases (11/132; 8.3%) were considered failures. Previous reports in the literature of toxicity trials on animals reporting no fetotoxic nor teratogenic effects of misoprostol at doses up to 10,000 micrograms/kg body weight seem to be of no validity in the human since we could demonstrate that almost 80% of pregnancies were interrupted at a dose of 10-15 micrograms/kg body weight. The conclusion is that vaginal administration of this prostaglandin analogue, not requiring cool temperature for storage, is remarkably effective in achieving safe interruption of pregnancy without any significant complications. PMID:8300007
Background The aim of this study was to describe the results of a 1-year patient follow-up after anterior vaginal wall darn, a novel technique for the repair of anterior vaginal wall prolapse. Methods Fifty-five patients with anterior vaginal wall prolapse underwent anterior vaginal wall darn. The anterior vaginal wall was detached using sharp and blunt dissection via an incision beginning 1 cm proximal to the external meatus and extending to the vaginal apex. The space between the tissues that attach the lateral vaginal walls to the arcus tendineus fasciae pelvis was then darned. Cough Stress Test, Pelvic Organ Prolapse Quantification, seven-item Incontinence Impact Questionnaire, and six-item Urogenital Distress Inventory scores were performed 1-year postoperatively to evaluate recovery. Results One-year postoperatively, all patients were satisfied with the results of the procedure. No patient had vaginal mucosal erosion or any other complication. Conclusions One-year postoperative findings for patients in this series indicate that patients with stage II–III anterior vaginal wall prolapse were successfully treated with the anterior vaginal wall darn technique.
Cocaine fistulae require repair with well-vascularized material. In the technique used this is accomplished by closure of the nasal layer by delayed palatal flaps and the oral layer with a tongue flap. Three cases are presented. PMID:19131723
Jackson, Ian T; Kelly, Chris; Bello-Rojas, Gustavo
Case reports of transdiaphragmatic fistulas connecting subphrenic collections and empyemas are uncommon. We report the rare complication of a fistulous connection between a subphrenic collection and the bronchial tree.??
Aortoesophageal and aortobronchial fistulas constitute a problem in therapy because of the high rates of morbidity and mortality associated with operation. From May 1996 to March 2000, we treated by an endovascular procedure one aortoesophageal and three aortobronchial fistulas. There was no postoperative death. We noted one peripheral vascular complication that required a surgical procedure, one postoperative confusion, and one inflammatory syndrome. In one case, because of a persistent leakage after 21 months, we had to implant a second endovascular stent graft. A few weeks later the reopening of this patient's esophageal fistula led to his death by mediastinitis 25 months after the first procedure. The few cases published seem to bear out the interest, observed in our 4 patients, of an endovascular approach to treat complex lesions such as fistulas of the thoracic aorta especially in emergency or palliative cases. PMID:12118773
Enterovesical fistulae are difficult to demonstrate by conventional radiographic methods. Computed tomography (CT), a sensitive, noninvasive method of documenting the presence of such fistulae, is unique in its ability to outline the extravesical component of the primary disease process. Twenty enterovesical fistulae identified by CT were caused by diverticulitis (nine), carcinoma of the rectosigmoid (two), Crohn disease (three), gynecologic tumors (two), bladder cancer (one), cecal carcinoma (one), prostatic neoplasia (one), and appendiceal abscess (one). The CT findings included intravesical air (90%), passage of orally or rectally administered contrast medium into the bladder (20%), focal bladder-wall thickening (90%), thickening of adjacent bowel wall (85%), and an extraluminal mass that often contained air (75%). CT proved to be an important new method in the diagnosis of enterovesical fistulae.
Background A gastroesophageal anastomotic fistula remains a potentially life-threatening post-esophagectomy complication. To promote fistula closure, we developed a modified endoscopic method of trans-fistula drainage with persistent negative pressure. In this study, we aimed to evaluate the efficacy of this endoscopic therapy. Methods Between June and November 2013, five male patients with post-surgical esophageal leakages who had undergone trans-fistula drainage therapy were treated with the modified endoscopic trans-fistula negative pressure drainage (E-TNPD) method. We placed a nasogastric silicone tube into the paraesophageal cavity through the fistula and accomplished drainage of the infected effusion with continuous negative pressure, resulting in shrinkage of the para-anastomotic cavity and eventual fistula closure. We withdrew the trans-fistula drainage when there were no signs of leakage, as confirmed by esophagography. Final closure was confirmed by esophagography before the patient was allowed to begin oral intake. Results E-TNPD was successful in all five patients. The median duration of drainage until tube removal was 34 days (range: 18 to 81 days). The duration for Cases 1 to 4 was 18 to 28 days. Case 5 suffered from multiple separate leaks at the anastomotic site and the gastric conduit. Complete restoration was achieved in 81 days for this patient. We found that in general, the earlier that trans-fistula drainage was established, the shorter the duration of hospitalization until complete defect closure. Conclusions E-TNPD provided reliable and convenient management of post-surgical gastroesophageal anastomotic fistula and esophageal perforation. This method promoted fistula closure and prevented unnecessary repeated endoscopic examinations, extra equipment and expense.
Hydrometrocolpos, occurring in approximately 1/6000 newborn girls, can be caused by a stenotic urogenital sinus, a severe cloacal malformation, but also by other conditions such as an imperforate hymen, a midline vaginal septum and vaginal atresia. The prenatal differential diagnosis of this wide spectrum of conditions is not easy and requires a multidisciplinary approach with follow-up scans and MRI to access the severity of the condition. A non-consanguineous couple was referred in the first pregnancy at 30 weeks. The father, 30 years of age, of Kaukasian origin, and the mother of Asian origin, 26 years of age. Ultrasound at 30 weeks revealed ambiguous genitalia (with suspicion of clitoral hypertrophy), a septated structure located behind the bladder compatible with hydrometrocolpos with a uterine malformation (uterus didelphys), a single umbilical artery, mild ascites and growth on the tenth centile. The differential diagnosis included a vaginal atresia, a urogenital sinus and a more severe cloacal malformation. After serial scans, MRI and counselling by an experienced surgeon the preferential diagnosis of a cloacal malformation was made and a late pregnancy termination was performed. Pathological examination revealed: low vaginal atresia with uterus didelphys, anal atresia with rectovaginal fistula and a normal urinary tractus. The differential diagnosis between hydrometrocolpos due to vaginal atresia or due to a more severe cloacal malformation is not straightforward. Care should be taken in decision making and counselling patients with these complex prenatal malformations. PMID:23431753
A female patient with a preotic fistula caused by a defect in the development of the first branchial arch is described. Repeated surgeries for lateral fistula of the neck brought no success. The pathogenesis of the defect and difficulties in its diagnosis are discussed; the authors claim that fistulography with contrast agents may be effective. Histologic verification is needed in all the cases. PMID:8713409
Semkin, V A; Bezrukov, V M; Rabukhina, N A; Grigorian, A S; Katanova, N I
Chronic pancreas transplant rejection with enteric exocrine drainage can lead to significant long-term complications. We report a case of a 47-year-old male insulin-dependent diabetic who survived the complications of peripancreatic abscess, enterocutaneous fistula, and arterioenteric fistula related to pancreas transplantation. To avoid these long-term complications, we now recommend elective removal of nonfunctioning, enterically drained pancreas allografts.
Gritsch, H. Albin; Shapiro, Ron; Egidi, Francesca; Randhawa, Parmjeet S.; Starzl, Thomas E.; Corry, Robert J.
Bronchobiliary fistula is a rare cause of chronic cough. Here we describe a 70-year-old woman complaining of chronic cough and copious dark-yellow watery sputum. The presence of air in the biliary tract in the lower cuts of a computerized tomography scan of the chest and positive bile in the sputum led to the suspicion of bronchobiliary fistula. The diagnosis was
Vesicovaginal fistula (VVF) is prevalent in the developing world, with recent estimates suggesting that 2 million women live with fistula, mainly in sub-Saharan Africa and South Asia. VVF is associated with urogenital infections and ammonia dermatitis, and the psychosocial ramifications may be devastating, as women may be socially isolated from their families and community. VVF also remains a challenging condition for the gynecologic surgeon. We present a case of a giant supratrigonal VVF repaired using an abdominal (suprapubic) transperitoneal transvesical approach.
Summary Eighty-two cases of anal fistula have been retrospectively reviewed, and their clinical presentations, pathology, and management\\u000a presented. Most of the fistulas were primary and, except for the four cases due to tuberculosis, there does not seem to have\\u000a been any underlying systemic or gastrointestinal causative factor. A preoperative fistulogram is essential in the management\\u000a of this condition.
This study is to assess the feasibility and outcome of vaginal hysterectomies using bicoagulation forceps. Eighty patients undergoing vaginal hysterectomy for several diagnoses were enrolled. In 40 patients, bicoagulation forceps were used for the entirety of the operation. In 19 patients, only vaginal hysterectomy was performed; in 21 patients, vaginal hysterectomy was part of surgery for pelvic floor repair. Forty
Wolfgang Zubke; Sven Becker; Bernhard Krämer; Diethelm Wallwiener
BACKROUND: Vaginitis is among the most common conditions women are seeking medical care for. Although these infections can easily be treated, the relapse rate is high. This may be due to inadequate use of the diagnostic potential. METHODS: We evaluated the misjudgement rate of the aetiology of vaginal complaints. A total of 220 vaginal samples from women with a vaginal
Andreas Schwiertz; David Taras; Kerstin Rusch; Volker Rusch
Introduction: While the development of fistulae is a well-known complication of radiotherapy, such fistulae can often be challenging to manage. Case Presentation: We describe the case of a 37 year old male who developed in succession a urethrocutaneous fistula to the thigh, a rectourethral fistula and a peritoneo-urethral fistula 35 years after radiotherapy for pediatric pelvic rhabdomyosarcoma. These complications were managed successfully after multiple surgical procedures. Discussion: We subsequently discuss the different approaches currently employed for the management of radiation induced urinary fistulas and describe the rationale behind our approach towards their surgical management.
Sharma, Arindam; Kurtz, Michael P.; Eswara, Jairam R.
In the past ten years four sportsmen with a traumatic perilymphatic fistula were treated. Three of these four patients were surgically treated: two of them underwent a labyrinthectomy and with one of them, the oval window was grafted. After the analysis of these cases, we have made a study of the literature. Careful attention to the patient history and accurate review of the recurrent vestibulocochlear symptomatology isolate a clinical "audiovestibular syndrome of perilymphatic fistule". There is lack of precise preoperatoire diagnostic test. Nevertheless, entire positionnal audiometric test is a reliable and easy to perform test. The medical management is based on bed rest during a reasonable period. Only patients with significant suggestive symptomatology are surgically explored . They sometimes need destruction of vestibular function without preservation of hearing. PMID:9687651
Roguet, E; Poncet, J L; Verdalle, P; Courtois, A; Kossowski, M; Raynal, M
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The present paper describes the newly developed classification of congenital parotid fistulas that distinguishes between 4 forms of these entities depending on the shape and the size of the canal. A total of 61 patients at the age from 7 to 80 years presenting with congenital parotid fistulas were available for the observation during the period from 1985 to 2011. Twenty seven (44.2%) patients underwent surgery for the excision of congenital parotid fistulas under local anesthesia. A 7-year old child and a 17-year old girl were treated by the same method using intravenous calypsol narcosis. The patients having forms 1 and 2 of congenital parotid fistulas did not apply for medical aid. Forms 3 and 4 of this pathology manifest themselves in the early childhood; they are frequently associated with inflammation and recurrence as well as the development of abscesses. It was shown that only the complete removal of congenital parotid fistula prevents its inflammation and suppuration. The hereditary nature of congenital parotid fistula was documented in 23 (37.7%) of the patients included in the present study. PMID:23250530
Anal fissures are linear splits in the anal mucosa. Acute fissures typically resolve within a few weeks; chronic fissures persist longer than 8 to 12 weeks. Most fissures are posterior and midline and are related to constipation or anal trauma. Painful defecation and rectal bleeding are common symptoms. The diagnosis typically is clinical. High-fiber diet, stool softeners, and medicated ointments relieve symptoms and speed healing of acute fissures but offer limited benefit in chronic fissures. Lateral internal sphincterotomy is the surgical management of choice for chronic and refractory acute fissures. Anorectal fistula is an abnormal tract connecting the anorectal mucosa to the exterior skin. Fistulas typically develop after rupture or drainage of a perianal abscess. Fistulas are classified as simple or complex; low or high; and intersphincteric, transsphincteric, suprasphincteric, or extrasphincteric. Inspection of the perianal area identifies the skin opening, and anoscopy visualizes internal openings. The goal of management is to obliterate the tract and openings with negligible sphincter disruption to minimize incontinence. Fistulotomy is effective for simple fistulas; patients with complex fistulas may require fistulectomy. Other procedures that are used include injection of fibrin glue or insertion of a bioprosthetic plug into the fistula opening. PMID:24742084
Effective hemodialysis requires a reliable vascular access. Clinical practice guidelines strongly recommend the fistula as the preferred option followed by arteriovenous (AV) grafts, with central venous catheters being least preferred. Recently, there has been a growing awareness of the limitations of the fistula, its high rate of primary failure and that a fistula may not be appropriate for all patients initiating or on hemodialysis. However, determinates for fistula eligibility have not been clearly defined. The creation and use of a fistula requires the complex integration of patient, biological, and surgical factors, none of which can be easily predicted or planned. There have been several successful initiatives over the last decade addressing patient suitability for AV access, but none have validated defined criteria for fistula eligibility. We discuss these initiatives by addressing: 1) process of care, 2) radiological and nonradiological tests and procedures, and 3) alternative surgical approaches. Careful clinical judgment, appropriate vascular access assessment and placement, and an individualized approach to the risks and benefits will optimize patient health outcomes while minimizing prolonged catheter dependence among hemodialysis patients. PMID:24494627
A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too. PMID:20387731
... cavity) Pulmonary arteriovenous (in a lung, the pulmonary artery and vein are connected, allowing the blood to bypass the oxygenation process in the lung) Umbilical (connection between the navel and gut) Types of ...
30 patients with mycologically confirmed vaginal candidosis on culture were treated with econazole vaginal cream (Gyno-Pevaryl) applied intravaginally once a day for 2 wk. 8 days after the end of treatment, mycological and clinical cures were demonstrated in 26 patients. Symptoms generally subsided rapidly, and the drug was well tolerated. This study confirms the efficacy of econazole in the treatment of vaginal candidosis. PMID:264069
The objective of this study is, within a broadly inclusive selection strategy for benign vaginal hysterectomy, to determine\\u000a whether the most commonly invoked “contraindications” to vaginal hysterectomy—fibroid enlargement >14 weeks, prior cesarean,\\u000a need for oophorectomy—result in increased risk of complications. This study is of retrospective design within a rural community\\u000a hospital. All vaginal hysterectomies performed by a single practitioner over an
The majority of extraoral facial fistulas are of odontogenic origin. Although the differential diagnosis of draining lesions should include various types of skin infection, infected tumour, specific infections, failed wound healing, foreign body, salivary gland fistula, sebaceous cysts and developmental cysts and fistulas. This report documents a group of patients with extraoral draining skin lesions and illustrates that their diagnosis is very important because clinically they can resemble many pathologic entities. One hundred and twenty-eight cases of extraoral fistulas are presented in this paper. This study aims to analyse a number of fistula cases so as to give a clear idea about relative frequency of etiology and to attract to some cases of non odontogenic etiology. PMID:3153689
Antoniadis, K; Triaridis, C; Dimitriou, C; Kommata, A; Karakasis, D
Background Purpose of this study was to identify predictors of vaginal ulcer after CT based three-dimensional image-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancies. Methods Records were reviewed for 44 female (14 with primary disease and 30 with recurrence) with gynecological malignancies treated with HDR-ISBT with or without external beam radiation therapy. The HDR-ISBT applicator insertion was performed with image guidance by trans-rectal ultrasound and CT. Results The median clinical target volume was 35.5 ml (2.4-142.1 ml) and the median delivered dose in equivalent dose in 2 Gy fractions (EQD2) for target volume D90 was 67.7 Gy (48.8-94.2 Gy, doses of external-beam radiation therapy and brachytherapy were combined). For re-irradiation patients, median EQD2 of D2cc for rectum and bladder, D0.5cc, D1cc, D2cc, D4cc, D6cc and D8cc for vaginal wall was 91.1 Gy, 100.9 Gy, 260.3 Gy, 212.3 Gy, 170.1 Gy, 117.1 Gy, 105.2 Gy, and 94.7 Gy, respectively. For those without prior radiation therapy, median EQD2 of D2cc for rectum and bladder, D0.5cc, D1cc, D2cc, D4cc, D6cc and D8cc for vaginal wall was 56.3 Gy, 54.3 Gy, 147.4 Gy, 126.2 Gy, 108.0 Gy, 103.5 Gy, 94.7 Gy, and 80.7 Gy, respectively. Among five patients with vaginal ulcer, three had prior pelvic radiation therapy in their initial treatment and three consequently suffered from fistula formation. On univariate analysis, re-irradiation and vaginal wall D2cc in EQD2 was the clinical predictors of vaginal ulcer (p?=?0.035 and p?=?0.025, respectively). The ROC analysis revealed that vaginal wall D2cc is the best predictor of vaginal ulcer. The 2-year incidence rates of vaginal ulcer in the patients with vaginal wall D2cc in EQD2 equal to or less than 145 Gy and over 145 Gy were 3.7% and 23.5%, respectively, with a statistically significant difference (p?=?0.026). Conclusions Re-irradiation and vaginal D2cc is a significant predictor of vaginal ulcer after HDR-ISBT for gynecologic malignancies. Three-dimensional image-guided treatment planning should be performed to ensure adequate target coverage while minimizing vaginal D2cc in order to avoid vagina ulcer.
A modified apical dissection of the prostate to improve the efficiency of vesico-urethral anastomosis (VUA) in laparoscopic radical prostatectomy (LRP) was reported. A total of 42 patients were randomly selected and enrolled in this study. A standard LRP was performed in 21 patients (group 1), whereas a novel, modified apical dissection of the prostate in LRP was performed in another 21 patients (group 2). Surgical data, total operative time, VUA time, extravasation rate, catheterisation time, occurrence of anastomotic strictures, and the early and late continence rates were analysed statistically. No differences in clinical or pathological characteristics were determined between the two groups. The total operative time, VUA time, blood loss and catheterisation time were lower in group 2, which received the novel, modified technique compared with group 1, which received the standard technique to dissect the apex of the prostate (P<0.01 for each variable). Regarding the extravasation rate and the occurrence of anastomotic strictures, no significant differences were found between the two groups (P>0.05 for each). After catheter removal, a statistically significant difference in the continence rates was present at 3 and 30 days post operation in the two groups (P<0.01, respectively). At 90 days post operation, the difference, although still present, was no longer statistically significant (P>0.05). The novel, modified apical dissection of the prostate facilitates the VUA and significantly improves the efficacy of the procedure and early restoration of continence.
Tentorial dural arteriovenous fistulae are rare intracranial fistulae, in which the fistula pocket is present within the leaves of tentorium cerebelli. These tentorial fistulae can be rarely present near the galenic complex, where they can engorge the deep venous system and cause symptoms of venous hypertension. We present an interesting case of endovascular treatment of a galenic tentorial dural arteriovenous fistula in a patient with headaches and imbalance. The fistula was accessed through the artery of Davidoff and Schecter from the posterior cerebral artery supplying the fistula. The fistula was completely embolized using Onyx and with preservation of vein of Galen. The video can be found here: http://youtu.be/igX2X5tfvrg . PMID:24983732
... OMIM Genetic disorder catalog Conditions > Esophageal atresia/tracheoesophageal fistula (often shortened to EA/TEF ) On this page: ... 2012 What is EA/TEF? Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal ...
A specialized Vulva Clinic with dedicated gynecologists and dermatologists was established in Oslo, Norway, in 2003. Fifty-eight women referred to the clinic in 2003-2009 were diagnosed with genital erosive lichen planus. All patients filled out a questionnaire. Gynecological examination, including vaginal inspection, was performed, if necessary in general anesthesia. Median age at symptom start was 51 years (range 17-78 years) with 15 women (26%) being younger than 40 years old. Sexual abstinence was reported by 36 women and dyspareunia by another 10. On examination, vaginal involvement was seen in 49 women, including vaginal synechiae in 29 and total obliteration of the vagina in 9. Of 56 women treated with topical corticosteroids for at least three months, two had complete response and 36 partial responses. Similarly, of 22 women treated with tacrolimus, three had complete and six partial response. We conclude that vaginal involvement is more common in genital erosive lichen planus than previously reported. PMID:20583940
Helgesen, Anne Lise Ording; Gjersvik, Petter; Jebsen, Peter; Kirschner, Rolf; Tanbo, Tom
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Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study.
... vaginal tape is surgery to help control stress urinary incontinence . This is urine leakage that happens when you ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...
Several models of arteriovenous fistula (AVF) have excellent patency and help in understanding the mechanisms of venous adaptation to the arterial environment. However, these models fail to exhibit either maturation failure or fail to develop stenoses, both of which are critical modes of AVF failure in human patients. We used high-resolution Doppler ultrasound to serially follow mice with AVFs created by direct 25-gauge needle puncture. By day 21, 75% of AVFs dilate, thicken, and increase flow, i.e., mature, and 25% fail due to immediate thrombosis or maturation failure. Mature AVF thicken due to increased amounts of smooth muscle cells. By day 42, 67% of mature AVFs remain patent, but 33% of AVFs fail due to perianastomotic thickening. These results show that the mouse aortocaval model has an easily detectable maturation phase in the first 21 days followed by a potential failure phase in the subsequent 21 days. This model is the first animal model of AVF to show a course that recapitulates aspects of human AVF maturation. PMID:24097429
Yamamoto, Kota; Protack, Clinton D; Tsuneki, Masayuki; Hall, Michael R; Wong, Daniel J; Lu, Daniel Y; Assi, Roland; Williams, Willis T; Sadaghianloo, Nirvana; Bai, Hualong; Miyata, Tetsuro; Madri, Joseph A; Dardik, Alan
We report a case of Mirizzi syndrome type II associated with biliary enteric fistula. It is important to identify this combination early, as it is associated with high morbidity. In our case, intraoperative findings were cholecystoduodenal fistula and communication of Hartmann’s pouch with common bile duct (CBD). A subtotal cholecystectomy with excision of cholecystoduodenal fistula was performed. A minimal surgical maneuver of Calot’s Triangle with repair of cholecystoduodenal fistula is required during the intraoperative period.
Design and development of a portable and self-contained vaginal probe, consisting of an acetone-filled silver cylinder attached to a pressure gauge, is described. Qualitative changes in vaginal thermal conductance were inferred from rates of thermal expansion of precooled acetone measured as a pressure rise. Administration of 10 mg estradiol-17 beta i.v. to ovariectomized heifers resulted in significant increases in rate of thermal expansion. PMID:1176036
Abrams, R M; Thatcher, W W; Gwazdauskas, F C; Sharp, D C; Bazer, F W; Wilcox, C J; Stolwijk, J A
This study investigated the relation between self-reported vaginal bleeding during pregnancy and preterm birth in a prospective cohort of 2,829 pregnant women enrolled from prenatal clinics between 1995 and 2000 in central North Carolina. The overall association between vaginal bleeding and preterm birth was modest (risk ratio (RR) = 1.3, 95% confidence interval (CI): 1.1, 1.6). Bleeding in the first
Juan Yang; Katherine E. Hartmann; David A. Savitz; Amy H. Herring; Nancy Dole; Andrew F. Olshan; John M. Thorp
It was the purpose of this study to design and evaluate a chitosan derivative as mucoadhesive excipient for vaginal drug delivery systems. The chemical modification of chitosan was achieved by conjugation of thioglycolic acid (TGA) resulting in 1594 ?mol thiol groups per gram of polymer followed by the linkage of mercaptonicotinic acid (MNA) to the immobilized thiol groups via disulfide bonding leading to 702 ?mol ligand per gram of preactivated polymer. The mucoadhesive properties of these polymers within newly designed vaginal formulations (Chitosan-TGA and Chitosan-TGA-MNA) and commercially available vaginal formulations (Candibene®, Daktarin®, Dalacin®, GynoPevaryl®) were tested over a time period of 24 h via a mucoadhesion test system simulating vaginal conditions, tensile studies and mucus polymer interaction studies via viscosity measurements. Within the vaginal test system simulating vaginal in situ conditions, a 1.5-fold increase in mucoadhesion could be observed for preactivated thiomer formulations after 24 h in comparison to commercially available formulations. Similar results were achieved for tensile studies, as the chitosan-TGA-MNA containing formulation resulted in a 4.9-fold increase in total work of adhesion (TWA) in comparison to Candibene which showed the highest TWA value of all tested commercial formulations. Also in terms of rheology investigations of mucus/formulation mixtures, a 5.8-fold increase in dynamic viscosity for chitosan-TGA-MNA containing mixtures could be observed in comparison to the mucus-free control. In contrast, commercially available formulations achieved a maximum enhancement of 1.9-fold. These outcomes confirm that the newly developed polymer is a promising tool for vaginal drug delivery likely providing a prolonged vaginal residence time due to its comparatively high mucoadhesive properties. PMID:23886732
Friedl, Heike E; Dünnhaupt, Sarah; Waldner, Claudia; Bernkop-Schnürch, Andreas
Chylous fistulas in cases treated surgically for breast cancer only, are rare. We encountered four chylous fistula cases after breast cancer operations out of a total of 851 cases, all of which involved the left breast. Chylous fistulas were confirmed by axillary white fluid and were unrelated to obesity, surgical method or the area of axillary lymph node dissection. All
A case of 18 years old male with tracheoesophageal fistula as a result of esophageal foreign body (chestnut) is described. Foreign body was removed using esophagoscopy. Bronchofiberoscopy performed because of difficulties with swallowing and frequent airway infections revealed tracheoesophageal fistula. Fistula was closed from intratracheal access. Symptoms of dysfagia disappeared after surgery. PMID:10689920
Stent-graft exclusion of an ischemic, hilar portobiliary fistula after liver transplantation has not been reported. Isolated reports have described peripheral or nonischemic fistulas, and alternative treatment options have ranged from balloon tamponade to surgical repair. We present a unique case of a hilar portobiliary fistula successfully treated to resolution by unilateral placement of a stent-graft.
Lorenz, Jonathan M.; Zangan, Steven M., E-mail: [email protected]; Leef, Jeffrey A.; Ha, Thuong G. Van [University of Chicago Medical Center, Department of Radiology (United States)
PURPOSE: The surgical management of complex perineal fistulas, such as high transsphincteric and suprasphincteric fistulas, or those associated with Crohn’s disease, radiotherapy, surgical trauma, or cavity or a secondary tract, is associated with the risk of sphincter injury and significant discomfort. Fibrin glue may close fistula tracts without muscle division. Therefore, the aim of this study was to evaluate the
Oded Zmora; Nelly Mizrahi; Nicolas Rotholtz; Alon J. Pikarsky; Eric G. Weiss; Juan J. Nogueras; Steven D. Wexner
Background. Ureteroarterial fistulae (UAFs) are a rare entity, often difficult to identify, and associated with a high mortality rate. This fact has been attributed to a delay in diagnosis and treatment. Five conditions that can predispose to the development of this uncommon entity have been described: prior pelvic surgery, prolonged ureteral stenting, radiation therapy, previous vascular surgery and vascular pathology. Methods. We present 4 patients with UAFs and at least three of the above-mentioned conditions. Ureteral ischemia and subsequent necrosis promote the formation of these fistulae. The constant pulsation of the iliac artery is transmitted to an already compromised ureter containing a stiff intraluminal foreign body, resulting in pressure necrosis, most likely where the ureter crosses the iliac artery. Results and Conclusion. Cases were managed percutaneously with a combination of the deployment of a covered prosthesis and, when needed, with mechanical occlusion of the ureter. Hematuria stopped in all the patients with no evidence of immediate rebleeding. One patient presented a new episode of vaginal bleeding 13 months after endograft placement and ureteral embolization. Arteriography showed the presence of a hypogastric artery pseudoaneurysm that was occluded using coils. No new bleeding has occurred in this patient 12 months after the second embolization. At present all 4 patients are alive with follow-up periods of 5, 9, 11 and 25 months since the first procedure.
Bilbao, Jose I., E-mail: [email protected]; Cosin, Octavio; Bastarrika, Gorka [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain); Rosell, David; Zudaire, Javier [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Urology (Spain); Martinez-Cuesta, Antonio [Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain)
Vesicouterine fistulas (VUF) are a pathological and uncommon connection between the uterus and the bladder. Although rare, they are usually related to cesarean section. Nowadays, their incidence increases because of the increase in Cesarean sections. Patients with VUF may have various clinical presentations. The main symptoms are urinary incontinence, which may be associated with hematuria. Vesicouterine fistulas are usually associated with psychological distress and have a negative effect on quality of life. The accurate and early diagnosis of VUF can be difficult. There are multiple ways to investigate VUF and several examinations may be required to confirm the diagnosis; these examinations may include a cystoscopy, a retrograde cystography, methylene blue test and a computed tomography scan. We present 3 cases of vesicouterine fistula with successful surgical repair in which 2 patients had an early repair. One patient had an early surgical repair because of intractable pain and the other patient because of the large size of the fistula. The fistula repair surgeries were uneventful and the patients had an unremarkable recovery. We report that early surgical management is technically feasible without significantly increasing the difficulty of the surgery, with an excellent outcome in selected patients.
Bettez, Mathieu; Breault, Guy; Carr, Lesley; Tu, Le Mai
Vesicouterine fistulas (VUF) are a pathological and uncommon connection between the uterus and the bladder. Although rare, they are usually related to cesarean section. Nowadays, their incidence increases because of the increase in Cesarean sections. Patients with VUF may have various clinical presentations. The main symptoms are urinary incontinence, which may be associated with hematuria. Vesicouterine fistulas are usually associated with psychological distress and have a negative effect on quality of life. The accurate and early diagnosis of VUF can be difficult. There are multiple ways to investigate VUF and several examinations may be required to confirm the diagnosis; these examinations may include a cystoscopy, a retrograde cystography, methylene blue test and a computed tomography scan. We present 3 cases of vesicouterine fistula with successful surgical repair in which 2 patients had an early repair. One patient had an early surgical repair because of intractable pain and the other patient because of the large size of the fistula. The fistula repair surgeries were uneventful and the patients had an unremarkable recovery. We report that early surgical management is technically feasible without significantly increasing the difficulty of the surgery, with an excellent outcome in selected patients. PMID:21806894
Bettez, Mathieu; Breault, Guy; Carr, Lesley; Tu, Le Mai
Perilymph fistula is defined as a leak of perilymph at the oval or round window. It excludes other conditions with "fistula" tests due to a dehiscent semicircular canal from cholesteotoma and the superior canal dehiscence syndrome. First recognized as a complication of stapedectomy, it then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause. Descriptions of "spontanenous" perilymph fistulas with no trauma history followed. It is likely that most perilymph fistula patients have a congential potential weakness of the otic capsule at the round or oval window. The vestibular symptoms have been assumed to be due to endolymphatic hydrops, but there is poor evidence. Their unilateral disequilibrium, nausea, and subtle cognitive problems suggest they are due to otolith disfunction and that these patients have a specific balance abnormality, unlike subjects with unilateral vestibular hypofuction. In this series of twenty patients with a confirmed fistula a logical simplification of Singleton's "eyes-closed turning" test predicted a PLF in twelve with a trauma history. In four no cause was found. In three a prior traumatic event was later recalled, but one patient had concealed it. PMID:23028388
Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closure and esophageal exclusion with a Jpeg tube. The patient was eventually successfully treated with a three-stage procedure consisting of firstly a posterior approach to reinforce the posterior stabilization of the cervical spine that was felt to be inadequate, secondly an anterior approach with removal of all the anterior instrumentation followed by iliac crest bone graft and thirdly a superior based sternocleidomastoid flap that was interposed between the esophagus and the anterior cervical spine. The patient's fistula healed successfully. However, yet asymptomatic, the anterior iliac crest bone graft resorbed almost completely at 16 months follow up. In light of this complication, we discuss the surgical options for the treatment of pharyngocutaneous fistulae and the closure of this fistula using a superiorly based sternocleidomastoid muscle flap.
Perilymph fistula is defined as a leak of perilymph at the oval or round window. It excludes other conditions with “fistula” tests due to a dehiscent semicircular canal from cholesteotoma and the superior canal dehiscence syndrome. First recognized as a complication of stapedectomy, it then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause. Descriptions of “spontanenous” perilymph fistulas with no trauma history followed. It is likely that most perilymph fistula patients have a congential potential weakness of the otic capsule at the round or oval window. The vestibular symptoms have been assumed to be due to endolymphatic hydrops, but there is poor evidence. Their unilateral disequilibrium, nausea, and subtle cognitive problems suggest they are due to otolith disfunction and that these patients have a specific balance abnormality, unlike subjects with unilateral vestibular hypofuction. In this series of twenty patients with a confirmed fistula a logical simplification of Singleton's “eyes-closed turning” test predicted a PLF in twelve with a trauma history. In four no cause was found. In three a prior traumatic event was later recalled, but one patient had concealed it.
Pulmonary thromboembolism is the leading direct cause of maternal deaths in the UK. The majority of deaths occur in the puerperium. Caesarean section has been recognised as a risk factor but there is concern that more attention to thromboprophylaxis after vaginal births is needed. The hospital maternity unit in Dumfries has written guidelines on thromboprophylaxis after vaginal births. This audit assessed the compliance with these guidelines within this maternity unit. The case notes relating to spontaneous vaginal births over a 2-month period (n=148) and instrumental vaginal births over a 7-month period (n=29) were reviewed. Information concerning venous thromboembolism risk and any thromboprophylaxis given was extracted. The audit showed that 9% of spontaneous vaginal births and 62% of instrumental vaginal births required specific thromboprophylaxis. However, only 31% of the spontaneous vaginal births and 22% of the instrumental vaginal births in which thromboprophylaxis was indicated did indeed receive the required treatment. Failure to respond to venous thromboembolism risk factors was common. Measures to increase the awareness of maternity staff to these factors are suggested. PMID:16390705
Objectives: We determined the efficacy of the use of a tension free prolene mesh to correct a grade III anterior vaginal wall prolapse recurrence.Methods: Twelve women (mean age 65.6 years) with stress urinary incontinence (SUI) (4 type II and 1 type III) and bladder prolapse entered the study. After vaginal incision a pretailored polypropylene mesh was fixed to its four
Roberto Migliari; Michele De Angelis; Giuliana Madeddu; Tiziano Verdacchi
Vaginal atrophy is common in postmenopausal women. This clinical guide provides the evidence for the clinical use of vaginal estrogens for this condition focussing on publications since the 2006 Cochrane systematic review. Use after breast cancer, before assessment of cervical cytology and prolapse surgery is also discussed. PMID:22818886
Leiomyomas of the vagina are very rare tumors of the female genital tract with only 300 cases reported so far. A case of removal of the vaginal leiomyoma presenting as tumor previa in advanced pregnancy is described. Removal of the tumor allowed vaginal birth three weeks after surgery. PMID:22873113
Boskovic, V; Vrzic-Petronijevic, S; Petronijevic, M; Atanackovic, J; Bratic, D
Preauricular sinus and fistulas are minor developmental anomalies. They are bilateral in 35% to 50% of cases. We describe the application of a combined technique in a rare case of bilateral congenital preauricular fistulas. Initial fistula probing serves as a surgical guide, and further methylene blue infection helps to avoid leaving viable squamous epithelial remnants. PMID:12361081
Martín-Granizo, R; Pérez-Herrero, M C; Sánchez-Cuéllar, A
This retrospective study describes a series of 191 children treated for congenital cysts and fistulas of the neck between 1984 and 1999 in the pediatric ORL Department of La Timone Children's Hospital. Preauricular fistulas and cystic hygromas were not included. The anomalies in this series were classified as either malformations of the midline or malformations of laterocervical region. Malformations of the midline included the thyroglossal duct cysts (n=102) and dermoid cysts (n=21). The most common malformations of the laterocervical region were cysts and fistulas of the second cleft (n=37) followed by those of the first cleft (n=20),those of the fourth pouch (n=7), and thymic cysts (n=4). Diagnosis of malformations of the midline is usually straightforward. However, diagnosis of malformation of the laterocervical region can be problematic. Misdiagnosis often leads to inadequate treatment with recurrence and functional as well as cosmetic sequelae. PMID:11006451
Introduction Colouterine fistula is a very rare condition; most cases described in the literature are secondary to complications of diverticulitis in elderly patients. Case presentation We report the case of a 34-year-old African woman who presented with a colouterine fistula secondary to polymyomectomy, which was diagnosed in the setting of severe endometritis. She had a Hartmann procedure and abundant irrigation of her abdominal and uterine cavities followed by placement of a double drainage in order to preserve fertility. This is the first case of a conservative management of the uterus in such conditions. Conclusion Conservative surgery in colouterine fistula should be discussed as an alternative to hysterectomy in young infertile women.
Coronary-cameral fistulas are usually congenital, rarely acquired; the complication of this anomaly with ventricular pseudoaneurysm is exceptional. We report a new case of acquired coronary-cameral fistula, occurred in a patient who had received a bypass graft and who had suffered from angina 1 year after the surgery. On computed tomography coronary angiography, the fistula seems to communicate the first diagonal to a left ventricle pseudoaneurysm. Embolization of the fistula and filling of the pseudoaneurysm by neurocoil were successfully performed. The clinical and angiographic control after 3 months showed symptoms improvement and absence of recanalization of the fistula. PMID:24119773
Hammami, R; Bosmans, J; Voormolen, M; Vermeulen, T; Salgado, R; Vrints, C
The aim of this work is to describe a relatively new technique for closure of large oroantral fistulas. Fistulas were treated surgically using autograft septal cartilage and a buccal pyramidal flap. There were 11 patients, 8 of whom had chronic oroantral fistulas. Four cases had extensive sinusitis and were managed by endoscopic sinus surgery. Complete closure of the fistula was obtained in 10 cases (90.9%), whereas 1 case (9.1%) failed. No other complications occurred. The septal cartilage and pyramidal buccal flap technique is a viable alternative for the closure of large oroantral fistulas. PMID:23520068
Congenital lacrimal fistulae are rare in Down syndrome and bilateral presentation is very unusual. It can be associated with nasolacrimal duct obstruction. We report a 3-year-old female with Down syndrome who presented with watering and discharge from both eyes and bilateral fistulous openings present inferonasal to the medial canthus. Upon examination, the lacrimal sac regurgitation test was positive on both sides. Our case report documents a distinctive case of bilateral congenital lacrimal fistulae in association with Down syndrome. It was managed successfully by primary fistulectomy and nasolacrimal duct probing.
Perianal fistulization is the result of a chronic inflammation of the perianal tissues. A wide spectrum of clinical manifestations, ranging from simple to complex fistulas, can be seen, the latter especially in patients with Crohn disease. Failure to detect secondary tracks and hidden abscesses may lead to therapeutic failure, such as insufficient response to medical treatment and relapse after surgery. Currently, magnetic resonance (MR) imaging is the preferred technique for evaluating perianal fistulas and associated complications. Initially used most often in the preoperative setting, MR imaging now also plays an important role in evaluating the response to medical therapy. PMID:24238135
Vanbeckevoort, Dirk; Bielen, Didier; Vanslembrouck, Ragna; Van Assche, Gert
A neovesicocutaneous fistula is a rare complication after orthotopic bladder reconstruction, particularly in the late postoperative period. We report the case of a 59-year-old man who had undergone ileal neobladder construction 17 months previously. He presented with urinary retention concomitant with urinary tract infection due to a neovesicourethral anastomotic stricture. After a combination of transurethral catheter drainage and broad-spectrum antibiotic therapy for 3 weeks, the fistulous tract completely closed. Therefore, conservative treatment may be regarded as a valid option for a delayed neovesicocutaneous fistula.
Dural arteriovenous fistulas (DAVF) involving the craniocervical junction are uncommon lesions that may result in neurological deficits referable to posterior fossa structures and/or the spinal cord. We report on two patients with craniocervical junction DAVF whose venous drainage involved the cervical spinal cord. Both cases presented with progressive quadriparesis and parenchymal magnetic resonance signal abnormality of the cervical spinal cord. Both patients improved following embolization of the fistulas. AVF of the craniocervical junction are an uncommon, but important cause of treatable neurological deficits referable to this region of the nervous system. ImagesFigure 1Figure 2p4-bFigure 3
Hurst, Robert W.; Bagley, Linda J.; Scanlon, Mary; Flamm, Eugene S.
Aortopulmonary fistula has been documented in adult patients with acute aortic dissection, atherosclerotic disease, and other comorbidities. However, until now we believe this was not previously reported as a complication after the arterial switch operation in a patient with transposition of the great arteries. We report the case of a 3-month-old boy who underwent an arterial switch operation as a neonate. After balloon dilation to relieve a postoperative supravalvular pulmonary stenosis, he presented with severe congestive heart failure due to an undiagnosed but previously present fistula between the ascending aorta and the main pulmonary artery. He underwent successful surgical repair and recovered uneventfully. PMID:20103260
Congenital urethrocutaneous fistula is a very rare anomaly with about 40 odd cases reported in literature till 2008 .We present here 9 such cases all of whom were uncircumcised at presentation.7 out of 9 cases had a fistula in the distal shaft and the rest 2 cases had a fistula in the mid-shaft of the penis with an associated chordee.Associated congenital anomaly was present in only one case which had an associated imperforate anus . When the fistula was present distally , we did a primary repair of the fistula which was reinforced by a Bayer's Flap. When the fistula was present in the mid shaft we did a Primary repair of the fistula & reinforced it by a Tunica Vaginalis Flap. PMID:24891786
Transverse vaginal septum is a defect of vertical fusion during embryogenesis of the vagina. The estimated incidence is 1 per 30,000 to 84,000 women. It is infrequently associated with genitourinary tract, gastrointestinal tract, musculoskeletal, and cardiac malformations. Previous reports of transverse vaginal septum have included unilateral absence of the fallopian tube and ovary and absence of the proximal portion of the fallopian tube. This report describes bilateral tubal atresia associated with a transverse vaginal septum. A 17-year-old nulligravida sought medical assessment because of primary amenorrhea and cyclic pelvic pain. Physical examination revealed a blind vaginal pouch and a tender pelvic mass. Radiologic studies showed a transverse vaginal septum 1.5 cm distal to the cervix. The septum was resected with laparoscopic guidance, and bilateral fallopian tubal atresia was noted. The pelvis was otherwise normal. Patients commonly have a pelvic or abdominal mass, pain, and amenorrhea at time of expected menarche. Surgical resection is the treatment of choice. Postoperative dilation may be necessary to prevent restenosis. Outlook for pregnancy is encouraging despite a higher than normal incidence of spontaneous abortion and endometriosis in such patients. PMID:7564549
Three percent to 4% of term fetuses will be breech at delivery. Evidence from randomized controlled trials has found a policy of planned cesarean section to be significantly better for the singleton fetus in breech presentation at term compared to a policy of planned vaginal birth. However, some women may wish to avoid cesarean section and for others, cesarean section may not be possible. We undertook this review to identify factors associated with higher and lower risk of adverse fetal or neonatal outcome at term during vaginal breech delivery. We searched MEDLINE from 1966 to 2002 using the search terms vaginal breech delivery and breech presentation and retrieved all relevant articles. We also reviewed personal references and reference lists of articles retrieved. Women who are older or who have a fetus that is either in footling presentation, has a hyperextended head or is estimated to weigh <2500 g or >4000 g may be at higher risk of adverse fetal outcome. Prolonged labor or not having an experienced clinician at vaginal breech birth may also increase the risk. Women with a fetus in breech presentation at term should be offered the option of delivery by planned cesarean section and should be informed that this will reduce their risk of adverse fetal or neonatal outcome. Practitioners should develop and maintain skills at vaginal breech delivery for those women not wishing or not able to be delivered by cesarean section. PMID:12641301
In order to evaluate an effective administration method of essential oils for vaginal candidiasis, efficacy of vaginal application of essential oils against murine experimental candidiasis was investigated. The effect on vaginal inflammation and Candida growth form was also studied. Vaginal candidiasis was established by intravaginal infection of C. albicans to estradiol-treated mice. These mice intravaginally received essential oils such as geranium and tea tree singly or in combination with vaginal washing. Vaginal administration of clotrimazole significantly decreased the number of viable C. albicans cells in the vaginal cavity by itself. In contrast, these essential oils did not lower the cell number. When application of geranium oil or geraniol was combined with vaginal washing, the cell number was decreased significantly. The myeloperoxidase activity assay exhibited the possibility that essential oils worked not only to reduce the viable cell number of C. albicans, but also to improve vaginal inflammation. The smear of vaginal washing suspension suggested that more yeast-form cells appeared in vaginal smears of these oil-treated mice than in control mice. In vitro study showed that a very low concentration (25 microg/ml) of geranium oil and geraniol inhibited mycelial growth, but not yeast growth. Based on these findings, it is estimated that vaginal application of geranium oil or its main component, geraniol, suppressed Candida cell growth in the vagina and its local inflammation when combined with vaginal washing. PMID:18670079
Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1?cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.
Introduction and hypothesis To estimate the risk of repeat surgery for recurrent prolapse or mesh removal after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. Methods We utilized longitudinal, adjudicated, healthcare claims from 2005 to 2010 to identify women ?18 years who underwent an anterior colporrhaphy (CPT 57420) with or without concurrent vaginal mesh (CPT 57267). The primary outcome was repeat surgery for anterior or apical prolapse or for mesh removal/revision; these outcomes were also analyzed separately. We utilized Kaplan–Meier curves to estimate the cumulative risk of each outcome after vaginal mesh versus native tissue repair. Cox proportional hazards models were used to estimate the hazard ratio (HR) for vaginal mesh versus native tissue repair, adjusted for age, concurrent hysterectomy, and concurrent or recent sling. Results We identified 27,809 anterior prolapse surgeries with 49,658 person-years of follow-up. Of those, 6,871 (24.7%) included vaginal mesh. The 5-year cumulative risk of any repeat surgery was significantly higher for vaginal mesh versus native tissue (15.2 % vs 9.8 %, p<0.0001) with a 5-year risk of mesh revision/removal of 5.9%. The 5-year risk of surgery for recurrent prolapse was similar between vaginal mesh and native tissue groups (10.4 % vs 9.3 %, p=0.70. The results of the adjusted Cox model were similar (HR 0.93, 95%CI: 0.83, 1.05). Conclusions The use of mesh for anterior prolapse was associated with an increased risk of any repeat surgery, which was driven by surgery for mesh removal. Native tissue and vaginal mesh surgery had similar 5-year risks for surgery for recurrent prolapse.
Funk, Michele Jonsson; Visco, Anthony G.; Weidner, Alison C.; Pate, Virginia
Women with recurrent vaginal candidosis were treated until the infection cleared and were then given one clotrimazole 500 mg vaginal tablet a month or an identical placebo as prophylaxis. Of 21 women who received placebo, 16 developed symptoms or signs within three months, compared with nine of 17 women given active treatment. Women who relapsed were treated and then given active prophylaxis once a month. Of 30 women given such treatment, 13 relapsed within three months. Women who relapsed were treated and then given two clotrimazole 500 mg vaginal tablets a month. Of 17 women given prophylaxis twice a month, four developed symptoms or signs within three months, but 10 remained clear for 12 months. No appreciable difference was seen in the incidence of mycological recurrence between the different regimens; within three months over half the women in all treatment groups had become recolonised.
Bushell, T E; Evans, E G; Meaden, J D; Milne, J D; Warnock, D W
A vaginal leiomyoma with heterologous paragangliomatous elements is reported. The patient was a 62-year-old woman who presented with uterovaginal prolapse and an asymptomatic vaginal mass that had been present for many years. Histology of the excised mass showed a leiomyoma in a submucosal location, with irregularly shaped islands of chief cells scattered throughout the lesion. These cells were arranged in nests and were surrounded by S100 protein-positive sustentacular cells. The chief cells showed immunoreactivity with chromogranin, synaptophysin, and neuron-specific enolase. Although various heterologous elements are commonly encountered within uterine leiomyomata, such elements have not been described within vaginal leiomyomata. Furthermore, the occurrence of paragangliomatous tissue within leiomyomata has not been reported to date. Int J Surg Pathol 8(4):359-365, 2000 PMID:11494018
A 13 yr old female spayed Labrador retriever presented for vulvar bleeding. Abdominal radiographs revealed a soft tissue mass in the ventral pelvic canal. A computed tomography (CT) exam and a CT vaginourethrogram localized the mass to the vagina, helped further characterize the mass, and aided in surgical planning. A total vaginectomy was performed and the histologic diagnosis was leiomyoma. Vaginal tumors make up 1.9-3% of all tumors. Seventy-three percent of vaginal tumors are benign, and 83% of those are leiomyomas. Leiomyomas often have a good long-term prognosis with surgical resection. The diagnostic investigation of this case report utilized a multimodal imaging approach to determine the extent and respectability of the vaginal mass. To the best of the authors' knowledge, this is the first report describing a CT vaginourethrogram. PMID:24051257
A skin and fascia flap from the medial thigh is proposed for vaginal and perineal reconstruction. Dissection, vascular injection, and radiographs of 20 fresh cadaver limbs uniformly demonstrated the presence of a communicating suprafascial vascular plexus in the medial thigh. Three to four nonaxial vessels were consistently found to enter the proximal plexus from within 5 cm of the perineum. Preservation of these vessels permitted reliable elevation of a 9 X 20 cm fasciocutaneous flap without using the gracilis muscle as a vascular carrier. Fifteen flaps in 13 patients were used for vaginal replacement and coverage of vulvectomy, groin, and ischial defects. Depending on the magnitude of the defect, simultaneous and independent elevation of the gracilis muscle provided additional vascularized coverage as needed. Our experience indicates that the medial thigh fasciocutaneous flap is a durable, less bulky, and potentially sensate alternative to the gracilis musculocutaneous flap for vaginal and perineal reconstruction.
Intracranial dural arteriovenous fistula (DAVF) is an uncommon neurosurgical condition; in particular, it has been infrequently reported in Korea. To understand the general clinical characteristics of DAVFs, the authors reviewed 53 cases and analyzed factors affecting DAVF hemorrhage of and treatment outcome. Since 1980 we have encountered 480 pial and 53 DAVFs, a ratio of 9.1 to 1. The age
Myoung Soo Kim; Dae Hee Han; O-Ki Kwon; Chang-Wan Oh; Moon Hee Han
Summary A rare case of dural sinus malformation with dural arteriovenous fistula in an infant is presented. Presenting symptom was progressive macrocrania without hydrocephalus. A high flow arteriovenous of the sigmoid sinus associated with jugular bulb diaphragm was demonstrated. Reflux in the intracranial sinus was present. The shunt was successfully occluded by transarterial embolization. The natural history and treatment strategy are discussed.
Summary A rare case of dural sinus malformation with dural arteriovenous fistula in an infant is presented. Presenting symptom was progressive macrocrania without hydrocephalus. A high flow AVS of the sigmoid sinus associated with jugular bulb diaphragm was demonstrated. Reflux in the intracranial sinus was present. The shunt was successfully occluded by transarterial embolization. The natural history and treatment strategy are discussed.
Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity, leading to unilateral nasal obstruction, fetid rhinorrhea, epistaxis, and it may cause complications. The authors present a case of rhinolithiasis with oronasal fistula and literature review. PMID:16446901
Dib, Gabriel Cesar; Tangerina, Rodrigo P; Abreu, Carlos E C; Santos, Rodrigo de Paula; Gregório, Luiz Carlos
Objective To assess the vaginal microbiome throughout full-term uncomplicated pregnancy. Methods Vaginal swabs were obtained from twelve pregnant women at 8-week intervals throughout their uncomplicated pregnancies. Patients with symptoms of vaginal infection or with recent antibiotic use were excluded. Swabs were obtained from the posterior fornix and cervix at 8–12, 17–21, 27–31, and 36–38 weeks of gestation. The microbial community was profiled using hypervariable tag sequencing of the V3–V5 region of the 16S rRNA gene, producing approximately 8 million reads on the Illumina MiSeq. Results Samples were dominated by a single genus, Lactobacillus, and exhibited low species diversity. For a majority of the patients (n?=?8), the vaginal microbiome was dominated by Lactobacillus crispatus throughout pregnancy. Two patients showed Lactobacillus iners dominance during the course of pregnancy, and two showed a shift between the first and second trimester from L. crispatus to L. iners dominance. In all of the samples only these two species were identified, and were found at an abundance of higher than 1% in this study. Comparative analyses also showed that the vaginal microbiome during pregnancy is characterized by a marked dominance of Lactobacillus species in both Caucasian and African-American subjects. In addition, our Caucasian subject population clustered by trimester and progressed towards a common attractor while African-American women clustered by subject instead and did not progress towards a common attractor. Conclusion Our analyses indicate normal pregnancy is characterized by a microbiome that has low diversity and high stability. While Lactobacillus species strongly dominate the vaginal environment during pregnancy across the two studied ethnicities, observed differences between the longitudinal dynamics of the analyzed populations may contribute to divergent risk for pregnancy complications. This helps establish a baseline for investigating the role of the microbiome in complications of pregnancy such as preterm labor and preterm delivery.
Walther-Antonio, Marina R. S.; Jeraldo, Patricio; Berg Miller, Margret E.; Yeoman, Carl J.; Nelson, Karen E.; Wilson, Brenda A.; White, Bryan A.; Chia, Nicholas; Creedon, Douglas J.
Vaginal sensitivity was investigated in a group of 60 volunteers by means of an electric stimulus and under nonerotic conditions. In comparison to the dorsum of the hand, the genital area has a low sensitivity for electric stimuli (p 0.001). Of the genital area, the vaginal wall measured 2 to 4 cm from the vaginal introitus was found to be
W. C. M. Weijmar Schultz; J. A. Klatter; B. E. Sturm; J. Nauta
A case occurred of imperforate, complete transverse vaginal septum in the lower third of the vagina. The patient presented at 16 years of age with primary amenorrhea and was found to have hematocolpos. The clinical impression was an imperforate hymen because of the very low position of the septum in the vagina. After excision the diagnosis of transverse vaginal septum was made histologically because of the presence of müllerian duct (mesodermal origin) tissue in the septum. The patient also had syndactyly of the second and third toes on her right foot. The association of these two congenital abnormalities has not been reported previously. PMID:7738932
Fibrin glue has been used in upper gastrointestinal and perianal fistula disease, but its success in proximal colorectal pathology has not been widely documented. This report describes the use of endoscopically injected fibrin glue as a successful adjunct to traditional methods in accelerating the closure of colorectal fistulas. A retrospective review was performed on cases of colon and rectal fistulas treated with fibrin glue using an endoscopic technique of injection. Fistulas were injected via a flexible fiberoptic endoscope with fluoroscopic guidance (three) or directly with a rigid proctoscope (one). Fibrin glue was mixed directly from cryoprecipitate, thrombin, and calcium (one) or using a Tisseel kit (three) (Baxter, Deerfield, IL). Four patients were identified and included: two J-pouch fistulas, a colocutaneous fistula, and a complex rectocutaneous fistula. The median duration of fistula was 33 days (range 4-365 days). Total parenteral nutrition and bowel rest were used in two patients and three required drainage of an abscess. All fistulas were obliterated and patients required a mean of one application of fibrin glue (range one to two). The mean time to resuming a regular diet postinjection was 2 days (range 1-5). No complications were identified. Fistula resolution was documented in all cases with a contrast enema and no patient has had a fistula recurrence at a median follow-up of 12 months (range 6-65). This preliminary series demonstrates that fibrin glue can be used to obliterate proximal rectal, colonic, and pouch fistulas. Endoscopy and fluoroscopy may aid in administering the fibrin glue. This adjunctive technique may shorten the time to fistula closure and may allow some patients to avoid further surgery. PMID:12132744
Lamont, Jeffrey P; Hooker, Glen; Espenschied, Jonathan R; Lichliter, Warren E; Franko, Edward
Alterations in regional hemodynamics were determined after construction of side to side femoral arteriovenous fistulas in dogs to quantitate the relationship between fistula size and reversal of distal arterial blood flow. When fistula size exceeded the t...
An acid buffering bioadhesive vaginal (ABBV) gel was developed for the treatment of mixed vaginal infections. Different bioadhesive polymers were evaluated on the basis of their bioadhesive strength, stability and drug release properties. Bioadhesion and release studies showed that guar gum, xanthan gum and hydroxypropyl methylcelullose K4M formed a good combination of bioadhesive polymers to develop the ABBV gel. Monosodium citrate was used as an acid buffering agent to provide acidic pH (4.4). The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as antibacterial) were used in the formulation along with Lactobacillus spores to treat mixed vaginal infections. The ex vivo retention study showed that the bioadhesive polymers hold the gel for 12-13 hours inside the vaginal tube. Results of the in vitro antimicrobial study indicated that the ABBV gel had better antimicrobial action than the commercial intravaginal drug delivery systems and retention was prolonged in an ex vivo retention experiment. PMID:19103575
Ahmad, Farhan Jalees; Alam, Mohd Aftab; Khan, Zeenat Iqbal; Khar, Roop Krishen; Ali, Mushir
An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion\\u000a experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for\\u000a an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4),\\u000a which is an attribute of a healthy vagina.
Mohd Aftab Alam; Farhan Jalees Ahmad; Zeenat Iqbal Khan; Roop Krishen Khar; Mushir Ali
Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…
Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.
This article discusses the tension-free vaginal tape (TVT) procedure, which attempts to recreate urethral support at the level of the pubourethral ligaments by placing a polypropylene sling at the midurethra as opposed to the bladder neck. The procedure has the proposed advantage of being done under local anesthesia and being an outpatient surgery and can be performed transvaginally or suprapubically. PMID:21353078
Objective: To describe vaginal bleeding and associated pain in pregnancies terminated by childbirth. Design: A descriptive study based on information obtained by questionnaires administered during pregnancy. Setting: Antenatal care clinic at the Obstetrical Department, Aarhus University Hospital, Denmark. Subjects: Women (n = 8714) with singleton pregnancies attending routine antenatal care at the Department during a 2-year period from 1989 to
Findings. Six percent of the sample reported experiencing any type of IPV in the past year, and 23% reported douching in the past year. IPV is significantly associated with douching after controlling for sociodemographic and health-related covariates. This finding holds for women with and without current reproductive capacity. Conclusions. This is the first study to identify an association between vaginal
Carol S. Weisman; Diane M. Grimley; Lucy Annang; Marianne M. Hillemeier; Gary A. Chase; Anne-Marie Dyer
Anovaginal fistula may be a very distressing complication of Crohn's disease. We review the definitive repair of such fistulas in ten patients. The objectives were to cure the fistula, maintain continence and avoid proctectomy. The fistula was low trans-sphincteric in five patients, high trans-sphincteric in three and suprasphincteric in two. Loop ileostomies were formed in nine patients. Overall, after 14 repair procedures 8/10 fistulas are healed. Seven remain healed at a mean of 38 months (range 10-66 months) after ileostomy closure (six) or repair without ileostomy (one). All of the patients are continent. Definitive repair is effective and worthwhile in selected patients with Crohn's anovaginal fistula.
Anovaginal fistula may be a very distressing complication of Crohn's disease. We review the definitive repair of such fistulas in ten patients. The objectives were to cure the fistula, maintain continence and avoid proctectomy. The fistula was low trans-sphincteric in five patients, high trans-sphincteric in three and suprasphincteric in two. Loop ileostomies were formed in nine patients. Overall, after 14 repair procedures 8/10 fistulas are healed. Seven remain healed at a mean of 38 months (range 10-66 months) after ileostomy closure (six) or repair without ileostomy (one). All of the patients are continent. Definitive repair is effective and worthwhile in selected patients with Crohn's anovaginal fistula. PMID:9771223
Female urethral injury following pelvic fracture is a rare entity. Due to the absence of large series, management guidelines are still not standardized. Patients can have associated urethrovaginal or vesicovaginal fistula, management of which poses a major challenge to the reconstructive urologist. Spontaneous closure of fistula produced by gynecological or obstetrical injuries have been described in the literature. Spontaneous closure of fistula caused due to pelvic fracture has not been described in the literature. PMID:24082449
Female urethral injury following pelvic fracture is a rare entity. Due to the absence of large series, management guidelines are still not standardized. Patients can have associated urethrovaginal or vesicovaginal fistula, management of which poses a major challenge to the reconstructive urologist. Spontaneous closure of fistula produced by gynecological or obstetrical injuries have been described in the literature. Spontaneous closure of fistula caused due to pelvic fracture has not been described in the literature.
BackgroundSpinal dural arteriovenous fistulas are abnormal arteriovenous connections on the surface of the dura. The site of the fistula is most commonly in the thoracic and lumbosacral regions and they are rarely located in the cervical region.CasesThe patients had two asymptomatic dural arteriovenous fistulas of the cervicomedullary junction fed by the left posterior meningeal artery and draining to the dilated
Jun Niwa; Shigeki Matsumura; Yoshihiro Maeda; Hiroshi Ohoyama
A case of dural arteriovenous (AV) fistula is presented with detailed radiological and pathological findings. The complex hemodynamic alterations that may result from dural AV fistulas are described. Pathological examination in this case demonstrated widespread occlusion of the superior sagittal sinus with multiple abnormal fistulous communications between abnormal arteries and arterialized veins. A portion of the lesion resembled a recanalized blood clot, in support of the theory proposed by others that dural AV fistulas are acquired lesions. PMID:3701446
Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas. Methods In depth qualitative interviews conducted with English- and Spanish-speaking women aged 16–40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish. Results Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about “overdouching”. About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US. Conclusions Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices.
Baquero, Maria; Anderson, Matthew R.; Alvarez, Adelyn; Karasz, Alison
A statistical study of the occurrence, in Japan, of fistula auris congenita was conducted in 15,114 subjects (8,018 elementary school and 7,096 junior high school students) in Kanagawa, Shizuoka, and Wakayama Prefectures. The incidence of fistula auris congenita was 2.6% (396 of 15,114 students). Many cases were unilateral and exhibited a single manifestation. The fistula sites were mainly in the preauricular region. Only 2.3% of the 396 fistula cases had a history of radical operation. PMID:9618835
The most common cause of vesicovaginal fistulasis injury to the bladder at the time of surgery. The operation most frequently responsible for vesicovaginal fistula formation is hysterectomy. The first successful transvaginal approach to vesicovaginal fistula repair was reported by Sims in 1838. Although many surgical procedures exist, there is no best approach for all patients with vesicovaginal fistula. However, it is an essential surgical principle that the fistulous tract and scar should be excised completely. Here we report our technique using a transurethral pointed electrode for the treatment of multiple, small vesicovaginal fistulas and its outcome.
Aortoduodenal fistula is a rare cause of gastrointestinal (GI) bleeding, and carries high morbidity and mortality even in modern practice. Cervical carcinoma is a major health threat among adult women, and its recurrence is not uncommon. We herein present a case of primary aortoduodenal fistula because of recurrent cervical carcinoma. Our case demonstrated that diagnosis of primary aortoenteric fistula requires a high index of suspicion and a combination of diagnostic modalities to establish the diagnosis. Prompt diagnosis and rapid treatment are critical in reducing mortality and morbidity. Although rare, metastatic carcinoma can lead to aortoenteric fistula. PMID:20800434
Acute suppurative thyroiditis is a rare disease because the thyroid gland is remarkably resistant to infection. We present a 2-year-old girl with refractory acute suppurative thyroiditis due to a pyriform sinus fistula (PSF). She complained of fever and painful anterior neck swelling. Her condition did not completely improved by multiple parenteral antibiotics along with incision and drainage. Barium esophagogram to detect PSF demonstrated no specific finding. Computed tomography scan showed air bubble superior to the left thyroid gland which indicated a possible fistula connected to the pyriform sinus. An intraoperative laryngoscopy revealed a 2-mm-sized fistula opening. The fistula was successfully treated by chemocauterization with trichloroacetic acid.
Purpose Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports\\u000a of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant\\u000a complications.\\u000a \\u000a \\u000a \\u000a Methods The outcome of patients who underwent treatment for anal fistula with the Surgisis® anal plug was retrospectively reviewed.\\u000a \\u000a \\u000a \\u000a Results Twenty patients were treated; three underwent
D. A. Lawes; J. E. Efron; M. Abbas; J. Heppell; T. M. Young-Fadok
Oral fistula (OAF) is a pathological communication between the oral cavity and maxillary sinus which has its origin either from iatrogenic complications or from dental infections, osteomyelitis, radiation therapy or trauma. OAF closures can be achieved using different flaps which show both advantages and limitations. Therefore they all need careful consideration in order to select the best approach depending on the situation. The most widely employed flaps are of three types: vestibular flap, palatal flap and buccal fat pad Flap(BFP). The authors present three cases of OAF with the different techniques. It is suggested that the buccal flap is best applied in the case of large fistulas located in the anterior region, the palatal flap is suitable to correct premolar defects and the BFP flap for wide posterior OAFs.
Borgonovo, Andrea Enrico; Berardinelli, Frederick Valerio; Favale, Marco; Maiorana, Carlo
INTRODUCTION We report on a patient cohort with dorsal horseshoe fistulas-in-ano. We sought to answer the question of whether these fistulas can be operatively treated, implementing a sphincter-preserving fistulectomy with primary closure of the internal opening, as is done when treating transsphincteric anal fistulas. Long-term clinical course is examined here and operative methods are discussed. METHODS During the time period
Andreas Koehler; Angelika Risse-Schaaf; Sotirios Athanasiadis
Hepatoprotective activity of the n-heptane extract of Cassia fistula leaves was investigated by inducing hepatotoxicity with paracetamol in rats. The extract at a dose of 400 mg/kg body wt. exhibited orally, significant protective effect by lowering the serum levels of transaminases (SGOT and SGPT), bilirubin and alkaline phosphatase (ALP). The effects produced were comparable to that of a standard hepatoprotective agent. PMID:11417916
Bhakta, T; Banerjee, S; Mandal, S C; Maity, T K; Saha, B P; Pal, M
AIM: Since 1987, laparoscopic cholecystectomy (LC) has been widely used as the favored treatment for gallbladder lesions. Cholecystoenteric fistula (CF) is an uncommon complication of the gallbladder disease, which has been one of the reasons for the conversion from LC to open cholecystectomy. Here, we have reported four cases of CF managed successfully by laparoscopic approach without conversion to open cholecystectomy. METHODS: During the 4-year period from 2000 to 2004, the medical records of the four patients with CF treated successfully with laparoscopic management at the Chang Gung Memorial Hospital-Taipei were retrospectively reviewed. RESULTS: The study comprised two male and two female patients with ages ranging from 36 to 74 years (median: 53.5 years). All the four patients had right upper quadrant pain. Two of the four patients were detected with pneumobilia by abdominal ultrasonography. One patient was diagnosed with cholecystocolic fistula preoperatively correctly by endoscopic retrograde cholangiopancreatography and the other one was diagnosed as cholecystoduodenal fistula by magnetic resonance cholangiopancreatography. Correct preoperative diagnosis of CF was made in two of the four patients with 50% preoperative diagnostic rate. All the four patients underwent LC and closure of the fistula was carried out by using Endo-GIA successfully with uneventful postoperative courses. The hospital stay of the four patients ranged from 7 to 10 d (median, 8 d). CONCLUSION: CF is a known complication of chronic gallbladder disease that is traditionally considered as a contraindication to LC. Correct preoperative diagnosis of CF demands high index of suspicion and determines the success of laparoscopic management for the subset of patients. The difficult laparoscopic repair is safe and effective in the experienced hands of laparoscopic surgeons.
Oesophageal atresia-tracheo-oesophageal fistula has featured in paediatric surgery since its beginnings. The first successful primary repair was in 1941. With overall survival now exceeding 90% in dedicated centres, the emphasis has changed to reducing morbidity and achieving improvements in the quality of life. An overview of current and emerging strategies in managing patients with this condition is presented. Advances in developmental biology and molecular genetics reflecting improved understanding of the pathogenesis are highlighted. PMID:16923940
Oesophageal atresia?tracheo?oesophageal fistula has featured in paediatric surgery since its beginnings. The first successful primary repair was in 1941. With overall survival now exceeding 90% in dedicated centres, the emphasis has changed to reducing morbidity and achieving improvements in the quality of life. An overview of current and emerging strategies in managing patients with this condition is presented. Advances in developmental biology and molecular genetics reflecting improved understanding of the pathogenesis are highlighted.
The surgical treatment of 13 posttraumatic arteriovenous (AV) fistulae and 32 pseudoaneurysmae (PsAn) treated in the last 5 years in the Center of vascular surgery of the institute of cardiovascular diseases, Clinical center of Serbia (Belgrade) was presented. Three women and 42 men (mean age 31.7 years) were examined. Twenty-one injuries occurred in a war, while 24 injuries occurred in the peacetime. In most of the cases the superficial femoral artery was involved. The average time elapsed from the moment of injury till surgery, was 9 months in patients suffering from AV fistulae, while in patients suffering from PsAn the elapsed time was one month. In all of those with AV fistulae, some reconstructions of artery and vein were performed, except in 2 cases where the vein was ligated. In twenty-six patients suffering from PsAn the arterial reconstruction was performed, while in 6 cases the artery was ligated. Considering the type of artery, none of the patients suffered from postoperative ischemia. Patients were followed up for 2 years and 2 months on the average after the operation. As far as the reconstructive operations were concerned, postoperative patency rate was 100%, while limb salvage was achieved in 96.9%. Namely, one amputation was done in spite of high arterial patency rate, but it was indicated by massive bone-muscle tissue loss, that occurred after an injury by the land-mine. Due to the rapid progress of the disease the authors suggested that the operative treatment of posttraumatic AV fistulae and PsAn should start as soon as possible. This was supported by good follow-up results in operatively treated patients. PMID:9235789
Primary intraventricular haemorrhage is a rare presentation of a dural arteriovenous fistula. We describe the case of a 52-year-old woman with a past history of idiopathic intracranial hypertension who presented with sudden-onset severe headache. The CT scan on admission showed primary intraventricular haemorrhage with no associated haemorrhage in the brain parenchyma or the extra-axial compartment. The cerebral angiogram demonstrated a
Generic guidelines are applied to reconstructive vaginal operations, so as to convert them to ambulatory procedures. Prototype operations are described and analyzed. These included conceptualizing vaginal prolapse as a type of intussusception caused by vaginal and ligamentous laxity in the middle or posterior parts of the vagina; the avoidance of vaginal excision, excessive tension, and refashioning excess vaginal tissue from
Introduction Human tails and pseudotails are rare sacrococcygeal lesions that are associated with a wide variety of anomalies and syndromes. Anorectal malformations are also relatively uncommon congenital defects that often occur in conjunction with syndromes or other congenital abnormalities. The anomalies associated with both disorders determine the timing and approach to surgical correction. We present an unusual case of a patient with both imperforate anus and a pseudotail in the absence of a syndrome or other associated anomalies and we emphasize the necessity of a thorough preoperative evaluation. Case presentation A Caucasian girl was born at term after an uncomplicated pregnancy and was noted at birth to have a skin-covered posterior midline mass and imperforate anus with a fistula to the vaginal vestibule. Ultrasound and magnetic resonance imaging revealed a predominately fatty lesion without presacral extension and ruled out associated spinal and cord abnormalities. The patient underwent diversion with colostomy and a mucous fistula in the newborn period as a fistulogram demonstrated a long fistulous tract to normal rectum and it was anticipated that anoplasty and resection of the mass would require extensive posterior dissection. The sacrococcygeal mass was removed during posterior sagittal anorectoplasty at the age of six weeks which was determined to be a pseudotail because of the composition of brown fat and cartilage. The patient is now 14 months old with normal bowel function after a colostomy takedown. Conclusion A comprehensive preoperative assessment and thoughtful operative plan were necessary in this unusual case because of the extensive differential diagnosis for sacrococcygeal masses in the newborn and the frequency of anomalies and syndromes associated with tail variants and imperforate anus. The pediatricians and neonatologists who initially evaluate such patients and the surgeons who correct these disorders must be aware of the potential pitfalls in their management.
Vaginal atrophy is a common chronic condition affecting up to 57% of postmenopausal women. The decrease in estrogen following cessation of menses can lead to bothersome symptoms that include vaginal dryness and irritation, pain and burning during urination (dysuria), urinary tract infections, and pain (dyspareunia) and bleeding during sexual activities. These symptoms can be safely and effectively managed with the use of local estrogen therapy, which reduces the risks associated with long-term systemic hormone therapy. The ultra-low-dose 10 ?g estradiol vaginal tablet is the lowest approved dose available and has an annual estradiol exposure of only 1.14 mg. Its development addresses recommendations from regulatory agencies and women's health societies regarding the use of the lowest hormonal dose. The 10 ?g vaginal tablet displays minimal estradiol absorption, causes no increased risk of endometrial hyperplasia or carcinoma, and provides significant symptom relief. The clinical evidence presented here may offer greater reassurance to health-care professionals and postmenopausal women that vaginal atrophy can be treated safely and effectively. PMID:23848490
BACKGROUND: Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic. CASES: We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment. CONCLUSION: We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients.
Trichomonas vaginalis and Tritrichomonas foetus cause common sexually transmitted infections in humans and cattle, respectively. Mouse models of trichomoniasis are important for pathogenic and therapeutic studies. Here, we compared murine genital infections with T. vaginalis and T. foetus. Persistent vaginal infection with T. foetus was established with 100 parasites but T. vaginalis infection required doses of 10(6), perhaps because of greater susceptibility to killing by mouse vaginal polymorphonuclear leukocytes. Infection with T. vaginalis persisted longest after combined treatment of mice with estrogen and dexamethasone, whereas infection was only short-lived when mice were given estrogen or dexamethasone alone, co-infected with Lactobacillus acidophilus, and/or pretreated with antibiotics. Infection rates were similar with metronidazole-resistant (MR) and metronidazole-sensitive (MS) T. vaginalis. High dose but not low dose metronidazole treatment controlled infection with MS better than MR T. vaginalis. These murine models will be valuable for investigating the pathogenesis and treatment of trichomoniasis. PMID:21976570
Cobo, Eduardo R; Eckmann, Lars; Corbeil, Lynette B
\\u000a Molar pregnancy and gestational trophoblastic neoplasia (GTN) comprise a group of interrelated diseases, including complete\\u000a and partial molar pregnancy, placental-site trophoblastic tumor (PSTT), and choriocarcinoma, that have varying propensities\\u000a for local invasion and distal spread. Vaginal bleeding is a common presenting sign, seen in as many as 97% of women with a\\u000a complete molar pregnancy; it is also a frequent
Lisa M. Barroilhet; Donald Peter Goldstein; Ross S. Berkowitz
Sixteen patients with symptomatic dural caroticocavernous fistulae were treated by transvenous embolization, via the jugular vein and inferior petrosal sinus. The fistula was occuladed by thrombogenic coils. Complete resolution of symptoms and signs was achieved in 14 patients, and complete angiographic resolution was also obtained in 14 patients. Failures to achieve angiographic cure were attributed to failure to reach the
K. Yamashita; W. Taki; S. Nishi; A. Sadato; I. Nakahara; H. Kikuchi; Y. Yonekawa
Aim: To review 12 cases of anovestibular fistula with normal anal opening. Methods: Retrospective analysis of 12 children with anovestibular fistula and normal anal opening were treated between the years 2000 and 2007. Of these, 11 patients were diagnosed as having acquired anovestibular fistula with normal anal opening and were managed by conservative management. Results: Most of them presented with diarrhea and labial redness. One patient was considered to have fistula of congenital origin and was managed surgically. Eleven patients presented between the ages of 1.5–11 months and were considered as cases of acquired anovestibular fistula and only two of them required surgical management in the form of colostomy and fistula excision. Others were successfully managed by conservative treatment; the fistulous output and labial redness decreased gradually within a period of 5–19 (average 11.5) days. Conclusions: Not all presentations of anovestibular fistula with normal anal opening can be considered as congenital. Presence of inflammation, paramedian fistula, and a favourable response to conservative management/colostomy suggest acquired etiology. Trial of conservative management should be given in the acquired variety.
Jain, Prashant; Mishra, Pankaj; Shah, Hemanshi; Parelkar, Sandesh; Borwankar, S. S.
Large palatal fistulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue flap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fistula closure with anteriorly based tongue flap. PMID:24647304
Enteric fistulas are a rare but serious complication following the repair of an incisional hernia using a prosthesis. We report the case of a 52-year-old man who developed an enterocolocutaneus fistula after incisional hernia repair with intra-abdominal polyester mesh. This case shows that one may want to avoid placing the parietal prostheses in direct contact with intestinal loops.
Traumatic tracheoesophageal fistula is a rare complication after blunt chest trauma, with all reported cases being more than 12 years of age. We report a 5-year-old boy with traumatic tracheoesophageal fistula after a blunt injury to the chest. PMID:17011255
Congenital coronary artery fistula is a rare disease and MRI is a promising technique that may be useful to demonstrate the coronary artery tree. We report three patients who underwent cardiac MRI to investigate right coronary artery fistulae. On clinical examination, a continuous murmur was heard along the left sternal border, and chest X-ray showed moderate cardiomegaly with enlargement of
J R PARGA; N M IKARI; L N P BUSTAMANTE; C E ROCHITTE; LFR DEAVILA; S A OLIVEIRA
Introduction: Anatomical studies on the bulbocavernosus muscle (BCM) and its supporting blood vessels were performed to explore the clinical roles of BCM flaps in the repair of complicated vesicovaginal fistulas. Methods: BCM and the supporting blood vessels of 15 female adult cadavers were anatomized. Pedicled BCM flaps were transposed to repair complicated vesicovaginal fistulas in 11 patients. Results: The left
We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.
Gregorio, Miguel Angel de; Gimeno, Maria Jose; Medrano, Joaquin [Interventional Radiology, Clinico Universitario Lozano Blesa (Spain); Schoenholz, Caudio; Rodriguez, Juan; D'Agostino, Horacio [Interventional Radiology, State University Health Sciences Center (United States)
A 51-year-old man suffered from bleeding esophageal varices. He had undergone partial gastrectomy for gastric cancer 1 year before. An extrahepatic arterioportal fistula and resultant portal hypertension were found. We successfully performed transarterial embolization of the fistula using stainless steel coils. Portal hypertension improved dramatically. RID='''' ID='''' Correspondence to: K. Ishigami, M.D.
Ishigami, Kousei; Yoshimitsu, Kengo; Honda, Hiroshi; Kuroiwa, Toshiro; Irie, Hiroyuki; Aibe, Hitoshi; Tajima, Tsuyoshi [Department of Radiology, Faculity of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Hashizume, Makoto [Department of Surgery II, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Masuda, Kouji [Department of Radiology, Faculity of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)
To examine the predictive accuracy of Goodsall's rule, the records of 216 patients (155 men and 61 women) who underwent surgery for complete submuscular anal fistulas from 1982 to 1989 were retrospectively reviewed. In accordance with Goodsall's rule, 90 percent of 124 patients with an external opening posterior to the transverse anal line had anal fistulas tracking to the midline
Twenty-one patients with high transsphincteric fistulas treated by the seton technique were re-examined after two to 14 years.\\u000a None had recurrent fistulas, but 13 (62 percent) had some degree of continence disturbances. All patients with anal deformities\\u000a had continence disorders.
Asbjørn Christensen; Lisbeth Nilas; John Christiansen
PURPOSE: Successful management of anal fistulas depends upon accurate assessment of the primary tract and any secondary extensions. Preoperative imaging has, to date, been disappointing. METHODS: A prospective study of 35 patients with a clinical diagnosis of fistula-in-ano was performed comparing magnetic resonance imaging with the independently documented operative findings. Magnetic resonance imaging was also compared with anal endosonography in
Peter J. Lunniss; Peter G. Barker; Abdul H. Sultan; Peter Armstrong; Rodney H. Reznek; Clive I. Bartram; Karen S. Cottam; Robin K. Phillips
PURPOSE: The aim of this study was to investigate the failure of fibrin sealant treatment for fistula-in-ano in an experimental porcine model and to determine histologic changes associated with the sealant and setons. METHODS: Three surgically created fistulas were treated by seton drainage in each of eight male pigs. After 26 days, magnetic resonance imaging was performed and setons were
Gordon N. Buchanan; Paul Sibbons; Mike Osborn; Clive I. Bartram; Tahera Ansari; Steve Halligan; C. Richard G. Cohen
Background. The FDA approved over-the-counter (OTC) use of vaginal antifungals in 1990. Subsequently, a plethora of OTC products have become available to women on drugstore shelves. Objectives. The purpose of this study was to determine the availability of OTC products marketed for the treatment of vaginitis and to determine if their efficacy had been confirmed by published prospective randomized control trials (RCTs). Materials and methods. The authors chose four retail locations frequented by women seeking vaginitis treatment. All products deemed a viable treatment option were purchased. Results. All intravaginal imidazoles purchased, regardless of treatment duration or active ingredient, were found to be of proven efficacy. We were unable to find an RCT confirming the effectiveness of vaginal anti-itch creams and homeopathic treatments for vaginitis. Conclusion. 45% of products available to women in the feminine hygiene section of the stores surveyed could not be confirmed to be effective for treating infectious vaginitis.
B. Angotti, Lauren; C. Lambert, Lara; E. Soper, David
Objective. To study the antimicrobial susceptibility of six vaginal probiotic lactobacilli. Methods. The disc diffusion method in Müeller Hinton, LAPTg and MRS agars by the NCCLS (National Committee for Clinical Laboratory Standards) procedure was performed. Due to the absence of a Lactobacillus reference strains, the results were compared to those of Staphylococcus aureus ATCC29213. Minimal Inhibitory Concentration (MIC) with 21 different antibiotics in LAPTg agar and broth was also determined. Results. LAPTg and MRS agars are suitable media to study antimicrobial susceptibility of lactobacilli. However, the NCCLS procedure needs to be standardized for this genus. The MICs have shown that all Lactobacillus strains grew at concentrations above 10 ?g/mL of chloramphenicol, aztreonam, norfloxacin, ciprofloxacin, ceftazidime, ceftriaxone, streptomycin and kanamycin. Four lactobacilli were sensitive to 1 ?g/mL vancomycin and all of them were resistant to 1000 ?g/mL of metronidazole. Sensitivity to other antibiotics depended on each particular strain. Conclusions. The NCCLS method needs to be standardized in an appropriate medium to determine the antimicrobial susceptibility of Lactobacillus. Vaginal probiotic lactobacilli do not display uniform susceptibility to antibiotics. Resistance to high concentrations of metronidazole suggests that lactobacilli could be simultaneously used with a bacterial vaginosis treatment to restore the vaginal normal flora.
Ocana, Virginia; Silva, Clara; Nader-Macias, Maria Elena
In Africa, the use of traditional herbal remedy is widespread. Acute renal failure (ARF) is one of the most serious complications. The use of herbal remedies (mostly orally) accounts for nearly 35% of all cases of acute renal failure in Africa. Development of renal failure following herbal vaginal pessary is rarely reported. In November 2003, a 35-year-old Nigerian female who is a petty trader and a primary school leaver with three children (all males) presented to us in the renal unit with oliguric ARF induced by herbal vaginal pessary. She had sought this alternative medicine in an attempt to have a female child as all her three children are males. Her condition was managed accordingly and required three sessions of hemodialysis. She started diuresing on the eighth day of admission. This case presentation highlights the potential tragedies of herbal preparation, of note, that herbal vaginal pessaries are as deleterious as the oral preparations, and that the dilemma of ignorance is still prevalent in our society.
Onyemekeihia, U. R.; Esume, C. O.; Oladele, C. O.; Oviasu, E.
Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.
Sadath, Shameema A.; Abo Diba, Fathiya I.; Nayak, Surendra; Shamali, Iman Al; Diejomaoh, Michael F.
Vaginal sponges offer women control over protection against both pregnancy and sexually transmitted diseases (STDs), including HIV. Spermicide-impregnated sponges combine the actions of a physical barrier that blocks the cervix with a material that absorbs the ejaculate and a spermicide. Commercially available spermicides contain 1-5% of nonoxynol-9, shown to inhibit organisms responsible for gonorrhea, chlamydia, candidiasis, genital herpes, syphilis, trichomoniasis, and HIV. On the other hand, nonoxynol-9 is associated with a significantly higher risk of vaginal colonization with bacterial agents, ulcerative genital diseases, and vulvitis. A lower dose of nonoxynol-9 appears to avert vaginal irritation without compromising contraceptive efficacy. Use of chlorhexidene, a spermicide less irritating to mucosal cells than nonoxynol-9 but active against HIV in vivo and in vitro, is under investigation. Also promising are initial findings regarding the Protectaid contraceptive sponge with F-5 gel. Epidemiologic studies and clinical trials should provide quantitative estimates of the level of protection offered by barrier methods and identify the method that combines the highest protection, ease of use, and user acceptability. PMID:9238301
Hassan, E; Creatsas, G; Gravanis, A; Georgoulias, V; Psychoyos, A
In Africa, the use of traditional herbal remedy is widespread. Acute renal failure (ARF) is one of the most serious complications. The use of herbal remedies (mostly orally) accounts for nearly 35% of all cases of acute renal failure in Africa. Development of renal failure following herbal vaginal pessary is rarely reported. In November 2003, a 35-year-old Nigerian female who is a petty trader and a primary school leaver with three children (all males) presented to us in the renal unit with oliguric ARF induced by herbal vaginal pessary. She had sought this alternative medicine in an attempt to have a female child as all her three children are males. Her condition was managed accordingly and required three sessions of hemodialysis. She started diuresing on the eighth day of admission. This case presentation highlights the potential tragedies of herbal preparation, of note, that herbal vaginal pessaries are as deleterious as the oral preparations, and that the dilemma of ignorance is still prevalent in our society. PMID:20535252
Onyemekeihia, U R; Esume, C O; Oladele, C O; Oviasu, E
Aim: Objective of this study is to report our experience with sigmoid vaginoplasty in adolescents. Materials and Methods: A retrospective study of children with vaginal atresia and Mayer–Rokitansky–Kuster–Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the cases. Results: Eight children were studied over a period of 7 years. The postoperative complications were ileus in 2, mucosal prolapse of the neovagina in 1, and minor wound infection in 1 patient. Seven patients are on regular follow-up. All the neovaginas were patent and functional. One patient had unacceptable perineal appearance, that is, badly scarred perineum as a late complication. None of the patients had vaginal stenosis or excessive mucus discharge, during follow-up visits. Out of the 7 patients, 2 patients are sexually active and satisfied. Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, and short recovery time.
Rawat, Jiledar; Ahmed, Intezar; Pandey, Anand; Khan, Tanvir R.; Singh, Sarita; Wakhlu, Ashish; Kureel, Shiv N.
Graves’ ophthalmopathy (GO) is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature.
Celik, Ozlem; Buyuktas, Deram; Islak, Civan; Sarici, A Murat; Gundogdu, A Sadi
Perianal fistula is a clinical entity with multiple surgical treatment options. Recently, magnetic resonance imaging (MRI) has emerged as an important imaging modality in the management of perianal fistulas. It provides accurate description of the fistula within the anal canal in relation to the sphincter complex and other pelvic floor structures as well as the associated complications such as abscess. By understanding the surgical viewpoint, the appearance of perianal fistulas, associated complications, and post-treatment findings of commonly used surgical interventions can more accurately be interpreted to aid clinicians. The objective of the article is to review MRI indications and findings, radiological versus surgical classification schemes, and surgical treatment options for perianal fistulas. PMID:23242265
A 79-year-old woman with pneumobilia and liver dysfunction was admitted to our hospital. ERCP and gastrointestinal endoscopy revealed choledochal stones and a cholecystogastric fistula at the greater curvature of the gastric antrum. The risk of cholecystectomy and fistulectomy appeared to be extremely high for this patient because of her advanced age and low respiratory function due to interstitial pneumonia. Therefore, only an endoscopic lithotomy was performed, and the cholecystogastric fistula remained. However, after 2 years of follow-up, she developed an advanced gallbladder carcinoma. This finding suggests that cholecystogastric fistula is a risk factor for gallbladder carcinoma. Because of the difficulty of early detection of gallbladder carcinoma associated with cholecystogastric fistula, both fistulectomy and cholecystectomy are necessary when cholecystogastric fistula is diagnosed. PMID:24806240
The objective was to identify proteins differentially expressed in vaginal cancer to elucidate relevant cancer-related proteins. A total of 16 fresh-frozen tissue biopsies, consisting of 5 biopsies from normal vaginal epithelium, 6 from primary vaginal carcinomas and 5 from primary cervical carcinomas, were analysed using two-dimensional gel electrophoresis (2-DE) and MALDI-TOF mass spectrometry. Of the 43 proteins identified with significant
K Hellman; A A Alaiya; S Becker; M Lomnytska; K Schedvins; W Steinberg; A-C Hellström; S Andersson; U Hellman; G Auer
Postpartum genital tract adhesions are unusual, and their cause has not been evaluated. However, severe dystocia and numerous pelvic examinations have been suggested as possible causes. Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months. Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum. The patient was successfully treated with surgical resection and administration of antibiotics. PMID:24596821
Kim, Hyun Mi; Bae, Jin Young; Cho, Yoo Jin; Kim, Mi Ju; Cha, Hyun-Hwa; Cha, Hyun Wha; Seong, Won Joon
...Bioequivalence Recommendations for Metronidazole Vaginal Gel; Availability AGENCY...Bioequivalence Recommendations for Metronidazole Vaginal Gel.'' The guidance provides...new drug applications (ANDAs) for metronidazole vaginal gel. DATES: Although...
A young patient with a vaginal tumor in early pregnancy is presented. The difficulty in diagnosis and subsequent management is discussed. Vaginal tumors with special reference to vaginal leiomyoma are reviewed and a differential diagnosis is presented. PMID:3425255
...Certain Vaginal Ring Birth Control Devices; Notice...certain vaginal ring birth control devices by reason...issue an exclusion order and cease and desist orders. ADDRESSES: The complaint...certain vaginal ring birth control devices...
Anal fistula is among the most common illnesses affecting man. Medical literature dating back to 400 BC has discussed this problem. Various causative factors have been proposed throughout the centuries, but it appears that the majority of fistulas unrelated to specific causes (e.g. Tuberculosis, Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces. The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases. The problem with this single, yet effective, treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses, the patient will have varying degrees of fecal incontinence from minor to total. In an attempt to preserve continence, various procedures have been proposed to deal with the fistulas. These include: (1) simple drainage (Seton); (2) closure of fistula tract using fibrin sealant or anal fistula plug; (3) closure of primary opening using endorectal or dermal flaps, and more recently; and (4) ligation of intersphincteric fistula tract (LIFT). In most complex cases (i.e. Crohn’s disease), a proximal fecal diversion offers a measure of symptomatic relief. The fact remains that an “ideal” procedure for anal fistula remains elusive. The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations. In essence, the price of preservation of continence at all cost is multiple and often different operations, prolonged disability and disappointment for the patient and the surgeon. Nevertheless, the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist. Conversely, an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.
So-called "vaginal rejuvenation", "designer vaginoplasty", "revirgination", and "G-spot amplification" are vaginal surgical procedures being offered by some practitioners. These procedures are not medically indicated, and the safety and effectiveness of these procedures have not been documented. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for her request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention. Women should be informed about the lack of data supporting the efficacy of these procedures and their potential complications, including infection, altered sensation, dyspareunia, adhesions, and scarring. PMID:17766626
Anal fistula management has long been a challenge for surgeons. Presently, no technique exists that is ideal for treating all types of anal fistula, whether simple or complex. A higher incidence of poor sphincter function and recurrence after surgery has encouraged the development of a new sphincter-sparing procedure, ligation of the intersphincteric fistula tract (LIFT), first described by Van der Hagen et al. in 2006. We assessed the safety, feasibility, success rate, and continence of LIFT as a sphincter-saving procedure. A literature search of articles in electronic databases published from January 2006 to August 2012 was performed. Analysis followed Preferred Reporting Items for Systematic Reviews recommendations. All LIFT-related articles published in the English language were included. We excluded case reports, abstracts, letters, non-English language articles, and comments. The procedure was described in detail as reported by Rojanasakul. Thirteen original studies, including 435 patients, were reviewed. The most common fistula procedure type was transsphincteric (92.64 %). The overall median operative time was 39 (±20.16) min. Eight authors performed LIFT as a same-day surgery, whereas the others admitted patients to the hospital, with an overall median stay of 1.25 days (range 1-5 days). Postoperative complications occurred in 1.88 % of patients. All patients remained continent postoperatively. The overall mean length of follow-up was 33.92 (±17.0) weeks. The overall mean healing rate was 81.37 (±16.35) % with an overall mean healing period of 8.15 (±5.96) weeks. Fistula recurrence occurred in 7.58 % of patients. LIFT represents a new, easy-to-learn, and inexpensive sphincter-sparing procedure that provides reasonable results. LIFT is safe and feasible, with favorable short- and long-term outcomes. However, additional prospective randomized studies are required to confirm these findings. PMID:23893217
Parotid fistula is a very rare, unpleasant and painful complication following surgery in the maxillofacial region. Although there is consensus in the literature that acute parotid injury must be explored primarily and all injured structures be repaired accurately, the treatment of the chronic injury is controversial. Numerous methods of treatment, conservative as well as aggressive, have been described with varying success and morbidity. This paper presents a simple but effective and conservative method of treating this complication with the use of hot hypertonic saline.
Rao, J. K. Dayashankara; Gehlot, Neelima; Laxmy, Vijay; Siwach, Vijay
A 25-year-old man was brought in after a preliminary diagnosis of chronic, exacerbated right otitis media. Following our physical examination a granulated, purulen ear pit was found out behind the right auricle. At the base of the helix a non-purulent external opening of the ear pit was found out. The operation showed that we had to do with preauricular fistula embracing the auricle from above and ending with a purulent cyst above the upper back wall of the external auditory meatus. The ear pit and cyst were extirpated as a whole. A 1,5-year observation period has not shown any recurrence of the disease. PMID:9173393
INTRODUCTION We present a case of direct carotico-cavernous fistula (CCF) and its successful treatment. PRESENTATION OF CASE A 55-year-old male presented with left eye discomfort, diplopia and pulsatile tinnitus. He had a recent history of head injury. Examination showed proptosis, chemosis, orbital bruit, and abducens nerve palsy. Digital subtraction angiography confirmed CCF, which was managed endovascularly. The patient recovered fully after treatment. DISCUSSION CCF has a variety of presenting clinical signs, imaging manifestations, and treatment options available. CONCLUSION CCF is a rare and dangerous neurological disorder that should be promptly diagnosed and treated.
Male urethral “play” has been described for centuries. There are serious potential complications in this. We present a bizarre case of a variant of such play. A 49-year-old man presented with abdominal pain and incontinence. He had created a “neovagina” at the perineum for self-pleasure. The handle of a toilet brush was placed in the neovagina for self-pleasure but retracted into the bladder via a vesicoperineal fistula. An open cystotomy was performed to remove the foreign body.
Potretzke, Aaron M.; Wong, Kelvin S.; Downs, Tracy M.
Four cases with hereditary combinations of branchial fistulas and middle ear malformations in three generations of one family are reported. We found preauricular fistulas and lateral cervical fistulas combined with different types of middle ear dysplasias. In one case a preauricular fistula running through the middle ear and ending in the dura could be exstirpated. Such rare varieties must be considered, when preauricular fistulas are found together with congenital middle ear deafness. PMID:763058
Summary and Conclusions A critical analysis of the records of 623 patients who had fistulas or fistulous abscesses and of three patients who had supralevator\\u000a abscesses of extrarectal origin was made. The 626 patients had a total of 657 fistulas or abscesses; 24 patients had two separate\\u000a fistulas, two patients had three fistulas, and one patient had four fistulas.\\u000a \\u000a Sixty-five per
Subarachnoid-pleural fistula is a well-described complication after anterior surgery for thoracic disc herniation, but is difficult to treat by means of traditional chest and lumbar drains due to interference by positive ventilation pressures that may keep the fistula open and prevent proper closure. Current treatment strategies include surgical repair, which is technically challenging, and noninvasive positive pressure ventilation, which can take several weeks to be effective. In this report, the authors describe a novel treatment for subarachnoid-pleural fistula using percutaneous obliteration with Onyx. Surgery for removal of a T7-8 disc herniation associated with ossification of the posterior longitudinal ligament was performed in a 56-year-old woman via an anterior transthoracic transpleural approach. Ten days after surgery, she presented with diplopia due to a subarachnoid-pleural fistula that was confirmed by CT myelography. Percutaneous injection of Onyx was performed under local anesthesia. Postprocedure CT showed complete obliteration of the fistula with no adverse events. A CT scan obtained 1 month later showed complete resolution of the pleural effusion. Neurological examination at 3 months postsurgery was normal. Clinical and radiological follow-up at 1 year showed complete recovery and no sign of fistula recurrence. Percutaneous treatment for subarachnoid-pleural fistula is an easy, safe, and effective strategy and can therefore be proposed as a first-line option for this challenging complication. PMID:23432323
Objective : To determine the incidence and most frequent anatomical locations of residual oronasal fistulas in children with different types of clefts who were treated at the University Department of Maxillofacial and Oral Surgery in Ljubljana. Design : Retrospective analysis of 857 consecutive patients with cleft born between 1984 and 2003. Results : After primary surgical repair, 33 out of 857 (3.9%) children had residual oronasal fistulas. The incidence of clinically significant fistulas that required surgical repair was 17 of 857 (2.0%). In children with unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), or isolated cleft palate (CP), the incidence of palatal fistulas was 23 of 644 (3.6%). Of these palatal fistulas, 12 (1.9%) were clinically significant. Oronasal fistulas were most frequently found in children with BCLP (9 of 88, 10.2%), followed by UCLP (12 of 215, 5.6%) and CP (12 of 341, 3.5%). No fistulas were found in children with unilateral cleft lip and alveolar ridge. In 10 cases (30.3%), the oronasal fistula remained in the alveolar ridge, in 11 cases (33.3%) in the anterior part of the hard palate, and in 11 cases (33.3%) at the junction of the hard and soft palates. In one case (3%), the records were lost. Conclusion : The low incidence of oronasal fistulas is the result of a surgical technique and tensionless suturing, followed by a two-layer closure, two-stage palate repair in BCLP and UCLP patients, and preoperative orthopedics in UCLP cases. PMID:21740163
Bronchobiliary fistula is a rare and is an uncommon but severe complication of hydatid disease of the liver. Treatment has traditionally been surgical resection, but embolization and stent placement have been described. The invasive method seems to be a key component of patient treatment. We describe a case of a 58-year-old woman who, 25 years before, had undergone surgery for a hydatid cyst. A total cystectomy without previous puncture or parasite extraction was carried out. The lower aspect of the cyst was found to be completely perforated over the biliary duct. During the postoperative course, the patient had subphrenic right-sided pleural effusion and biliary fistula that subsided with medical treatment. Afterward, the patient came to the outpatient area of our hospital complaining of leakage of purulent exudate through the cutaneous opening, pain located on the right hypochondrium radiating to the right hemithorax, malaise, fever, chronic cough, and occasional vomiting of bile. Fistulography revealed an anfractuous cavity communicating with a residual cystic cavity on the right hepatic lobe. We observed communication with the intrahepatic canaliculi. Computed tomographic scan revealed a fistulous tract on the anterior liver border through the abdominal wall. There were no posttreatment complications. The patient is asymptomatic.
Prieto-Nieto, M. I., E-mail: [email protected]; Perez-Robledo, J. P., E-mail: [email protected] [La Paz Teaching Hospital, Department of General and Digestive Surgery (Spain); Alvarez-Luque, A., E-mail: [email protected]; Suz, J. I. Acitores, E-mail: [email protected]; Torres, J. Novo, E-mail: [email protected] [La Paz Teaching Hospital, Department of Interventional Radiology (Spain)
Perilymph fistula (PLF) is defined as a leak of perilymph at the oval or round window. It excludes other conditions with "fistula" tests due to a dehiscent semi circular canal from cholesteatoma and the superior canal dehiscence syndrome. It was first recognized in the early days of stapedectomy as causing disequilibrium and balance problems before sealing of the stapedectomy with natural tissue became routine. It then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause of PLF. Descriptions of "spontaneous" PLF with no trauma history followed. A large literature on PLF from all causes accumulated. It became an almost emotional issue in Otolaryngology with "believers" and "nonbelievers." The main criticisms are a lack of reliable symptoms and diagnostic tests and operative traps in reliably distinguishing a perilymph leak from local anaesthetic. There are extensive reviews on the whole topic, invariably conveying the authors' own experiences and their confirmed views on various aspects. However, a close examination reveals a disparity of definitions and assumptions on symptoms, particularly, vestibular. This is an intentionally provocative paper with suggestions on where some progress might be made. PMID:23724269
Purpose. The carotid-cavernous fistula (CCF) is an abnormal arteriovenous communication and its drainage pathways may affect the clinic presentation and change treatment approach. We evaluated drainage patterns of CCFs by digital subtraction angiography (DSA) and categorized drainage pathways according to their types and etiology. Materials and Methods. Venous drainage patterns of 13 CCFs from 10 subjects were studied and categorized as anterior, posterior, superior, inferior, and contralateral on DSA. Drainage patterns were correlated to types and etiology of CCFs. Diagnosis of CCFs was first made by noninvasive imaging techniques. Results. On DSA, traumatic CCFs were usually high flow, direct type while spontaneous CCFs were usually slow flow, indirect type. Bilaterality and mixed types were observed among the indirect spontaneous CCFs. In all CCFs, anterior and inferior drainages were the most common. Contrary to the literature, posterior and superior drainages were noted only in high flow and long standing direct fistulas. Contralateral drainage was not observed in all, supporting plausible compartmentalization of cavernous sinuses. Conclusion. Types, etiology, and duration of the CCFs may affect their drainage patterns. DSA is valuable for categorization of CCFs and verification of drainage patterns. Drainage pathways may affect the clinic presentation and also change treatment approach.
We report the case of a patient, a 19-year-old young man, with a rare malformation of the pulmonary blood vessels--a complex arteriovenous (A-V) fistula. The disease was characterized by typical signs of the right-to-left shunt: cyanosis, clubbed fingers and exertional dyspnea. Hypoxemia and polyglobulia were present in the blood examination findings and functional tests showed significantly reduced diffusion lung capacity and progressive dyspnea, while ergometry revealed cyanosis. The physical examination, ECG and ultrasound of the heart were normal as well as aortography. The final diagnosis was made by pulmonary angiography which showed a complex A-V malformation of several feeding arteries and profuse initial multiple venous drainage. Following a successful surgical procedure the diagnosis was also confirmed histopathologically-diffuse teleangiectatic A-V fistula of the lower lobe of the left lung. Following surgery cyanosis, dyspnea, hypoxemia and polyglobulia disappeared and the young man has been well for the following two years. PMID:7651067
Zorici?-Letoja, I; Mikuli?, Z; Simuni?, S; Vladovi?-Relja, T; Krizanac, S
OBJECTIVE To compare the risk of ureteral compromise and of recurrent vault prolapse following vaginal vs. laparoscopic uterosacral vault suspension at the time of vaginal hysterectomy. STUDY DESIGN In this retrospective, cohort study, uterosacral ligament suspension was performed using either a vaginal or laparoscopic approach. The primary outcome was intraoperative ureteral compromise; secondary outcomes were postoperative anatomic result and recurrent prolapse. The Canadian Task Force Classification was II-2. RESULTS One hundred eighteen patients were included: 96 patients in the vaginal group and 22 patients in the laparoscopic group. Ureteral compromise was identified intraoperatively in 4 (4.2%) cases in the vaginal group; no ureteral compromise was observed in the laparoscopic group (p = 0.33). Failure at the apex, defined as stage ? II for point C, was seen in 6.3% of patients in the vaginal group as compared with 0% in the laparoscopic group; this difference did not achieve statistical significance. Similarly, trends toward lower recurrent symptomatic vault prolapse (10% vs. 0%), any symptomatic prolapse recurrence (12.5% vs. 4.6%), and higher postoperative Pelvic Organ Prolapse Quantification point C were observed in the laparoscopic group (p > 0.05 for all). CONCLUSION Laparoscopic uterosacral vault suspension following vaginal hysterectomy is a safe alternative to the vaginal approach.
Rardin, Charles R.; Erekson, Elisabeth A.; Sung, Vivian W.; Ward, Renee M.; Myers, Deborah L.
In the light of very recent studies, this paper reviews two controversial issues in the area of female sexuality: vaginal eroticism and female orgasm. From the available evidence, it is concluded that most (and probably all) women possess vaginal zones, mainly located on the anterior wall, whose tactile stimulation can lead to orgasm. The apparent contradiction between this finding and
... it doesn't come back. Stage I Squamous cell cancers: Radiation therapy is used for most stage I vaginal cancers. ... for some patients with stage II vaginal squamous cell cancer if it is small ... already had radiation therapy for cervical cancer and who would not be ...
A 33-year old woman with nitroimidazole-resistant vaginal trichomoniasis is described. She was treated with intravaginal paromomycin (500mg daily for 2 days). This cured the trichomoniasis but resulted in severe local side effects. Paromomycin may be useful for difficult cases of nitroimidazole-resistant Trichomonas vaginalis vaginitis. The exact dosage still has to be determined.
The ratio of vaginal hysterectomy to abdominal hysterectomy in the UK is 1:3. It is well known that patients who have had a vaginal hysterectomy recover better compared with abdominal hysterectomy. However, abdominal hysterectomy is the preferred method in most hospitals because it is deemed easier to do. With ERBE Biclamp diathermy forceps, vaginal hysterectomy could be safely and easily performed by gynaecologists. This study showed a different surgical technique for performing vaginal hysterectomy. It allowed easier and safer operations in patients with large uterus, fibroid uterus, where there was no uterine descent and narrow introitus. Also it allowed the adnexal appendages to be removed easily by the vaginal route. We compared 100 patients who had a vaginal hysterectomy performed using this method, with patients who had a vaginal hysterectomy performed by the conventional method using sutures. We found that we could safely perform vaginal hysterectomy with greater ease. Also, the need for postoperative analgesia was less and the patients were discharged earlier. Consequently, the patients' convalescence period was shorter and better. PMID:17999303
We describe the case of a 27-year-old woman with a three-month history of persistent green vaginal discharge following vaginal delivery of her first child. Group C ?-haemolytic streptococcus was ultimately isolated, which appears to be an uncommon cause of this clinical presentation. PMID:23970614
Intramuscular methotrexate followed by vaginal misoprostol has been shown to be effective for abortion at ?49 days gestation. Oral dosing of the methotrexate may offer advantages over parenteral dosing. This pilot study was performed to evaluate if oral methotrexate would be effective when combined with vaginal misoprostol to effect abortion at ?49 days gestation. Twenty pregnant women were randomized to
Objective: To compare vaginal versus oral misoprostol for induction of labor. Method: Induction of labor was carried out in 40 women near term in two equal and randomized groups (according to a computer generated table) using misoprostol. Group I received vaginal misoprostol (100 ?g) every 3 h while group II patients were given the same dose via the oral route.
M. K. Toppozada; M. Y. M. Anwar; H. A. Hassan; W. S. El-Gazaerly
Mesh erosion is one of the major complications of prolapse surgery conducted by transvaginal approach. Following the extensive use of meshes and warning about potential complications, a new classification of mesh-related adverse events has been proposed. Due to the wide scope of clinical features, no standardized approach has been proposed. Surgery is required after failure of conservative management, mostly based on mesh partial or total excision by transvaginal route, following the classic rules of re-do vaginal surgery. Complex cases are best managed in tertiary reference centers. PMID:23873511
Cornu, Jean-Nicolas; Peyrat, Laurence; Haab, François
This is a case study presented by the University of Pittsburgh Department of Pathology in which an elderly woman experienced bloody vaginal discharge long after menopause. Visitors are given both the microscopic pap smear and biopsy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.
Dickson, H.; Mahood, L.; Manlucu, E. D.; Nath, Manju E.
Throughout the years 1978-1998, 13 patients, 9 months to 16 years of age, were treated for vaginal malignancy at the Medical City Hospital, Baghdad, Iraq. The majority were found to have an embryonal sarcoma, an endodermal sinus tumour or a clear cell adenocarcinoma. Most were treated by genital resection combined with triple cytotoxic therapy. We have eight survivors for more than 3 years following surgery. This study also illustrates the potential curability of these tumours with preservation of urinary function. PMID:15512636
Nonoxynol-9 (N-9) is a typical surfactant. For more than 30 years that very property of N-9 has been successfully exploited for its spermicidal action. It is available as an over-the-counter, locally acting vaginal spermicide. The suitability of N-9 as a spermicide is elaborated in this article. The reasons why N-9 may fail as a contraceptive are discussed. In spite of many drawbacks, which are mentioned in the article, N-9 is still often resorted to as a locally acting contraceptive. The review ends with suggestions to alter the molecular structure of N-9 and to adjust the dosages. PMID:19117251
Malignant neoplasms in lateral cervical cysts and fistulae have been frequently described in the literature. In the following case, a tumor is reported which was found in the unusual localization of a preauricular fistula. The histologic diagnosis was basal cell carcinoma. In this 41-year-old male patient the tumor led to local recurrent inflammatory symptoms. Therapy consisted first of excision of the fistula. After final diagnosis was made, total parotidectomy and an additional excision of the skin were carried out. PMID:651483
Intestinal fistulae formation in the open abdomen is a rare, but devastating and complex complication for patients. Often, there will be no spontaneous healing or closure of the fistulae. Effective wound care is essential to contain fistulae effluent, protect surrounding tissue and skin, and promote granulation, and patient comfort and mobility. Management options include the use of wound management pouches and negative pressure wound therapy. Effective wound care needs to be underpinned by adequate nutrition, and fluid and electrolyte management. Despite the challenges involved in providing effective care for these patients, this aspect of nursing practice can be extremely rewarding. PMID:24547863
The arteriovenous fistula (AVF) failure is a major cause of morbidity in the hemodialysis population. Most AVFs fail due to neointimal hyperplasia (NIH). In this issue, Yang et al. delineated a mechanism responsible for transforming the fistula adventitia into a fertile soil for neointimal precursors. These authors pondered the role of hypoxia-regulated hypoxia-inducible factor-1 (HIF-1?), vascular endothelial growth factor A (VEGF-A), and matrix metalloproteinases (MMPs) in the activation of those adventitial myofibroblasts that may significantly contribute to the formation of the fistula neointima. PMID:24487362
Seventy-two cases of palatal fistulae are presented. The location on anterior part of secondary palate is due to lack of double layer closure. Vascular pattern of tongue is detailed. Operative details of using tongue flap as oral layer in closure of fistula are described. Undue mobility of tongue and prevention of breakdown of tongue flap repair incidence of which is low in present series are mentioned. It is suggested as excellent method of closure of palatal fistulae in difficult cases. PMID:1279921
The Kidney Dialysis Outcomes Quality Initiative and Fistula First Initiative have embraced the arteriovenous fistula as the gold standard for hemodialysis accesses. Despite this status, fistulae are fraught with complex issues ranging from a high primary failure rate to high flow resulting in increased cardiovascular morbidity. It is important not to overlook the insidious peril of a hyperfunctioning access that may actively promote cardiac overload, cardiopulmonary recirculation, rapid access growth with aneurysm enlargement, recurrent venous stenosis resulting in access failure, and inflow/outflow mismatch. Once recognized, flow can and should be reduced to mitigate these and other negative effects. PMID:23217334
Summary Endovascular procedures are commonly used for treatment of vascular pathologies. These interventions are routinely performed under angiographic control. Angioplasty is increasingly more often used for correction of dialysis fistula – especially dilatation of stenosis. We describe the technique of dialysis fistula angioplasty under ultrasound control. Benefits of this procedure include lack of nephrotoxic contrast, what is especially important in chronic kidney disease patients in pre-dialysis period. Advantages of ultrasound guidance during dialysis fistula angioplasty lead to cause more and more frequent employment of this technique.
Bojakowski, Krzysztof; Gora, Rafal; Szewczyk, Dariusz; Andziak, Piotr
We describe three surgical methods used to repair salivary fistulas in different situations that are seen after reconstruction of the pharyngoesophagus in patients with hypopharyngeal cancer. The principle of these methods is the same; a cervical skin flap next to the fistula is used as the internal lining and an anterior chest skin flap is rotated as an external lining to cover it. For the primary closure of heavily irradiated fistulas, this combination may not always be effective, and we emphasize that a combined use of a pedicled pectoralis major muscle flap with these two kinds of pedicled skin flap is extremely reliable.
A gastrocolocutaneous fistula after placement of a percutaneous endoscopic gastrostomy (PEG) tube is a rare complication. This fistula is defined as an epithelial connection between the mucosa of the stomach, colon, and skin. We present an interesting case in which a PEG tube was placed inadvertently through the colon. During a subsequent fever workup, an abdominal computed tomography scan suggested that the feeding tube had traversed the colon. Gastrograffin enema and colonoscopy confirmed the location of the misplaced feeding tube. We review the clinical presentation, diagnosis, errors in procedural technique, and treatment of gastrocolocutaneous fistulas. PMID:11928047
Conduit failure and conduit airway fistula are rare complications after esophagectomy, however they can be catastrophic resulting in high mortality. Survivors can expect a prolonged hospital course with multiple interventions and an extended period of time prior to being able to resume oral nutrition. High index of suspicion can aid in early diagnosis. Conduit failure usually requires a period of proximal esophageal diversion and staged reconstruction. Conduit airway fistulas may be amenable to endoscopic repair but this has a high failure rate and many patients will require surgical repair with closure of the fistula and interposition of vascularized tissue to minimize recurrence.
PURPOSE: The aim of this study was to evaluate the results\\u000aconcerning recurrence and continence after sphincter-saving\\u000asurgery for fistula-in-ano. METHODS: Forty-two patients\\u000awith anal fistula traversing the sphincter were operated on\\u000awith fistula excision and closure of the internal opening.\\u000aPatients answered a questionnaire concerning bowel habits\\u000aand continence before and 3 and 12 months after surgery. A\\u000asubgroup
The aim of this study was to evaluate medical and economic justification of vaginal smears as a part of primary screening for cervical carcinoma and its precursors. Study included 245.048 participants whose VCE (vaginal, cervical, endocervical) smears were examined at Department of clinical cytology of University Hospital Center Osijek from 2003 till 2008. There were 12.639 (5.2%) abnormal findings, and they were divided into three groups: abnormal cells found only in vaginal smear (V), abnormal cells found in vaginal and in at least one other smear (V+) and abnormal cells not found in vaginal smear (C/E). These three groups were analysed in respect to cytological differential diagnosis and age of participants. It was estimated how many women could be additionally included in the screening, if vaginal smear would be included in the Pap test only after 50 years of age. In 6.9% of cytologically diagnosed lesions abnormal cells were found exclusively in vaginal smears (0.35% of all findings). As for squamous cell lesions, 91.2% were mild lesions (ASC and LSIL). Invasive squamous cell carcinoma was not diagnosed exclusively by vaginal smear in either woman under 50 years of age, while in women over 50 years of age it was diagnosed in 2.3% of cases. Exclusively by vaginal smear was diagnosed 3.9% of all AGC and 6.3% of adenocarcinoma, while in 85.0% of glandular epithelium lesions abnormal cells were not found in vaginal smears. Two thirds of adenocarcinoma diagnosed exclusively by vaginal smears were endometrial adenocarcinoma, but that is only 10.3% of all endometrial carcinoma diagnosed by Pap test. Obtained results show that taking of vaginal smears along with cervical and endocervical smears as a part of primary screening for cervical carcinoma and its precursors in women under 50 years of age is not justifiable, since vaginal smear only has a role in detection of endometrial carcinoma that are extremely rare in younger age groups. If vaginal smear would be taken only in women over 50 years of age, additional 37.7% of women under 50, or 25.1% women over 50 years of age could be included in the screening. PMID:20437636
Vaginal practices are a variety of behavioral techniques that women use to manage their sexual life and personal hygiene. Women perceive vaginal practices as a beneficial practice. However, vaginal cleansing has been identified as one of the main risk factors for bacterial vaginosis and is potentially implicated in Human Immune Deficiency Virus (HIV) and sexually transmitted infection transmission. This study examined the prevalence of vaginal practices and the types of practices used among a sample of HIV positive women living in Lusaka, Zambia. Over 90% of all women recruited engaged in vaginal practices. Certain practices, such as use of water or soap, were more frequently used for hygiene reasons. Herbs and traditional medicines were mainly used to please sexual partner. Strategies to decrease VP appear urgently needed in the Zambian community. PMID:22041932
Alcaide, Maria L; Mumbi, Miriam; Chitalu, Ndashi; Jones, Deborah
Vaginal reconstruction can be challenging when there is a paucity of tissue, as the ideal donor source has yet to be determined. Many of the existing and commonly used techniques, such as vaginal replacement with skin grafts or bowel segments, have both advantages and disadvantages. A novel technique for vaginal replacement and reconstruction is with autologous buccal mucosa, an epithelium which is an excellent tissue match to the vagina. As urologists often have extensive experience with the use of oral mucosa for urethral reconstruction, it is fitting to apply these techniques to procedures where native vaginal tissue is lacking. This review presents the existing literature as well as the author's own experience with the use of autologous buccal mucosa for a variety of vaginal reconstructive procedures. PMID:24948036
The results of the Women’s Health Initiative (WHI) led to a distinct decline in the routine use of estrogen as preventive therapy for vasomotor symptoms, osteoporosis, and cardiovascular disease in postmenopausal women. Without estrogen replacement, one third of women experience symptoms of atrophic vaginitis including dryness, irritation, itching and or dyspareunia. Local application of estrogen has been shown to relieve these symptoms and improve quality of life for these women. In addition, local estrogen therapy may have a favorable effect on sexuality, urinary tract infections, vaginal surgery, and incontinence. This review examines the effects of vaginally applied estrogen on the vaginal epithelium, urethra and endometrium. An accompanying review examines the systemic effects of vaginally applied estrogen.
Krause, Megan; Wheeler, Thomas L.; Snyder, Thomas E.; Richter, Holly E.
Objective To estimate whether tampon users are more likely to select the contraceptive vaginal ring than combined oral contraceptive pills (OCPs). Methods The Contraceptive Choice Project is a longitudinal study of 10,000 St. Louis-area women promoting the use of long-acting, reversible methods of contraception and evaluating user continuation and satisfaction for all reversible methods. We performed univariable and multivariable analyses of the 311 women who were asked about tampon use at the time of enrollment and who chose the contraceptive vaginal ring or OCPs to assess the association of tampon use and choice of combined hormonal method. Results Among contraceptive vaginal ring and OCP users, 247 (79%) reported using tampons. Contraceptive vaginal ring users were not significantly different than OCP users in terms of age, race or ethnicity, marital status, insurance, BMI, and parity. Adjusted analysis indicates tampon users were more likely to choose the contraceptive vaginal ring instead of OCPs (adjusted RR=1.34; 95%CI: 1.01–1.78). Women with previous contraceptive vaginal ring experience were also more likely to choose the contraceptive vaginal ring (adjusted RR=1.96; 95%CI: 1.6–2.4). Recent OCP use did not influence method choice. Conclusion In our baseline analysis of the Contraceptive Choice Project, tampon users were more likely to choose the contraceptive vaginal ring than OCPs. Use of tampons could be considered an indicator for the initial acceptability of the contraceptive vaginal ring, but all women should be offered the contraceptive vaginal ring regardless of experience with tampon use.
OBJECTIVE: To evaluate knowledge of vaginal atrophy among postmenopausal women (aged 55-65 years), using the Vaginal Health: Insights, Views & Attitudes (VIVA) survey. METHODS: An independent research organization conducted a quantitative Internet-based survey, to obtain information from 3520 women who were living in the UK, the USA, Canada, Sweden, Denmark, Finland or Norway. Findings from Canada are presented (n = 500). RESULTS: Almost half of Canadian respondents had experienced vaginal discomfort since they had stopped menstruating, most commonly (88%) vaginal dryness; over half (56%) reported having experienced symptoms for three years or longer. Seven percent would have attributed vaginal symptoms to vaginal atrophy. Eighty-two percent of women felt that vaginal discomfort would have a negative impact on various aspects of their lives, most notably sexual intimacy (72%), 'having a loving relationship with a partner' (39%) and 'overall quality of life' (30%). While the majority of women (66%) who had experienced vaginal atrophy eventually sought the assistance of a health-care professional, a considerable proportion (34%) did not. Most women (58%) had tried lubricating gels and creams to treat their symptoms, but many were less aware of specific means of treating the underlying cause. However, compared with systemic hormone replacement therapy, more women indicated that they would consider local estrogen therapy (e.g. vaginal tablets or creams). CONCLUSIONS: These data indicate that many postmenopausal women in Canada have a low understanding of vaginal atrophy. Medical practitioners should proactively initiate dialogue about this chronic condition with their patients, and discuss appropriate treatment options. PMID:23201626
Frank, Sheldon M; Ziegler, Cleve; Kokot-Kierepa, Marta; Maamari, Ricardo; Nappi, Rossella E
Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar?4. Twenty-nine in the planned vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p?0.001) were transferred to the neonatal intensive care unit. However, only one infant was admitted for ?4 days. According to follow-up data (median six years) none of these infants had long-term sequelae. Regarding maternal morbidity, blood loss was the only variable that was significantly higher in the planned cesarean section group versus in the vaginal delivery group (p?0.001). Conclusions Strict guidelines were followed in all cases. There were no neonatal deaths. Two infants had serious neonatal morbidity in the planned vaginal group without long-term sequelae.
Oophorectomized, estrogen-treated rats were susceptible to experimental vaginal infection by Candida albicans. After spontaneous clearing of the primary infection, the animals were highly resistant to a second vaginal challenge with the fungus. The vaginal fluid of Candida-resistant rats contained antibodies directed against mannan constituents and secretory aspartyl proteinase(s) of C. albicans and was capable of transferring a degree of anti-Candida protection to naive, nonimmunized rats. This passive protection was mediated by the immunoglobulin fraction of the vaginal fluid and was substantially abolished by preabsorption of the vaginal fluid with C. albicans, but not with Saccharomyces cerevisiae, cells. Vaginal anti-mannan antibodies were also produced by active immunization with heat-killed cells of C. albicans or with a mannan extract when administered via the vaginal route. The protection conferred was comparable to that resulting from clearing of the primary infection. In summary, the data suggest that acquired anticandidal protection in this vaginitis model is mediated at least in part by antibodies, among which those directed against the mannan antigen(s) might play a dominant role.
Cassone, A; Boccanera, M; Adriani, D; Santoni, G; De Bernardis, F
Background Bacterial vaginosis (BV) – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS) in The Gambia, West Africa. Methods We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for T vaginalis and vaginal flora microscopy, and for Lactobacillus spp, aerobic organisms, Candida spp and BV-associated bacteria (Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma spp) cultures; and cervical swabs were collected for N gonorrhoeae culture and C trachomatis PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire. Results BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. Lactobacillus spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H202)-producing strains. Prevalence of BV-associated bacteria were: G vaginalis 44.4%; Bacteroides 16.7%; Prevotella 15.2%; Peptostretococcus 1.5%; Mobiluncus 0%; other anaerobes 3.1%; and Mycoplasma hominis 21.4%. BV was positively associated with isolation of G vaginalis (odds-ratio [OR] 19.42, 95%CI 7.91 – 47.6) and anaerobes (P = 0.001 [OR] could not be calculated), but not with M hominis. BV was negatively associated with presence of Lactobacillus (OR 0.07, 95%CI 0.03 – 0.15), and H2O2-producing lactobacilli (OR 0.12, 95% CI 0.05 – 0.28). Presence of H2O2-producing lactobacilli was associated with significantly lower prevalence of G vaginalis, anaerobes and C trachomatis. HIV prevalence was 12.8%. Overall, there was no association between BV and HIV, and among micro-organisms associated with BV, only Bacteroides spp. and Prevotella spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting). Conclusion In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics.
Demba, Edward; Morison, Linda; van der Loeff, Maarten Schim; Awasana, Akum A; Gooding, Euphemia; Bailey, Robin; Mayaud, Philippe; West, Beryl
Pelvic organ prolapse is a common problem in women that increases with age and adversely affects quality of life and sexual function. If conservative treatments fail, surgery becomes the main option for symptom abatement. For uterovaginal prolapse, treatment with or without hysterectomy can be offered, and operations must include a specific apical support procedure to be effective. Operations for apical prolapse include transvaginal, open, and laparoscopic or robotic options; few clinical trials have compared the effectiveness and risk of these various surgeries. Grafts can be used selectively for apical suspensions and may improve cure rates but also increase risk of some complications. Slings should be added selectively to reduce postoperative stress incontinence. For women interested in future sexual activity who require apical prolapse surgery, we suggest using transvaginal apical repairs for older patients, those with primary or less severe prolapse, and those at increased surgical risk. We recommend sacral colpopexy with polypropylene mesh (preferably by minimally invasive route) in younger women, those with more severe prolapse or recurrences after vaginal surgery, and women with prolapsed, short vaginas. In older women with severe prolapse who are not interested in sexual activity, obliterative operations are very effective and have high satisfaction rates. An interactive consent process is mandatory, because many decisions-about route of surgery; use of hysterectomy, slings, and grafts; and vaginal capacity for sexual intercourse-require an informed patient's input. Selective referral to specialists in Female Pelvic medicine and Reconstructive Surgery can be considered for complex and recurrent cases. PMID:23344287
In the past 15 years five neonates and children have been treated for high vaginal atresia at the Surgical Unit of Department of Pediatrics, University Medical School, Pécs, Hungary. In three of the six patients distal atresia of the vagina was found (Type III). Two of the three were neonates and had a large hydrometrocolpos and the third, a 13-year-old girl, hematometrocolpos. In the fourth patient the vaginal atresia was associated with cloacal and anorectal malformation (Type V). In the fifth there was a duplication of uterus and vagina; however, only one of the two vaginas was atretic. In three patients a pull-through of the vagina was carried out, in one of them according to Pena, in another a transvesical approach, as suggested by Monfort, was used. Following repeated surgeries in the patient with cloacal malformation the vagina was replaced with large intestine. In the case of duplication of vagina and uterus one half of the duplication was removed. PMID:8464627
This publication describes a redesigned esophageal fistula plug and an esophageal cannula. These closure devices set forth state-of-the-art structural design, are more rugged, require minimal time to construct, and are relatively light when compared with ...
D. M. Anderson D. L. Mertz W. E. Franklin P. J. Manz
Carotid cavernous sinus fistulas are abnormal communications between the carotid system and the cavernous sinus. Several classification schemes have described carotid cavernous sinus fistulas according to etiology, hemodynamic features, or the angiographic arterial architecture. Increased pressure within the cavernous sinus appears to be the main factor in pathophysiology. The clinical features are related to size, exact location, and duration of the fistula, adequacy and route of venous drainage and the presence of arterial/venous collaterals. Noninvasive imaging (computed tomography, magnetic resonance, computed tomography angiography, magnetic resonance angiography, Doppler) is often used in the initial work-up of a possible carotid cavernous sinus fistulas. Cerebral angiography is the gold standard for the definitive diagnosis, classification, and planning of treatment for these lesions. The endovascular approach has evolved as the mainstay therapy for definitive treatment in situations including clinical emergencies. Conservative treatment, surgery and radiosurgery constitute other management options for these lesions.
For treatment of two consecutively opened into abdominal cavity perforating fistulas of small bowel in conditions of purulent peritonitis the author successfully used funnel-shaped obturators by Kolchenogov. In the same patients in later adhesive intestinal obstruction, which could not be eliminated by common surgical mode, continuous introduction of semifluid food and intestinal chyme collected from enterostoma (located above the obstruction) were carried out through enterostoma located above the obstruction. After resorption of inflammatory infiltrate bowel continuity was restored. Based on favourable results of treatment for perforation fistulas opening into free abdominal cavity, the author more than once in conditions of purulent peritonitis successfully applied sutureless suspending enterostomies on the catheter of Petzer, which principally is an analogue of the obturator by Kolchenogov, using the same method as in perforation fistulas. Inflamed bowel wall thus is well accreted with abdominal wall, and after withdrawal of catheter by Petzer the developed tubular bowel fistula is rapidly healing spontaneously. PMID:9825626
Acute suppurative thyroiditis is a rare disease because the thyroid gland is remarkably resistant to infection. We present a 2-year-old girl with refractory acute suppurative thyroiditis due to a pyriform sinus fistula (PSF). She complained of fever and painful anterior neck swelling. Her condition did not completely improved by multiple parenteral antibiotics along with incision and drainage. Barium esophagogram to detect PSF demonstrated no specific finding. Computed tomography scan showed air bubble superior to the left thyroid gland which indicated a possible fistula connected to the pyriform sinus. An intraoperative laryngoscopy revealed a 2-mm-sized fistula opening. The fistula was successfully treated by chemocauterization with trichloroacetic acid. PMID:25077095
Seo, Jee Hyue; Park, Yong Hoon; Yang, Sei Won; Kim, Hyun Young
Background:Although the transposed basilic vein arteriovenous fistula (TBAVF) is increasingly performed for hemodialysis vascular access in patients lacking adequate superficial veins, little is known about the long-term patency or risk factors for failure.
Jonathan H. Segal; Liise K. Kayler; Peter Henke; Robert M. Merion; Sean Leavey; Darrell A. Campbell
Necrotizing fasciitis (NF) is an uncommon, rapidly progressive, and potentially fatal infection of the superficial fascia and subcutaneous tissue. NF caused by an enterocutaneous fistula has special clinical characters compared with other types of NF. NF caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple germs infection and corrosion by digestive juices. We treated three cases of NF caused by postoperative enterocutaneous fistula since Jan 2007. We followed empirically the principle of eliminating anaerobic conditions of infection, bypassing or draining digestive juice from the fistula and changing dressings with moist exposed burn therapy impregnated with zinc/silver acetate. These three cases were eventually cured by debridement, antibiotics and wound management.
Gu, Guo-Li; Wang, Lin; Wei, Xue-Ming; Li, Ming; Zhang, Jie
There is little consensus on the optimal management of postparotidectomy salivary fistulas. Timely treatment is important since fistulas may result in wound dehiscence and infection. Management options include pressure dressings, total parotidectomy, tympanic neurectomy, graft interpositioning, surgical closure of the tract, radiation therapy, and pharmacotherapy. Unfortunately, many therapies require weeks to months for resolution and possess additional risks. The affected patient often suffers social embarrassment from the drainage. Through our work with neurologically impaired children with sialorrhea, we have had success with using glycopyrrolate, an anticholinergic frequently used to decrease salivary secretions. We present a case of a patient with a postparotidectomy fistula which was successfully treated with glycopyrrolate and pressure dressings. The rationale and potential use of glycopyrrolate for the treatment of a salivary fistula are the focus of this presentation. PMID:10321782
We present a patient with tracheoesophageal fistula as the initial manifestation of Hodgkin's disease with oesophageal involvement. To our knowledge, this has not been previously reported. The diagnosis of Hodgkin's lymphoma was made at autopsy. Images Figure 1
Alba, D.; Lobato, S. D.; Alvarez-Sala, R.; Villasante, C.; Echevarria, C.
We present a rare case of a symptomatic acquired large coronary fistula and aneurysm secondary to chest trauma that was successfully closed using stent graft. This case is followed by review of the literature. PMID:22891139
Safi, Morteza; Ebrahim, Nematollah Pour; Namazi, Mohammad Hasan; Saadat, Habibollah; Vakili, Hosein; Hekmat, Manuchehr; Movahed, Mohammad Reza
We present a rare case of a symptomatic acquired large coronary fistula and aneurysm secondary to chest trauma that was successfully closed using stent graft. This case is followed by review of the literature.
For the closure of oroantral fistula, many techniques have been described. There are advantages and disadvantages of all these techniques. We present a technique in which nasoseptal cartilage graft is used for the closure of the oroantral communication. PMID:20644947
Rectovaginal fistula and imperforate anus were diagnosed and surgically corrected in a young toy Poodle. Radiology, surgical repair, and clinical course will be presented. Complications included occasional liquid incontinence, constipation, and anal gland...
We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.
Barley, Fay L.; Kessel, David, E-mail: [email protected]; Nicholson, Tony [St. James University Hospital, Department of Radiology (United Kingdom); Robertson, Iain [Gartnaval Hospital, Department of Radiology (United Kingdom)
Saccular coronary artery aneurysm, associated with coronary artery fistula, is a very rare condition. A 48-year-old woman was referred to our hospital for the evaluation of an abnormal shadow on the left cardiac border from a chest X-ray film during regular medical health examination. A huge saccular aneurysm with organized thrombi in the proximal left anterior descending artery (LAD) and coronary artery fistulae from LAD and conus branch of the right coronary artery to pulmonary artery was diagnosed by transthoracic echocardiography, multi-detector computer tomography (MDCT), and coronary angiography. The patient received surgical treatment, including thrombectomy of aneurysm, ligation of the inlet and outlet of aneurysmal sac, coronary artery bypass graft (left internal mammary artery-to-distal LAD), and ligation of fistulae. The postoperative course was uneventful, and postoperative echocardiography and MDCT revealed patent bypass graft; however, a small fistula from proximal LAD across aneurysmal sac to pulmonary artery was observed.
Jeong, Eun Haeng; Bang, Ki Bae; So, Min Suk; Sung, Ki Chul; Kim, Jung Tae; Kong, Joon Hyuk; Kim, Tae Ho
Necrotizing fasciitis (NF) is an uncommon, rapidly progressive, and potentially fatal infection of the superficial fascia and subcutaneous tissue. NF caused by an enterocutaneous fistula has special clinical characters compared with other types of NF. NF caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple germs infection and corrosion by digestive juices. We treated three cases of NF caused by postoperative enterocutaneous fistula since Jan 2007. We followed empirically the principle of eliminating anaerobic conditions of infection, bypassing or draining digestive juice from the fistula and changing dressings with moist exposed burn therapy impregnated with zinc/silver acetate. These three cases were eventually cured by debridement, antibiotics and wound management. PMID:24976737
Gu, Guo-Li; Wang, Lin; Wei, Xue-Ming; Li, Ming; Zhang, Jie
Background: The study was carried out to discuss the pathogenesis and management protocol of seven different varieties of female uro-genital fistulas (FUGFs). Patients and Methods: During 2000–2007, total of 15 FUGFs were operated, which belonged to seven different varieties requiring different routes and surgical procedures for their repair. Different fistulas with different pathophysiological factors required specific examinations and investigations preoperatively. Results: The results of the repaired FUGFs, following the general surgical principles, were acceptable with formation of only one residual fistula. Conclusions: Successful correction of FUGFs is a surgical challenge. Detailed history, through examination and planning, atraumatic tissue handling, routine use of the interposition or onlay reinforcement flaps and vigilant postoperative care were found the key factors in successful outcome of the repaired fistulas.
Singh, R. B.; Dalal, Satish; Nanda, S.; Pavithran, N. M.
Damaged mucosal sites seem to be vulnerable to tumor cell implantation. We describe a case of exfoliated tumor cells from a sigmoid colon cancer seeding a long-standing anal fistula. The implications of this finding are reviewed.
Background Fistulas are abnormal communications between two epithelial surfaces, either between two portions of the intestine, between\\u000a the intestine and some other hollow viscus, or between the intestine and the skin of the abdominal wall. The etiology of intestinal\\u000a fistulas is in most cases a result of multiple contributing factors. Despite significant advances in their management over\\u000a the past decades, intestinal
Colonic fistulas in an open wound are always a challenge for colorectal surgeons, and this report provides a technique for the appropriate management of these cases. We communicate the use of a negative pressure dressing therapy as part of the palliative care for a patient following the development of an enterocutaneous fistula. The use of this therapy allowed us to keep the patient clean and comfortable during the last few days of his life. PMID:22928992
Ruiz-Lopez, Manuel; Titos, Alberto; Gonzalez-Poveda, Ivan; Carrasco, Joaquin; Toval, Jose Antonio; Mera, Santiago; Santoyo, Julio
Augmentation enterocystoplasty has been extensively used to attain high-capacity low-pressure urinary reservoirs in patients with neuropathic bladder, exstrophy-epispadias complex, valve bladder syndrome, and contracted bladder. Enterovesical fistula might occur as an early complication after enterocystoplasty. We report the case of a 16-year-old boy, who presented with chronic watery diarrhea 7 years after augmentation ileocystoplasty. A colovesical fistula was diagnosed. We discuss the clinical presentation, management plan, and operative findings. PMID:23830082
A 60-year-old man with esophageal carcinoma in the upper 3rd underwent palliative treatment including photodynamic therapy, brachytherapy, external beam irradiation, and esophageal stenting. He developed a symptomatic malignant esophagotracheo-bronchial fistula that could not be closed by telescope-stenting in the esophagus. Implantation of a self-expanding, covered metal, tracheal bifurcation stent by flexible bronchoscopy resulted in immediate closure of the fistula with an uneventful recovery. PMID:19515888
Hepatoprotective activity of the n-heptane extract of Cassia fistula leaves was investigated in rats by inducing hepatotoxicity with carbon tetrachloride:liquid paraffin (1:1). The extract has been shown to possess significant protective effect by lowering the serum levels of transminases (SGOT and SGPT), bilirubin and alkaline phosphatase (ALP). The extract of C. fistula at a dose of 400 mg/kg showed significant hepatoprotective activity which was comparable to that of a standard hepatoprotective agent. PMID:10473173
Bhakta, T; Mukherjee, P K; Mukherjee, K; Banerjee, S; Mandal, S C; Maity, T K; Pal, M; Saha, B P
PURPOSE: Although anorectal disease is common in human immunodeficiency virus-positive patients, little is known about the type and anatomic distribution of anal fistulas in this patient group. The aim of this study was to compare anatomic characteristics of anal fistulas in human immunodeficiency virus-positive patients with those in human immunodeficiency virus-negative patients by use of a retrospective chart review. METHODS:
Carlo M. Manookian; Thomas P. Sokol; Charles Headrick; Phillip R. Fleshner
Predictors of adequacy of arteriovenous fistulas in hemodialysis patients.BackgroundDialysis access procedures and complications represent a major cause of morbidity, hospitalization, and cost for chronic dialysis patients. To improve the outcomes of hemodialysis access procedures, recent clinical guidelines have encouraged attempts to place an arteriovenous (A-V) fistula, rather than an A-V graft, whenever possible in hemodialysis patients. There is little information,
Paul E. Miller; Ashita Tolwani; C. Peter Luscy; Mark H. Deierhoi; Robert Bailey; David T. Redden; Michael Allon
Upper pouch tracheoesophageal fistula occurs is less than 1% of all oesophageal atresia variants. Meconium peritonitis is a rare neonatal condition with an incidence of 1:30 000 live births. In this case report, we describe the presentation, clinical findings and management of a patient diagnosed with an oesophageal atresia with upper pouch fistula as well as meconium peritonitis. To the best of our knowledge, this is the first case such as this described in published literature. PMID:22878767
Theron, Andre; Loveland, Jerome; Naidoo, Jaishree; Theron, Anne
. Pancreatic fistula is a major form of morbidity following pancreatic resection. We conducted a nonrandomized clinical\\u000a trial comparing the sealing and sandwich techniques of spraying fibrin glue to prevent pancreatic fistula following distal\\u000a pancreatectomy. The pancreas was transected with a scalpel to identify and suture the main pancreatic duct and its small branches.\\u000a In the sealing group, fibrin glue
In a five year period 227 patients with anal abscesses and\\/or fistulas of suspected cryptoglandular origin were observed and treated by one surgeon. In 201 patients the primary opening or the crypt of origin of the abscesses and\\/or fistulas were identified. These lesions were evaluated according to two classifications [1, 2]. The aim was to verify whether primary abscesses and\\/or
Summary Six hundred thirty-one cases of perianal abscess, fistula and sinus were reviewed to determine the pathogenesis and cause.\\u000a Of 19 patients in whom the supralevator space had been involved, seven apparently arose from primary anal disease. In 12 cases\\u000a the fistula resulted from rare or unusual local or general conditions. Study of these cases proved the following:\\u000a \\u000a Involvement of the
PURPOSE: This study was designed to evaluate the effectiveness of hydrogen peroxide-enhanced, endoanal ultrasound in the assessment of fistula-in-ano and compare ultrasonographic results with the surgical outcome. METHODS: A total of 80 patients with anal fistula were studied prospectively by physical examination and endoanal ultrasound enhanced with hydrogen peroxide. We used standarized ultrasonography and operation notes. The results of these
Alberto Navarro-Luna; Josep Rius-Macías; Constancio Marco-Molina
Multiple SDAVFs are quite rare. We present two cases with double synchronous shunts and both were treated during one-stage interventional or surgical procedure. Unique images of the multiple SDAVFs as a PMAVF-like fistula were obtained. These interesting findings suggest the presence of multiple fistulas must be considered in patients being evaluated for SDAVF. A multidisciplinary approach to the management of multiple SDAVFs should depend on the anatomic location and angioarchitecture. | <urn:uuid:2b80f2f6-e332-437f-bf43-18ebb30ce39a> | CC-MAIN-2014-49 | http://www.science.gov/topicpages/v/vesico+vaginal+fistula.html | s3://commoncrawl/crawl-data/CC-MAIN-2014-49/segments/1416400372634.37/warc/CC-MAIN-20141119123252-00104-ip-10-235-23-156.ec2.internal.warc.gz | en | 0.927026 | 83,628 | 2.75 | 3 |
I have a ten year old ficus tree indoors that is oozing and dripping a sticky substance on my floors. I suspect that it is caused by some sort of insect or parasite. It looks like it is very healthy and still putting out new leaves but the sticky stuff is quite a nuisance. Some leaves have small dark scale type things on them. If this is the cause is there anything I can do to rid my plant of them. I've tried spraying with insecticidal soap and removing what I see with rubbing alcohol . Maybe something systemic would work better?
Your ficus tree could have scale, just like the azaleas in the previous question, but ficus trees are also notorious for a process called guttation—where they basically sweat—they have built up too much moisture in their leaves and it has to come out somewhere. It typically occurs when there has been a major change in the plants environment-often when they are moved back indoors in the fall. They ooze excess moisture typically out of the leaf where it is attached on the stem. It is very sticky and it can stain, just like the honeydew that comes from sucking insects. If you determine that insects or scale is the culprit, there is systemic houseplant insecticide that comes in a pellet form of imidacloprid. You put the pellet into the soil and it slowly releases the insecticide and fertilizer into the soil to be absorbed by the root system. They are safe to use indoors.
I always repot my plants in the fall to bring around 4 in my house. I repot because my brother brought 11 baby copperheads in the house one fall. Anyway, I always get gnats, several hundreds of them come out of my plants so therefore I have to move them to the garage and cannot enjoy my plants in winter. Do you know what I can do to avoid the gnats? I always buy good soil.
Wow! And I thought the snake story was an urban legend! If you have gnats every year, I would say you are overwatering. Fungus gnats multiply more rapidly in moist soils. Especially during the cooler, winter months, houseplants would benefit from being on the dry side—usually no more than once every two weeks for most plants. Timing of course will vary by plant, plant and container size and how hot you keep your house. Top-dressing the soil with sand, using a mild insecticidal soap drench when you move them inside can also help.
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The mention of any commercial product in this web site does not imply its endorsement by the University of Arkansas Division of Agriculture over other products not named, nor does the omission imply that they are not satisfactory. | <urn:uuid:f6892343-9018-48c7-8e64-14e83e8d936e> | CC-MAIN-2023-06 | https://www.uaex.uada.edu/yard-garden/in-the-garden/reference-desk/houseplants/insects.aspx | s3://commoncrawl/crawl-data/CC-MAIN-2023-06/segments/1674764500151.93/warc/CC-MAIN-20230204173912-20230204203912-00485.warc.gz | en | 0.964768 | 684 | 2.75 | 3 |
October 28, 2012 - By Krista Conger
Amyotrophic lateral sclerosis, also called Lou Gehrig’s disease, is a devastatingly cruel neurodegenerative disorder that robs sufferers of the ability to move, speak and, finally, breathe. Now researchers at the Stanford University School of Medicine and San Francisco’s Gladstone Institutes have used baker’s yeast — a tiny, one-celled organism — to identify a chink in the armor of the currently incurable disease that may eventually lead to new therapies for human patients.
“Even though yeast and humans are separated by a billion years of evolution, we were able to use the power of yeast genetics to identify an unexpected potential drug target for ALS,” said Aaron Gitler, PhD, an associate professor of genetics at Stanford. “Many neurodegenerative disorders such as ALS, Parkinson’s and Alzheimer’s exhibit protein clumping or misfolding within the neurons that is thought to either cause or contribute to the conditions. We are trying to figure out why these proteins aggregate in neurons in the brain and spinal cord, and what happens when they do.”
In 2008, Gitler received a New Innovator award from the National Institutes of Health to use yeast as a model for understanding human neurodegenerative diseases and as a way to identify new targets for drug development.
Gitler is the co-senior author of the research, published online Oct. 28 in Nature Genetics. Robert Farese, Jr., MD, a senior investigator at the Gladstone Institutes, is the other co-senior author. Stanford graduate student Maria Armakola shares co-first authorship with Matthew Higgins, PhD, a postdoctoral scholar at Gladstone.
Most cases of ALS have no clear-cut cause. However, it has recently been shown that an RNA-binding protein called TDP-43 accumulates in clumps in the cytoplasm of spinal cord neurons in many people with the condition, and mutations in this protein have been found in some people with the ALS. Researchers like Gitler and Farese have been able to mimic the disease in yeast by expressing TDP-43 at higher-than-normal levels, which causes the protein to form lethal clumps in the cells’ cytoplasm.
“In humans, the progression of the disease can take years before symptoms arise,” said Gitler. “But in yeast, we see protein clumping in the cytoplasm within two days and the cells rapidly begin to die.” With their model system in place, Gitler and Farese set out to see whether it was possible to protect yeast cells from this effect by tinkering with the function of other proteins in the cell.
In this study, the researchers discovered that blocking the production of a protein called Dbr1 in a yeast model stops the TDP-43 clumping and allows the cells to live normally. The researchers confirmed the results in human nerve cells grown in the laboratory and in rat neurons overexpressing TDP-43.
“In this study we made no assumptions as to how TDP-43 injures cells,” said Farese, “but instead screened the whole yeast genome to find genes that might prevent the toxicity. Independently, both our lab and the Gitler lab found that loss of Dbr1, an enzyme involved in RNA processing, could do this.”
Dbr1 serves as part of the cellular clean-up crew that mops up the bits of unwanted RNA generated as part of the protein production line. In our DNA, most genes consist of coding regions, called exons, broken up into several segments by non-coding regions, called introns. Cells can make many different, related proteins from the same stretch of DNA by mixing and matching different exons in a process called splicing.
When the DNA is first copied, or transcribed, into RNA, the introns as well as the exons are included. But the cell quickly splices out the introns, which are released into the cytoplasm as little loops, or lariats. Dbr1, in turn, clips the loops to open them and make them accessible to the cell’s disposal system.
Blocking the production of Dbr1 causes the RNA lariats to build up in the cytoplasm. The researchers showed — by creating lariats with a binding site for a fluorescent tracking protein — that the mutant TDP-43 binds to these excess lariats rather than clumping. The effect is like using a paper towel to mop up a spill on your computer keyboard: binding to the lariats appears to keep TDP-43 from causing havoc elsewhere.
“Normally, TDP-43 is found in the nucleus,” said first author Armakola. “But in the diseased cells, it aggregates in the cytoplasm and forms clumps. We developed a novel way to track where these lariats go in living cells, and we saw that when Dbr1 is missing, the lariats act as a sink to sequester TDP-43.”
The researchers note that it’s still not entirely clear whether the cells die because the mutant TDP-43 is drawing essential RNA transcripts or regulatory molecules away from the nucleus and into the cytoplasm, or because it’s not performing its normal RNA-binding function in the nucleus. Both could contribute to the progression of the disease.
The results in the yeast, rodent and human cells, however, suggest that therapeutic approaches aimed at blocking Dbr1 function, or even creating artificial lariat-like formations to draw away the mutant molecule, should be explored.
“Next, we’d like to explore blocking Dbr1 function in animals such as flies, worms and rodents,” said Armakola. “We’re also interested in identifying small molecule inhibitors of Dbr1.”
Other Stanford co-authors include graduate student Matthew Figley. The research was supported by the NIH, the Ellison Medical Foundation, the Packard Center for ALS Research at Johns Hopkins, the Consortium for Frontotemporal Research, the ALS Association, the Taube-Koret Center, the Hellman Family Foundation, the Pew Charitable Trusts, the Rita Allen Foundation, the Searle Scholars Program, the Keck Foundation and the National Center for Research Resources.
Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu. | <urn:uuid:b90e4fed-8600-4ade-9c05-3320e01e3fa0> | CC-MAIN-2022-05 | https://med.stanford.edu/news/all-news/2012/10/yeast-model-offers-clues-to-possible-drug-targets-for-lou-gehrigs-disease-stanfordgladstone-study-shows.html | s3://commoncrawl/crawl-data/CC-MAIN-2022-05/segments/1642320301263.50/warc/CC-MAIN-20220119033421-20220119063421-00112.warc.gz | en | 0.942945 | 1,420 | 3.375 | 3 |
Have u ever heard about the red bananas. Most of the people never ever have thought about the colour of banana other than yellow. Children from the primary classes are told banana as in yellow colour. Majority of you have never bought banana in red colour. But red banana do exist.
One of the varieties of banana is Red bananas, also known as Red Dacca Bananas. They are named so due reddish-purple skin.They are softer and sweeter than the yellow Cavendish varieties, with a slight raspberry flavor.
These red bananas grow all over Asia and South America. They are most favorites in Central America but are sold all over the world. The red banana tree can grow up to 8 to 25 feet depending on the plant variety.
They are ripe when deep red colour with spots appears on their skin. When ripe, raw red bananas have a flesh that is cream to light pink in colour due to presence of carotene. They are not optimal for consumption when they are over ripe i.e. when they become too soft and smelly.
They are highly nutritional containing:
- High level of potassium
- Beta carotene
- Vitamin c
Planting your own red bananas is advantageous as they are very expensive all over the world. But before that you should make sure that soil is moist and acidic. For plantation choose the area where sun rays fall directly as they grow best in direct sunlight. | <urn:uuid:013ccb8b-a4c3-4649-8601-0339075456f2> | CC-MAIN-2018-43 | http://farmvilleitems.com/2016/09/red-dacca-bananas/ | s3://commoncrawl/crawl-data/CC-MAIN-2018-43/segments/1539583514005.65/warc/CC-MAIN-20181021115035-20181021140535-00295.warc.gz | en | 0.959808 | 290 | 2.796875 | 3 |
If your child has entered the school years, you are probably well aware how much attention teachers give to reading and reading comprehension. Your family has probably been encouraged to listen to your child read, ask questions and probably even enrolled your child in some sort of reading incentive program to encourage your child to practice reading on a regular basis.
For some reason though, churches and families are often not as passionate about helping their children learn how to read and understand the Bible. In fact, many children raised in Christian homes get little if any training on how to read and understand the Scriptures.
Even simple versions of the Bible, like the NIrV (written on a third grade reading level), can be difficult to understand. The style of the writing is suited to ancient cultures with ways of saying things that are very different front the way we communicate ideas – even if the words used are simple English words. The way things are said may still sound like a foreign language or a tongue or brain twister of sorts.
There are some things you can do as a parent to help your child become comfortable and even enjoy reading the Bible. More importantly, doing these simple things will encourage your children to continue to read independently and to turn to the Bible for the answers they seek in life.
- Purchase an easy to read version like the NIrV for children and teens who have not been reading the Bible independently. Thankfully, the publishers are now selling the NIrV version with covers appropriate for older children, teens and adults.
- Don’t try to read the Bible starting with Genesis and going straight through with a beginning Bible reader. Begin with books like Mark, Proverbs, James, Esther, Jonah, Acts, Ruth, Luke, Matthew, Genesis, I and II Samuel, Judges, Exodus and even Psalms. These books either contain a lot of practical, godly advice or have mainly very clear story lines. The other books with more complex ideas, long genealogies or lists, visions and figurative language are great for when your child is more comfortable with the style and content of the books which are easier to understand.
- Sit down with your child and read or have your child read a few verses out loud.
- Ask your child to tell the verses again in his or her own words. You may have to help very young children with this process phrase by phrase.
- Ask your child what rule or idea God wants us to learn from the verses.
- Think with your child of ways to practice the rule or idea.
- Have your child practice the rule or idea from the verses.
You may wonder when you and your kids will have time to do all of this. Many schools require a number of minutes of reading at home each day. Often they leave which books are read up to the child. Consider using your child’s reading time for school to teach her or her how to read and understand the Bible. It’s the most important reading practice your child will ever get. | <urn:uuid:7d0d9915-ae67-4000-9c29-ee4d071abcb2> | CC-MAIN-2018-09 | http://www.parentinglikehannah.com/2015/11/seven-tips-for-reading-the-bible-with-kids.html | s3://commoncrawl/crawl-data/CC-MAIN-2018-09/segments/1518891813602.12/warc/CC-MAIN-20180221083833-20180221103833-00573.warc.gz | en | 0.962522 | 611 | 3.3125 | 3 |
How to Correctly Add Text into Part Design
Lots of reasons exist to add text to a part. It could be an assembly instruction, a part number, a legal advisory or warning, or simply a logo (see Figure 1). Whatever the reason, text characters tend to be the smallest features of a part and, as such, deserve the designer's careful attention.
Raised vs. Recessed
The first thing to keep in mind is that it works much better if text on a plastic part is raised above, rather than recessed into, the part (which means it will be milled into the mould). Raised letters on a part are easier to read, and recessed text in a mould allows for polishing, whereas raised letters in a mould make it difficult to achieve a good finish.
The second issue is consistency of wall size in your lettering. Avoid serif fonts, the ones with the little squiggles at the ends of uprights. The serifs are typically narrower than the primary lines of the letter itself, making them too small to mill. Instead, use a sans-serif (non-serif) font like Century Gothic Bold, (the default font in SolidWorks). Other common sans-serif fonts are Arial and Verdana. In general, remember that while most 3D CAD programs allow you to use standard Windows fonts, you should resist the temptation to get cute without a good reason.
The third issue is the size of the letters themselves (see Figure 2). Text doesn't need to stand very tall above the surface of a part—0.508mm is plenty—but even so, the rules for thin ribs apply. You don't need to measure the thickness of every line of each letter; just stick to font sizes of 20 points or more and use the Bold version of the font and odds are excellent it can be milled (see Figure 3). In some cases, we can mill smaller fonts. If you need to do so, submit the part with the smaller text for a quote and we'll let you know.
Finally, if text is located at the top of a tall feature—a tall rib, for example—the text may have to be larger.
In summary, for best results when incorporating text in your parts:
- Use raised text
- Choose a bold sans-serif font of 20 points or more
- Stay away from the tops of tall features
If you are wondering whether you've designed your text properly, simply upload your 3D CAD model for a free ProtoQuote. If there are any problems you'll know by the next day.
As mentioned, feel free to contact an applications engineer with any questions, at +44 (0) 1952 683047 or [email protected]. | <urn:uuid:037baad6-b105-4d1d-a196-1ddb53c79213> | CC-MAIN-2017-30 | https://www.protolabs.co.uk/resources/design-tips/adding-text-into-part-design/ | s3://commoncrawl/crawl-data/CC-MAIN-2017-30/segments/1500549429485.0/warc/CC-MAIN-20170727202516-20170727222516-00112.warc.gz | en | 0.912239 | 575 | 2.71875 | 3 |
Interesting facts about the Moon
10 strange facts you didn't know about the Moon. What created the Moon? And what are moonquakes?
Insight Investment Astronomy Photographer of the Year 2017 photographers share their top facts about the Moon. Visit Insight Investment Astronomy Photographer of the Year
1. The Moon is Earth's only permanent natural satellite
It is the fifth-largest natural satellite in the Solar System, and the largest among planetary satellites relative to the size of the planet that it orbits.
2. The Moon is the second-densest satellite
Among those whose densities are known anyway. The first densest is Jupiter's satellite Io.
3. The Moon always shows Earth the same face
The Moon is in synchronous rotation with Earth. Its near side is marked by large dark plains (volcanic ‘maria’) that fill the spaces between the bright ancient crustal highlands and the prominent impact craters. Learn more about the Moon's phases
4. The Moon’s surface is actually dark
Although compared to the night sky it appears very bright, with a reflectance just slightly higher than that of worn asphalt. Its gravitational influence produces the ocean tides, body tides, and the slight lengthening of the day.
5. The Sun and the Moon are not the same size
From Earth, both the Sun and the Moon look about same size. This is because, the Moon is 400 times smaller than the Sun, but also 400 times closer to Earth.
6. The Moon is drifting away from the Earth
The Moon is moving approximately 3.8 cm away from our planet every year.
7. The Moon was made when a rock smashed into Earth
The most widely-accepted explanation is that the Moon was created when a rock the size of Mars slammed into Earth, shortly after the solar system began forming about 4.5 billion years ago.
8. The Moon makes the Earth move as well as the tides
Everyone knows that the Moon is partly responsible for causing the tides of our oceans and seas on Earth, with the Sun also having an effect. However, as the Moon orbits the Earth it also causes a tide of rock to rise and fall in the same way as it does with the water. The effect is not as dramatic as with the oceans but nevertheless, it is a measurable effect, with the solid surface of the Earth moving by several centimetres with each tide.
9. The Moon has quakes too
They're not called earthquakes but moonquakes. They are caused by the gravitational influence of the Earth. Unlike quakes on Earth that last only a few minutes at most, moonquakes can last up to half an hour. They are much weaker than earthquakes though.
10. There is water on the Moon!
This is in the form of ice trapped within dust and minerals on and under the surface. It has been detected on areas of the lunar surface that are in permanent shadow and are therefore very cold, enabling the ice to survive. The water on the Moon was likely delivered to the surface by comets. | <urn:uuid:ba5cb8d2-d803-4d22-bf8f-9d16fec1bdef> | CC-MAIN-2021-31 | https://www.rmg.co.uk/stories/topics/interesting-facts-about-moon | s3://commoncrawl/crawl-data/CC-MAIN-2021-31/segments/1627046152000.25/warc/CC-MAIN-20210726031942-20210726061942-00267.warc.gz | en | 0.959507 | 635 | 3.71875 | 4 |
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An Introduction to Macbeth. of the play and various essays.They negative positive elements of a narrative essay, persuasive essay topics for high school students free english. | <urn:uuid:83544ae1-dab1-4dcd-8878-85a9973709a2> | CC-MAIN-2017-43 | http://itmatchonline.us/vera/macbeth-essay-topics-high-school-sug.php | s3://commoncrawl/crawl-data/CC-MAIN-2017-43/segments/1508187825497.18/warc/CC-MAIN-20171023001732-20171023021732-00885.warc.gz | en | 0.842984 | 725 | 2.796875 | 3 |
The Gift of Black Folk. Negroes in the Making of America. (Presentation Copy?)
Within the orbit of W.E.B. Du Bois, Shirley Graham, and Langston Hughes
First edition. From the collection of Anna and Thomas O. Johnson with their bookplate. Thomas O. Johnson was a Harlem dentist and a friend to Langston Hughes. On its face value, this copy appears to be a very early presentation copy from Shirley Graham to the Johnson, but the evidence is perplexing.
An inscription on the front pastedown reads: “– To – Tom – From – Shirley Christmas 1924” and laid into the book is a Christmas card that is inscribed: “Tom Dear – From – Shirley” Pencil notes attribute both inscriptions to Shirley Graham, W.E.B. Du Bois’s future wife.
Later in life, Shirley Graham inscribed and gifted the Johnsons with a copy of her biography of W.E.B. Du Bois (His Day is Marching On: A Memoir of W.E.B. DuBois), but we don’t know if she knew the Johnsons in 1924, at aged 28. We have not found any non-cursive examples of Graham’s hand, or any examples of Graham’s handwriting this early, to compare with the book’s inscription. Right now, we leave the attribution of these inscriptions as an open question mark.
Shirley Graham (1896–1977) met W.E.B. Du Bois in 1920, when she was thirteen. Her father subscribed to The Crisis which Graham avidly read. In His Day is Marching On she notes that “Langston Hughes’ poems were published in The Crisis long before they appeared anywhere else.” (p28) Graham lived in Spokane in 1924, raising her two children. She reconnected with Du Bois in 1932 when he gave a favorable review of her music-drama “Tom Tom” in The Crisis. (p39)
A co-founder of the Niagara Movement and the NAACP, W.E.B. Du Bois’s The Gift of Black Folk documented the significant ways African Americans helped to build America. Chapters are devoted black explorers, labor, soldiers, African American art and literature, and the “Freedom of Womanhood.”
Description: The Gift of Black Folk. Negroes in the Making of America. (Presentation Copy?)
Boston: The Stratford Co., Publishers, 1924. 349pp. Navy blue cloth with gilt lettering. Light spine wear; a near fine copy.
Work p610. bcj 332893 wq10 | <urn:uuid:406e7cef-6b12-4d0f-9c62-b14ce4ac6a51> | CC-MAIN-2022-27 | https://www.rareamericana.com/pages/books/3731677/w-e-b-du-bois-1868-1963/the-gift-of-black-folk-negroes-in-the-making-of-america-presentation-copy | s3://commoncrawl/crawl-data/CC-MAIN-2022-27/segments/1656103617931.31/warc/CC-MAIN-20220628203615-20220628233615-00397.warc.gz | en | 0.904906 | 580 | 2.90625 | 3 |
International Mother Language Day is a great opportunity to try something new! Here are some suggestions to get involved in a world-wide celebration to promote your language:
“Throughout the day, tweet using your mother language. Please share ‘why is it important to use your language on the internet?’ or tweet greetings or your favorite words/phrases in your language. You might also choose to tweet a translation in order to encourage speakers of other indigenous and minority language communities.“
Check this page out for more information: http://tweetmotherlanguage.org/
- Write a poem in/about your mother tongue. Here’s an example from Sujata Bhatt – a poem about the Gujarati language called “Search for My Tongue”:
You ask me what I mean
By saying I have lost my tongues.
I ask you, what would you do
If you had two tongues in your mouth,
And lost the first one, the mother tongue,
And could not really know the other,
The foreign tongue.
Listen to the full poem here
- Learn a new word in an endangered language.
- Teach someone a new word and practice speaking it with them.
- Ask a speaker to help you with pronunciation or understanding of a word or phrase.
- Text someone in your language.
- Write a story in your language.
- Attend or organize an IMLD celebration in YOUR area! (See next question for more info) | <urn:uuid:c0317f32-e399-4806-86c7-61ba462b1d6f> | CC-MAIN-2019-13 | https://www.languageconservancy.org/news-events/2016/02/20/fun-ways-to-celebrate-international-mother-language-day/ | s3://commoncrawl/crawl-data/CC-MAIN-2019-13/segments/1552912201521.60/warc/CC-MAIN-20190318172016-20190318194016-00033.warc.gz | en | 0.901634 | 311 | 3.296875 | 3 |
A new report reveals that the world might surpass a dangerous heat threshold by as early as 2027
The threshold for dangerous global warming will likely be surpassed between 2027 and 2042 reveals a new study published in Climate Dynamics. The new threshold is much narrower than predicted by the Intergovernmental Panel on Climate Change’s (IPCC) estimate of between now and 2052.
Researchers from McGill University introduced a new and more accurate way to estimate global projections through 2100. The new approach is based on historical data and a simple model of the system memory based on scaling symmetries.
Scientists have been making climate projections using Global Climate Model (GCM). It is a complex mathematical representation of major climate system components like atmosphere, land surface, ocean, and sea ice and their interactions. The earth’s energy balance between the four components helps to make long-term climate predictions.
More robust and certain than GCM
The new approach used by the researchers has smaller uncertainty and is more robust. According to some climate sceptics, IPCC projections are untrustworthy because they are entirely GCM based. Each GCM has its own climate (“structural uncertainty”) and this leads to very large discrepancies in projection, the study says.
“Our new approach to projecting the Earth’s temperature is based on historical climate data, rather than the theoretical relationships that are imperfectly captured by the GCMs. Our approach allows climate sensitivity and its uncertainty to be estimated from direct observations with few assumptions,” says co-author Raphaël Hébert, from the Alfred-Wegener-Institut, Germany in a statement.
According to the study, due to dire ecological consequences of global warming, better information about climate sensitivity is of extreme importance to meet the urgency of adjusting economic and environmental policies.
A new scaling factor
The researchers performed analysis on five observation records of surface air temperature each spanning at least the period 1880-2014. They introduced a new scaling factor- Scaling Climate Response Function (SCRF) to make projections about Earth’s temperature to 2100.
SCRF is used by the researchers to reconstruct the forced temperature variability over the historical period and make future projections according to Representative Concentration Pathway (RCP) scenario. RCP is a greenhouse gas concentration (not emissions) trajectory adopted by the IPCC.
The study looks into three forcing- solar, volcanic, and anthropogenic forcing. Forcing is the physical process affecting the climate on earth through several forcing factors.
“Our new approach to projecting the Earth’s temperature is based on historical climate data, rather than the theoretical relationships that are imperfectly captured by the GCMs. Our approach allows climate sensitivity and its uncertainty to be estimated from direct observations with few assumptions” says Hébert in a statement.
Variations in predictions from IPCC’s estimates
According to the study, the threshold for dangerous warming 1.5 degree Celsius will likely be crossed between 2027 and 2042 which is much narrower than GCM’s estimates between now and 2052.
The study reveals that between 1860-2000 the temperature variability observed by SCRF track closely to that of IPCC. There is a small gap between the two over the 1915-1960 period when the IPPC’s predictions were “consistently warmer” compared to SCRF.
After 2000, the SCRF predicted lower warming than IPCC. The overshoots in IPCC’s predictions are contributed to a combination of factors mainly errors in volcanic and solar input, representation of aerosols and evolution of El-Niño (a climate pattern that describes the unusual warming of surface waters in the eastern tropical Pacific Ocean).
Over the 2043-2100 period, the SCRF projections are similar to that of IPCC.
To avert a 1.5-degree Celsius warming, the study suggests a drastic cut in emission similar to RCP 2.6.
RCP 2.6 requires that carbon dioxide (CO2) emissions start declining by 2020 and go to zero by 2100. It also requires that methane emissions (CH4) curtail to approximately half the CH4 levels of 2020, and that sulphur dioxide (SO2) emissions decline to approximately 10% of those of 1980-1990.
Tipping points to improve future projections
The study assumes a linear stationary relationship between forcing and temperature, abandoning the non-linear interactions which can arise once the system evolves.
“In particular, so-called tipping points could be reached in the coming century which would lead to a breakdown of the linear model proposed,” says the study.
Such tipping points are not observed in GCM also but the study claims that there is a need to study these points to improve future projections. The researchers have assumed in the study that “increased variability in the climate regime to be strictly a result of forcing,” excluding internal modes of variability. To have a better understanding of low-frequency natural variability, the study advocates the use of paleoclimate archives which consist of geologic (like sediment cores) and biologic (like tree rings) materials that preserve evidence of past changes in climate.
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Asia’s humid heatwave in April made at least 30 times more likely due to climate change: Study | <urn:uuid:d24c0b15-00d3-4d0e-bb5e-f98e146f5a6f> | CC-MAIN-2023-23 | https://carboncopy.info/global-warming-threshold-will-be-crossed-by-2027-study/ | s3://commoncrawl/crawl-data/CC-MAIN-2023-23/segments/1685224655092.36/warc/CC-MAIN-20230608172023-20230608202023-00366.warc.gz | en | 0.936224 | 1,184 | 3.6875 | 4 |
Białowieża Forest is one of the largest forest complexes in the European lowlands with stands representing all types of a lowland forest characteristic for this climate zone.
There are 26 tree species forming a part of various forest communities in Białowieża Forest.
All types of forest communities characteristic for the geographical location of the Forest are present here, and represent over 95 % of this complex area. Besides the forest communities, you will find here meadow, peat bog and water communities.
Nearly 50% of species of the vascular plants growing in Poland can be found in Białowieża Forest. Several nature species, such as Thesium ebracteatum, eastern pasqueflower, and hairy agrimony, and many other valuable species, including over a dozen species of orchids, can be found here.
Also over 3500 species of fungi, 325 species of lichens and about 260 species of moss were observed in the Forest.
The fauna of Białowieża Forest is even more diversified and rich. Dead wood present in large quantities is a habitat for many valuable species of invertebrates, such as Boros schneideri, Goldstreifiger, great capricorn beetle, hermit beetle and numerous individuals of Cucujus cinnaberinus. The scientists estimate that about 9300 species of insects live here.
59 species of mammals can be found in Białowieża Forest. This area is of special significance to wolves and lynxes, and it is also the most important in Poland (and in the world) refuge of the bison.
The Forest definitely is a paradise for birds, of which about 240 species are found. Majority of them nest here but spend the winter in a warmer climate. At least 45 bird species listed in Annex I to the Birds Directive and 12 species listed in the Polish Red Book of Animals live here. An attentive watcher can count upon close encounters with such ornithological rarities as white-backed and three-toed woodpeckers, red-breasted flycatcher, pygmy owl, nightjar, lesser spotted eagle, black stork or honey buzzard.
Twelve species of amphibians and seven species of reptiles are another proof of biological diversity of this region. | <urn:uuid:82826602-12a3-4887-92df-863e71bbcb67> | CC-MAIN-2018-26 | http://en.e-puszcza.pl/puszcza-bialowieska/unikalna-przyroda/ | s3://commoncrawl/crawl-data/CC-MAIN-2018-26/segments/1529267863259.12/warc/CC-MAIN-20180619232009-20180620012009-00466.warc.gz | en | 0.918045 | 489 | 3.796875 | 4 |
After the 1970 elections, President Gen Yahya Khan announced Shaikh Mujibur Rehman to be the next prime minister of Pakistan. Bhutto did not like the idea and, on his asking, the date for the National Assembly session was changed from March 3, 1971 to March 25, 1971. Shaikh Mujib wanted the National Assembly session to be held at Dhaka, but Bhutto opposed the idea. The postponement and Bhutto’s opposition did not go well with Mujib.
On March 1, 1971, a jalsa was organised by the Awami League at Paltan Maidan, Dhaka, which, according to eyewitnesses, was attended by a massive number of people. In that jalsa, a non-cooperation movement was announced. Throughout East Pakistan, Bengalis refrained from attending their government offices. Non-Bengalis, commonly known as Biharis, were not sufficient in numbers to run the government offices. The province came to a standstill in terms of work.
We lived in Dinajpur, a northern district of East Pakistan. During the second half of March 1971, we witnessed many processions with people carrying weapons like swords, bamboo sticks and daggers, since firearms were not common in those days.
An eyewitness to the ‘fall of Dhaka’ recounts the terrible events and his family’s flight from the civil war
My father was a doctor, employed with the provincial government and posted at the southern district of Patuakhali, a day’s distance of rail and ship from Dinajpur where we siblings lived with our mother. Dinajpur was a Bihari populated city and we owned our own house, while in Patuakhali my father was the only non-Bengali.
When the violence started, we shifted to our khala’s house in Parbatipur, a railway junction almost 50 kilometres away.
Bhutto threatened the National Assembly members from West Pakistan going for the NA session to be held in Dhaka on March 25. He was quoted as saying, “If anybody goes there I will break his legs [Main uski taangein torr doon ga]. He should go with a one-way ticket.”
The National Assembly session of March 25 was cancelled and the army took control of East Pakistan. Lt. Gen Tikka Khan became Martial Law Administrator. Shaikh Mujib was arrested for treason and sent to West Pakistan. The fate of the majority was to be decided by a minority. For the first time in the history of Pakistan, tanks and armoured vehicles were seen in civilian areas, marching to victory over its own people. In April, due to his strong anti-Bengali attitude, Lt. Gen Tikka Khan was replaced by Lt. Gen Amir Abdullah Khan Niazi.
Soon after our family moved to Parbatipur, train communication between Dinajpur and Parbatipur broke down because of acion by pro-Awami League militants. Massacres in all minor cities with small Bihari populations started. During the second week of April, almost 15,000 Bihari citizens of Dinajpur were slaughtered by pro-Awami League militants. After the massacre, the army took over the city. The Bengalis fled to nearby villages and the city wore a deserted look.
In June 1971, I visited Dinajpur with a friend. We went to the slaughter ground which was near the river. We counted 326 human skulls and then we could bear it no more. Most of the dead bodies were buried. The river bed was black with the stain of blood.
Then, the war started. Indian bombing began from December 3, 1971, and continued till the day of their success. On December 14, Indian helicopters dropped pamphlets saying India had won the war and the people should not resist, they should co-operate with the Indian Army.
The alarm bells rang and, for two days, total confusion and bewilderment prevailed in the city.
On December 16, the local army formally announced that surrender had taken place. The people panicked in the midst of news of massacres in smaller cities and towns. In the absence of the army, they were afraid of getting killed. The leaders of the city decided to shift to the nearby city of Syedpur, which had a larger Bihari population.
Trains were run from the night of December 16, 1971, through the entire day of December 17 to shift the entire population of Parbatipur to Syedpur. We took shelter in one of our paternal uncle’s house. On the radio, we listened to the news of the fall of Dhaka and the surrender ceremony of Lt. Gen Amir Abdullah Khan Niazi in front of the Indian Army commander of the Eastern Wing, Lt Gen Jagjeet Singh Arora.
In his speech to the nation on the historic day, Gen Yahya declared that the war was never-ending; it would continue. The Justice Hamoodur Rahman Commission Report, published by daily Dawn much later in the late 1990s, revealed that Gen Niazi, the commander of half of Pakistan and Chief Martial Law Administrator of the Eastern Wing, was also involved in smuggling paan from East Pakistan to West Pakistan.
My father and elder brother, who was studying in medical college, had joined us in May. After the fall, we had no money; the banks were closed and our bank was not in Syedpur anyway. My father sold two of my mother’s gold bracelets for 250 rupees (gold was around 125 per tola at that time). He gave me and my brother the money to start some kind of small business so that the kitchen expenses could be met. We saw kitchen utensils and crockery coming from India and decided to sell these items.
The jeweller who had bought the bracelets allowed us to sit in the veranda in front of his shop. After a few days, a gentleman came to us saying that he wanted to sell his used crockery. Not sure whether we would be able to sell them or not, we nevertheless took the risk and bought his crockery. After the fall, the Bengalis who had fled from the cities in fear of the Pakistan Army started to return and they needed utensils and crockery. We were able to sell them profitably. A new chapter opened for us.
One day, a gentleman told us that he would go door to door to see if any used crockery sets were available for sale. In return he would take 15 percent commission from us. We agreed. On an average, we visited at least one home on a daily basis to buy their crockery. Our little efforts helped our four families living together to subsist.
When news of our homelessness reached our maternal uncle in India, he sent an agent to take us to India. The agent was totally unaware of the gravity of the situation. My family and my khalas ventured to go with him. We tried to cross the border at Chilahati but were caught by the Bengalis. They took all my mother’s ornaments (more than 300 tolas). They got so much that they didn’t disturb my khala at all; all her jewellery (more than 200 tolas) remained safe. They finally released us. Across the Indian border, we were caught by Indian Army on the night of March 28, 1972, who took us to the cantonment. They offered us food: chawal, daal and aalu ka bhorta. They kept us overnight and released us in the early hours of the morning.
The locals, seeing us with bag and baggage, suspected us to be from Bangladesh. One of them took us to his house, probably expecting some money for shelter and protection. But we had nothing left. The only valuable thing with us was my father’s wristwatch, which he sold for 50 rupees. We used the money for our two days’ stay there. Left with 20 rupees, which we were sure was enough for the bus fare, we went to the bus stop and took a bus.
By this time my younger brother and sister had chicken pox. In India, chicken pox is called ‘choti mata’ and small pox ‘bari mata’, and was not uncommon in those days. They don’t disturb any person having mataas. So no one disturbed us.
We got down in Jalpaiguri, the last town of West Bengal. From there, we hired a taxi for 300 rupees to reach Kishangaj, where my maternal uncle was to receive us. The fare was paid by my uncle. This was the first city of Bihar. My uncle told my father to shave his beard so that he would not be recognised.
The next morning, April 1, 1972, we took the train to Bhagalpur, our native land and the second biggest city of Bihar. Soon after, we started planning on moving to Pakistan. My elder brother came to Pakistan in November 1972
and got his admission transferred to Nishtar Medical College in Multan, from where he graduated later. I landed in Karachi on August 31, 1973. The rest of the family followed in 1976.
And so a young boy in his teens, full of aspirations and ambition, came to find his fortune to Pakistan, penniless, shelterless and with no one to hold his hand or offer any support.
The writer is a PhD candidate in marketing and visiting faculty at a number of private universities
Published in Dawn, EOS, December 16th, 2018 | <urn:uuid:5ca3bd73-17b3-43d2-ac82-d3d9b45132a5> | CC-MAIN-2019-04 | https://www.dawn.com/news/1451742/history-the-last-days-of-east-pakistan | s3://commoncrawl/crawl-data/CC-MAIN-2019-04/segments/1547583657907.79/warc/CC-MAIN-20190116215800-20190117001800-00607.warc.gz | en | 0.986672 | 2,012 | 2.59375 | 3 |
Exciting Advances In Robotic Limb Replacements
The US government recently announced that it has had success developing a robotic arm replacement that actually allows the wearer to feel things, reminiscent of something from science fiction. In summer 2015 the agency responsible confirmed it had made significant progress producing a prosthetic limb that could have its movement controlled by a human brain, but just months later the same developers were able to implement the ability to actually feel through the device. We have been making progress with prosthetic limbs for decades but this is a very major development.
For now many details remain unclear, for example the practical applications of the arm in the near future. We don’t yet know the specific detail level of the artificial touch sensation, for example whether it can detect different textures. In order to truly resemble natural feeling the limb would probably have to be much more sophisticated, if you imagine all the different things we can sense with our real hands such as different temperatures. We would expect that this technology isn’t that advanced yet, but it shouldn’t be understated: this is a major breakthrough that could have very meaningful results for millions of people. We look forward to seeing how this sort of technology develops in the future, and how soon we can get to the stage where it’s being used in hospitals all over the world. | <urn:uuid:4224f9d7-c776-4102-9690-4e864125bcaf> | CC-MAIN-2019-30 | https://www.healthnews247.com/exciting-advances-robotic-limb-replacements/ | s3://commoncrawl/crawl-data/CC-MAIN-2019-30/segments/1563195529175.83/warc/CC-MAIN-20190723085031-20190723111031-00415.warc.gz | en | 0.966055 | 272 | 2.5625 | 3 |
Starting school is one of the most important steps for any child, but the good thing is that there are things you can do to ensure they are a little more comfortable as they start the new journey in life.
With new baseline assessments in primary schools by 2022 -2023 according to Tradewind, as well as all the old variables, there is a lot to prep for.
With September fast approaching, we have made a list of tips that will go a long way in helping your kid on his/her first day at school as they get to know the new routine.
Before school starts
Get organized: Ensure that you have everything needed in time for your first day. You should also make an effort on including them in the decision-making process – even if it is just choosing a backpack – so they can get excited about school. Show them where the label is on the clothes so they can see it for themselves.
Talk about the things they can expect: You should try explaining the school rules to them, routines, and schedules so they can have a rough idea of what to expect. Give them assurance that the teacher is there to help them, and the end of the day you will be there to talk to them. You can even share a little experience of your own at school.
Become familiar with the school : Take them for a walk around the school so they get to see it when it is empty with no people around. Let them see the playground, gates, and where they are going to be on the first day.
On the first day
Proper preparation: Make sure everything is ready the day before because this will give you enough time the next day to enjoy instead of having to rush to get out of the door. Take that time to take a photo so they can have a memory of their first day. Having the memory of their photos will also be great for you because you can always go back and see how your kid was on their first day of school. Keeping memories through photos is great.
Dealing with separation anxiety: You should give the young one assurance that you will be there to pick them in a couple of hours and hear how their day went, and also they should know that teachers are there to help if they need it.
Talk to the teacher if you have concerns about the kid settling in or you know of a problem at home that can have an effect on their behavior. Teachers are professionals who have the necessary skills needed to deal with all type of children starting out in school. They will call you in case of any problem. This means you can relax and enjoy your day without having to worry.
Home time: Ensure you aren’t late when picking the kids up. You should not make the child anxious because you have not yet arrived, and they will also be very happy to tell you how their day was. Create some time to talk with them more about their day at school.
Ensure they have plenty of rest: School is a big step for them and changes the routine of the child. Make sure you are strict with betimes because you don’t want them to be tired and feeling grumpy the next day when in class.
Stay organized: The first couple of weeks can be hectic, so you should try your best to prepare everything you can the day before, especially at night. Kids do not have the sense of urgency as adults, making it even more important to get them up in time and prepare them without having to rush or panic around the house. Things will be smoother this way.
Amila Gamage Wickramarachchi is the founder of this blog where she shares her parenting and lifestyle experiences. She is an engineer and a trainer who works in the construction industry. She is the founder of Sihela Consultants.(www.sihelaconsultants.com) | <urn:uuid:3f065a90-9fbb-4b12-bd75-12c9e1579505> | CC-MAIN-2021-43 | https://diaryofanewmom.com/guide-to-starting-school/ | s3://commoncrawl/crawl-data/CC-MAIN-2021-43/segments/1634323588242.22/warc/CC-MAIN-20211027181907-20211027211907-00693.warc.gz | en | 0.977331 | 787 | 2.59375 | 3 |
You know how long it takes to pack the car to go on holidays. But there's a moment when you're all in, everyone has their seatbelt on, you pull out of the drive and you're off.
Our ASKAP (Australian Square Kilometre Array Pathfinder) telescope has just pulled out of the drive, so to speak, at its base in Western Australia at the Murchison Radio-astronomy Observatory (MRO), about 315km northeast of Geraldton.
ASKAP is made of 36 identical 12-metre wide dish antennas that all work together, 12 of which are currently in operation. Thirty ASKAP antennas have now been fitted with specialised phased array feeds, the rest will be installed later in 2017.
Until now, we'd been taking data mainly to test how ASKAP performs. Having shown the telescope's technical excellence it's now off on its big trip, starting to make observations for the big science projects it'll be doing for the next five years.
And it's taking lots of data. Its antennas are now churning out 5.2 terabytes of data per second (about 15 percent of the internet's current data rate).
Once out of the telescope, the data is going through a new, almost automatic data-processing system we've developed.
It's like a bread-making machine: put in the data, make some choices, press the button and leave it overnight. In the morning you have a nice batch of freshly made images from the telescope.
Go the WALLABIES
The first project we've been taking data for is one of ASKAP's largest surveys, WALLABY (Widefield ASKAP L-band Legacy All-sky Blind surveY).
On board the survey are a happy band of 100-plus scientists – affectionately known as the WALLABIES – from many countries, led by one of our astronomers, Bärbel Koribalski, and Lister Staveley-Smith of the International Centre for Radio Astronomy Research (ICRAR), University of Western Australia.
They're aiming to detect and measure neutral hydrogen gas in galaxies over three-quarters of the sky. To see the farthest of these galaxies they'll be looking three billion years back into the universe's past, with a redshift of 0.26.
Neutral hydrogen – just lonely individual hydrogen atoms floating around – is the basic form of matter in the universe. Galaxies are made up of stars but also dark matter, dust and gas – mostly hydrogen. Some of the hydrogen turns into stars.
Although the universe has been busy making stars for most of its 13.7-billion-year life, there's still a fair bit of neutral hydrogen around. In the nearby (low-redshift) universe, most of it hangs out in galaxies. So mapping the neutral hydrogen is a useful way to map the galaxies, which isn't always easy to do with just starlight.
But as well as mapping where the galaxies are, we want to know how they live their lives, get on with their neighbours, grow and change over time.
When galaxies live together in big groups and clusters they steal gas from each other, a processes called accretion and stripping. Seeing how the hydrogen gas is disturbed or missing tells us what the galaxies have been up to.
We can also use the hydrogen signal to work out a lot of a galaxy's individual characteristics, such as its distance, how much gas it contains, its total mass, and how much dark matter it contains.
This information is often used in combination with characteristics we learn from studying the light of the galaxy's stars.
Oh what big eyes you have ASKAP
ASKAP sees large pieces of sky with a field of view of 30 square degrees. The WALLABY team will observe 1,200 of these fields. Each field contains about 500 galaxies detectable in neutral hydrogen, giving a total of 600,000 galaxies.
This image (above) of the NGC 7232 galaxy group was made with just two nights' worth of data.
ASKAP has now made 150 hours of observations of this field, which has been found to contain 2,300 radio sources (the white dots), almost all of them galaxies.
It has also observed a second field, one containing the Fornax cluster of galaxies, and started on two more fields over the Christmas and New Year period.
Even more will be dug up by targeted searches. Simply detecting all the WALLABY galaxies will take more than two years, and interpreting the data even longer. ASKAP's data will live in a huge archive that astronomers will sift through over many years with the help of supercomputers at the Pawsey Centre in Perth, Western Australia.
ASKAP has nine other big survey projects planned, so this is just the beginning of the journey. It's really a very exciting time for ASKAP and the more than 350 international scientists who'll be working with it.
Who knows where this Big Trip will take them, and what they'll find along the way?
This article was originally published on The Conversation. Read the original article. Follow all of the Expert Voices issues and debates — and become part of the discussion — on Facebook, Twitter and Google +. The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on Space.com. | <urn:uuid:65197af6-cb7f-40fb-aeb0-956f888997d8> | CC-MAIN-2019-35 | https://www.space.com/35532-australian-square-kilometer-array-pathfinder-big-data.html | s3://commoncrawl/crawl-data/CC-MAIN-2019-35/segments/1566027313589.19/warc/CC-MAIN-20190818022816-20190818044816-00098.warc.gz | en | 0.949049 | 1,126 | 2.6875 | 3 |
Monday, December 14 marked the third anniversary of the Sandy Hook Elementary School shootings. This is a sad day made only more difficult because since that horrific event, gun violence has killed another 555 children under 12. It could be said that children have become an easy target. The mass closure of all the LAUSD schools this Tuesday would only reinforce that notion. Time, energy, and precious resources are now being spent as police search all 900 schools in the district while, once again, we all adjust to just how vulnerable we are.
Aside from arming ourselves and living and operating behind secure enclosures, what can we do to reverse this threatening epidemic that places our children at extraordinary risk in so many ways?
Our initial reaction, of course, is to assure safety, become vigilant, and offer a reasonable counter to any threat. However, such an approach can lead to an increased sense of paranoia and suspicion that could easily yield to excessive force, violence, and a dangerous reactionary cycle which serves only to exacerbate a bad situation. So although this may be an initial approach, it does not provide a sustainable long-term solution or address the issues that are at the core of the violence.
Many of the children, youth, and families we serve at Hillsides have either been the victims of violence or are at risk of experiencing it. For some, the threat is physical; for many, it is the emotional violence that comes from living in a dangerous environment with no assurances of security or safety. Either one is traumatizing and can trigger reactions that range from withdrawal to violent outbursts. Effective treatment of these traumas is made only more challenging in a world that seems more vulnerable to violence with each passing day.
Learning to live with such vulnerability while not succumbing to violence is the goal. Knowing what can be controlled while not becoming a victim is essential. For children in particular, recognizing who they can count on to protect and keep them safe is particularly important. Reinforcing familiar routines can also encourage the sense of well-being for children. After the recent shootings in San Bernardino, the city decided to go ahead with a holiday parade, principally to reassure the children in their community that although they were sad and grief- stricken, the rituals of the season would still be celebrated as a promise that everything would be okay.
All this can help to reassure our children, but it does address the proliferation of firearms, the paralyzing phobias that isolate people and communities from one another, or the lack of resources to address the most vulnerable who experience mental illness.
As we reassure our children throughout this holiday season, let us not lose sight of the bigger issues that threaten their well-being. Let’s encourage a public dialogue to help identify reasonable solutions to the core issues that fuel the unease we are experiencing. There are 555 reasons for such a discussion, a number that sadly, if we do not act, will only continue to grow. | <urn:uuid:6357fc2c-3733-45e5-beac-2fee968924da> | CC-MAIN-2017-43 | https://hillsidescommunity.wordpress.com/2015/12/16/555-reasons-for-new-solutions-to-violence/ | s3://commoncrawl/crawl-data/CC-MAIN-2017-43/segments/1508187824357.3/warc/CC-MAIN-20171020211313-20171020231313-00026.warc.gz | en | 0.966214 | 593 | 2.578125 | 3 |
Method of connecting a mobile decoder to a locomotive
The NMRA and NEM have adopted standard mechanical and electrical interfaces to connect Mobile Decoders to a Locomotive's electrical system. These plugs and sockets make it much simpler to install a decoder into a suitably equipped locomotive. In most cases, a blanking plug must be removed before installing the decoder. If a locomotive is not DCC-ready then it doesn't have a locomotive interface and must use a Hardwired Decoder or a drop in replacement DCC control board if available for that specific model.
NMRA and NEM 6, 8 and 4 Pin Interfaces
These interfaces are designed for basic installations without sound or many additional functions. The various sizes are intended to cope with the various physical size and power requirements for different scales.
The 6 pin small interface is intended for N gauge locomotives due to their restrictive size and lower power requirements. The locomotive side is a 1x6 female socket with 0.05" pitch.
The 8 pin medium interface is intended for HO/OO gauge locomotives and allows for slightly higher power and simplifies headlight wiring. The locomotive side is a 2x4 female socket with 0.1" pitch.
The 4 pin large interface is intended for O gauge and above and allows for higher power. The locomotive side is 4 male pins, the decoder side is 4 female sockets. The standards do not define the physical connector layout.
Pin Assignments and Wire Colours
|6 pin||8 pin||4 Pin||9 Pin JST2|
|NEM 651||NEM 652||NEM 654|
|NMRA Small||NMRA Medium||NMRA Large||NMRA JST|
|Pin 1||Motor Right||Motor Right||Motor Left||F2|
|Pin 2||Motor Left||Rear Headlight (F0)||Motor Right||Left Rail|
|Pin 3||Right Rail||N/C1||Left Rail||Motor Left|
|Pin 4||Left Rail||Left Rail||Right Rail||Rear Headlight (F0)|
|Pin 5||Front Headlight (F0)||Motor Left||Front Headlight (F0)|
|Pin 6||Rear Headlight (F0)||Front Headlight (F0)||Common (V+)|
|Pin 7||Common (V+)||Motor Right|
|Pin 8||Right Rail||Right Rail|
1 The standards do not define a use for this pin although it is often used for a function output
2 A JST Connector is not strictly a locomotive interface since it connects a mobile decoder to its harness, not to the locomotive
21 Pin MTC Interface
The 21 pin MTC interface is a standard adopted by both the NMRA and NEM 660.
This interface is always a direct-connect type where there is no wiring harness. The decoder plugs directly on to the pin header mounted on the locomotive chassis.
The NMRA standard has discouraged the use of this connector in new locomotive designs from January 2010. It is intended to be replaced by the PluX interface.
The PluX connector consists of two rows of 4, 6, 8 or 11 pins. The smaller interfaces are subsets of the larger interfaces. The pins are meant to interface directly with a female connector, with the preferred method being that the pins pass through holes in the PCB and enter the bottom of the female connector. This would keep the height to a minimum.
The Standard sets maximum dimensions for the decoder. This allows for small, drop in decoders.
The PluX interface is based on the connector used by Marklin. The pins are rated at 1A each.
- One orientation possible within the locomotive. The Index to be marked with an arrow/triangle adjacent, on the visible side of the decoder, the Locomotive PCB will also have an arrow/triangle index mark. The user just has to align the two marks. The pin will be missing at the index position, and there will be no hole drilled into the locomotive PCB at that position.
You can insert a PluX8 decoder into a PluX22 socket, as it is a subset of the larger connector. This gives the consumer choice as to the type of decoder to be installed while giving the manufacturer a single decoder interface for all decoder types. The index will ensure correct connections. | <urn:uuid:13cb142f-efcf-43fd-86bb-a01cad7cab93> | CC-MAIN-2014-49 | http://www.dccwiki.com/Locomotive_Interface | s3://commoncrawl/crawl-data/CC-MAIN-2014-49/segments/1416400380037.17/warc/CC-MAIN-20141119123300-00099-ip-10-235-23-156.ec2.internal.warc.gz | en | 0.880629 | 940 | 2.75 | 3 |
Learning and plasticity are hot topics in neuroscience. Whether exploring old world wisdom or new age science fiction, the possibility that playing videogames might turn us into attention superheroes or that practicing esoteric meditation techniques might heal troubled minds is an exciting avenue for research. Indeed findings suggesting that exotic behaviors or novel therapeutic treatments might radically alter our brain (and behavior) are ripe for sensational science-fiction headlines purporting vast brain benefits. For those of you not totally bored of methodological crisis, here we have one brewing anew. You see the standard recommendation for those interested in intervention research is the active-controlled experimental design. Unfortunately in both clinical research on psychotherapy (including meditation) and more Sci-Fi areas of brain training and gaming, use of active controls is rare at best when compared to the more convenient (but causally ineffective) passive control group. Now a new article in Perspectives in Psychological Science suggests that even standard active controls may not be sufficient to rule out confounds in the treatment effect of interest.
Why is that? And why exactly do we need active controls in the first place? As the authors clearly point out, what you want to show with such a study is the causal efficacy of the treatment of interest. Quite simply what that means is that the thing you think should have some interesting effect should actually be causally responsible for creating that effect. If you want to argue that standing upside down for twenty minutes a day will make me better at playing videogames in Australia, it must be shown that it is actually standing upside down that causes my increased performance down under. If my improved performance on Minecraft Australian Edition is simply a product of my belief in the power of standing upside down, or my expectation that standing upside down is a great way to best kangaroo-creepers, then we have no way of determining what actually produced that performance benefit. Research on placebos and the power of expectations shows that these kinds of subjective beliefs can have a big impact on everything from attentional performance to mortality rates.
Typically researchers attempt to control for such confounds through the use of a control group performing a task as similar as possible to the intervention of interest. But how do we know participants in the two groups don’t end up with different expectations about how they should improve as a result of the training? Boot et al point out that without actually measuring these variables, we have no idea and no way of knowing for sure that expectation biases don’t produce our observed improvements. They then provide a rather clever demonstration of their concern, in an experiment where participants view videos of various cognition tests as well as videos of a training task they might later receive, in this case either the first-person shooter Unreal Tournament or the spatial puzzle game Tetris. Finally they asked the participants in each group which tests they thought they’d do better on as a result of the training video. Importantly the authors show that not only did UT and Tetris lead to significantly different expectations, but also that those expectation benefits were specific to the modality of trained and tested tasks. Thus participant who watched the action-intensive Unreal Tournament videos expected greater improvements on tests of reaction time and visual performance, whereas participants viewing Tetris rated themselves as likely to do better on tests of spatial memory.
This is a critically important finding for intervention research. Many researchers, myself included, have often thought of the expectation and demand characteristic confounds in a rather general way. Generally speaking until recently I wouldn’t have expected the expectation bias to go much beyond a general “I’m doing something effective” belief. Boot et al show that our participants are a good deal cleverer than that, forming expectations-for-improvement that map onto specific dimensions of training. This means that to the degree that an experimenter’s hypothesis can be discerned from either the training or the test, participants are likely to form unbalanced expectations.
The good news is that the authors provide several reasonable fixes for this dilemma. The first is just to actually measure participant’s expectations, specifically in relation to the measures of interest. Another useful suggestion is to run pilot studies ensuring that the two treatments do not evoke differential expectations, or similarly to check that your outcome measures are not subject to these biases. Boot and colleagues throw the proverbial glove down, daring readers to attempt experiments where the “control condition” actually elicits greater expectations yet the treatment effect is preserved. Further common concerns, such as worries about balancing false positives against false negatives, are address at length.
The entire article is a great read, timely and full of excellent suggestions for caution in future research. It also brought something I’ve been chewing on for some time quite clearly into focus. From the general perspective of learning and plasticity, I have to ask at what point is an expectation no longer a confound. Boot et al give an interesting discussion on this point, in which they suggest that even in the case of balanced expectations and positive treatment effects, an expectation dependent response (in which outcome correlates with expectation) may still give cause for concern as to the causal efficacy of the trained task. This is a difficult question that I believe ventures far into the territory of what exactly constitutes the minimal necessary features for learning. As the authors point out, placebo and expectations effects are “real” products of the brain, with serious consequences for behavior and treatment outcome. Yet even in the medical community there is a growing understanding that such effects may be essential parts of the causal machinery of healing.
To what extent might this also be true of learning or cognitive training? For sure we can assume that expectations shape training outcomes, otherwise the whole point about active controls would be moot. But can one really have meaningful learning if there is no expectation to improve? I realize that from an experimental/clinical perspective, the question is not “is expectation important for this outcome” but “can we observe a treatment outcome when expectations are balanced”. Still when we begin to argue that the observation of expectation-dependent responses in a balanced design might invalidate our outcome findings, I have to wonder if we are at risk of valuing methodology over phenomena. If expectation is a powerful, potentially central mechanism in the causal apparatus of learning and plasticity, we shouldn’t be surprised when even efficacious treatments are modulated by such beliefs. In the end I am left wondering if this is simply an inherent limitation in our attempt to apply the reductive apparatus of science to increasingly holistic domains.
Please do read the paper, as it is an excellent treatment of a critically ignored issue in the cognitive and clinical sciences. Anyone undertaking related work should expect this reference to appear in reviewer’s replies in the near future.
Professor Simons, a co-author of the paper, was nice enough to answer my question on twitter. Simons pointed out that a study that balanced expectation, found group outcome differences, and further found correlations of those differences with expectation could conclude that the treatment was causally efficacious, but that it also depends on expectations (effect + expectation). This would obviously be superior to an unbalanced designed or one without measurement of expectation, as it would actually tell us something about the importance of expectation in producing the causal outcome. Be sure to read through the very helpful FAQ they’ve posted as an addendum to the paper, which covers these questions and more in greater detail. Here is the answer to my specific question:
What if expectations are necessary for a treatment to work? Wouldn’t controlling for them eliminate the treatment effect?
No. We are not suggesting that expectations for improvement must be eliminated entirely. Rather, we are arguing for the need to equate such expectations across conditions. Expectations can still affect the treatment condition in a double-blind, placebo-controlled design. And, it is possible that some treatments will only have an effect when they interact with expectations. But, the key to that design is that the expectations are equated across the treatment and control conditions. If the treatment group outperforms the control group, and expectations are equated, then something about the treatment must have contributed to the improvement. The improvement could have resulted from the critical ingredients of the treatment alone or from some interaction between the treatment and expectations. It would be possible to isolate the treatment effect by eliminating expectations, but that is not essential in order to claim that the treatment had an effect.
In a typical psychology intervention, expectations are not equated between the treatment and control condition. If the treatment group improves more than the control group, we have no conclusive evidence that the ingredients of the treatment mattered. The improvement could have resulted from the treatment ingredients alone, from expectations alone, or from an interaction between the two. The results of any intervention that does not equate expectations across the treatment and control condition cannot provide conclusive evidence that the treatment was necessary for the improvement. It could be due to the difference in expectations alone. That is why double blind designs are ideal, and it is why psychology interventions must take steps to address the shortcomings that result from the impossibility of using a double blind design. It is possible to control for expectation differences without eliminating expectations altogether. | <urn:uuid:75b3c07e-0a11-4612-baae-a634fbcbec53> | CC-MAIN-2019-51 | https://micahallen.org/tag/plasticity/ | s3://commoncrawl/crawl-data/CC-MAIN-2019-51/segments/1575540585566.60/warc/CC-MAIN-20191214070158-20191214094158-00287.warc.gz | en | 0.950004 | 1,861 | 2.765625 | 3 |
Keratoconus is an eye disease that affects the structure of the cornea. The cornea is the clear tissue that covers the front of the eye.
With this condition, the shape of the cornea slowly changes shape from round to a cone shape. It also gets thinner and the eye bulges out. This causes vision problems. In most people, these changes continue to get worse.
The cause is unknown. It is likely that the tendency to develop keratoconus is present from birth. The condition may be due to a defect in collagen. This is the tissue that provides the shape and strength to the cornea.
Allergy and eye rubbing may speed up the damage.
There is a link between keratoconus and Down syndrome.
The earliest symptom is a slight blurring of vision that cannot be corrected with glasses. (Vision can most often be corrected to 20/20 with rigid, gas-permeable contact lenses.) Over time, you may have eye halos, glare, or other night vision problems.
Most people who develop keratoconus have a history of being nearsighted. The nearsightedness tends to become worse over time. As the problem gets worse, astigmatism develops and may worsen over time.
Keratoconus is often discovered during the teenage years. It may also develop in older people.
Exams and Tests
The most accurate test for this problem is called corneal topography, which creates a map of the curve of the cornea.
A slit-lamp exam of the cornea can diagnose the disease in the later stages.
A test called pachymetry can be used to measure the thickness of the cornea.
Contact lenses are the main treatment for most patients with keratoconus. The lenses may provide good vision, but they do not treat or stop the condition. For people with the condition, wearing sunglasses outdoors after being diagnosed may help slow or prevent the progress of the disease. For many years, the only surgical treatment has been corneal transplantation.
The following newer technologies may delay or prevent the need for corneal transplantation:
- High-frequency radio energy (conductive keratoplasty) changes the shape of the cornea so contact lenses fit better.
- Corneal implants (intracorneal ring segments) change the shape of the cornea so contact lenses fit better
- Corneal collagen cross-linking is a treatment that causes the cornea to become stiff. In most cases, it prevents the condition from getting worse. It may then be possible to reshape the cornea with laser vision correction.
In most cases, vision can be corrected with rigid gas-permeable contact lenses.
If corneal transplantation is needed, results are very often good. However, the recovery period can be long. Many people still need contact lenses after the surgery.
If left untreated, the cornea may thin to the point where a hole develops in the thinnest part.
There is a risk of rejection after a cornea transplant, but the risk is much lower than with other organ transplants.
You should not have laser vision correction (such as LASIK) if you have any degree of keratoconus. Corneal topography is done beforehand to rule out people with this condition.
In rare cases, other laser vision correction procedures, such as PRK, may be safe for people with mild keratoconus. This may be more possible in people who have had corneal collagen cross-linking.
When to Contact a Medical Professional
Young people whose vision cannot be corrected to 20/20 with glasses should be checked by an eye doctor familiar with keratoconus. Parents with keratoconus should consider having their children screened for the disease starting at age 10.
There is no way to prevent this condition. Most health care providers believe that people should take steps to control allergies and avoid rubbing their eyes.
Vision changes - keratoconus
Jain A, Paulus YM, Cockerham GC, Kenyon KR. Keratoconus and other noninflammatory corneal thinning disorders. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 4, chap 16C.
Kojima T, Primack JD, Azar DT. Intrastromal corneal ring segments and collagen crosslinking. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 3.9.
Sugar J, Batta P. Keratoconus and other ectasias. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4.18.
Review Date 8/20/2016
Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. | <urn:uuid:b8d47775-23b0-4743-98a3-c6d8884d3f6f> | CC-MAIN-2018-39 | https://medlineplus.gov/ency/article/001013.htm | s3://commoncrawl/crawl-data/CC-MAIN-2018-39/segments/1537267165261.94/warc/CC-MAIN-20180926140948-20180926161348-00392.warc.gz | en | 0.899458 | 1,105 | 3.890625 | 4 |
अनेजद् एकं मनसो जवीयो नैनद्देवा आप्नुवन्पूर्वमर्षत् ।
तद्धावतोऽन्यानत्येति तिष्ठत् तस्मिन्न् अपो मातरिश्वा दधाति ॥ ४ ॥
anejad ekaṃ manaso javīyo nainaddevā āpnuvanpūrvamarṣat |
taddhāvato’nyānatyeti tiṣṭhat tasminn apo mātariśvā dadhāti || 4 ||
anejad – nonmoving (immobile), ekaṃ- one, manaso javīyo – faster than the mind. Devah- sense organs (Gods – consciousness of sense organs – shining ones), purvam arsat enat – always ahead of others, na apnuvan – could not overtake. tat tishtat – it is always still (always same); dhavatah anyan – others who move fast, ati eti – leaves behind. tasminn – on this, matarishwa – air /life force (prana) – lord who dwells in space, apaha dhadati – supports all activities.
Brahman is still, yet faster than the mind. Sense organs (devas) cannot overtake Brahman since Brahman went even before them. Being still it outruns all other runners. It (Matarishva) supports the activities of all beings.
Q4-1). What is the essence of this sloka ?
Brahman is beyond human mind and comprehension. Hence Brahman is devoid of any quality. Even though Brahman is devoid of any qualities, nature of Brahman is explained in terms of manifestation. Manifestation is expression of Brahman. Brahman is total stillness yet faster than the reach of the mind. There is no place where mind cannot reach. In this way, all pervasive nature of Brahman is explained.
Our mind can only think in terms of binary logic. If something is still – it cannot move. But Brahman is beyond mind. Brahman is beyond activity and inactivity. Brahman is unactive. Brahman is not inert like a stone. Hence by explaining Brahman in contradictory terms of stillness & motion, the sloka brings out the transcendental nature of Brahman.
Next four slokas are for pointing out nature of Brahman.
Q4-2). How can Brahman be still but faster than the mind ?
Brahman is stillness – motionless as compared to the world which is constantly changing and hence called jagat. Stillness aspect of Brahman is highlighted to draw our attention to Brahman – our SELF (atma).
Brahman is my SELF. Brahman is sat-chit-ananda (existance-consciousness-bliss). Brahman is unmanifest, unborn and invisible. Being unmanifest Brahman is beyond grasp of mind. How can we know such Brahman ?
Even though Brahman is beyond mind, we have intuitive understanding of Brahman all the time. Intuition is knowledge without intervention of reasoning ability of mind or sense organs. Whenever we refer “I am ” we are referring to SELF – Brahman only. “I stands for consciousness – chit”; am stands for sat aspect of Brahman.
I know I exist intuitively. Nobody has to prove me I exist and I am conscious. In other wards, I am sat-chit. This aspect nobody has to educate me. Neither I need sense organs to prove that I exist. For example if I am in dark room, if somebody asks me is there chair, I will say – “I cant see. There is no light” . However, if the question is are you there ? , the answer is definite “yes”. I don’t need light to know my existence.
I exist, therefore I am able to think. Mind is nothing but thoughts. Hence existance comes first and thought comes later. Mind can travel faster than light but existance is there before the reach of the mind. My SELF is existance – consciousness. Mind is only my expression. Hence, ” I am” is there even before mind travels. “I am” is unmanifest. I am the SELF (atma). “I am” is stillness. Hence the praradoxical statement that Brahman is still yet faster than the mind. In other words “Being (atma) is before thinking (mind)”
This is quite contrary to the statement of the philosopher Descartes – ” I think therefore I am.”
Upanishads teach “I am” therefore “I think”. My existence which is nothing but Brahman comes before the mind. I am never travels. It is total stillness. Unmanifest. Yet it is faster than the mind because of this reason.
Mind reaches out to any object near or far. We say – “Table exists. Chair exists”. The existence aspect of table or chair is expressed as “is ness”. The chair is, the table is … I am. ..
Brahman is in me as “I am” and in all the object of the universe as “is ness”. Hence all pervading reality of Brahman reaches anywhere before the mind. | <urn:uuid:b7455e22-a4ec-4427-ac0f-9cf9d9b6c30f> | CC-MAIN-2022-49 | https://lightoftheself.net/2018/06/23/133/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-49/segments/1669446710924.83/warc/CC-MAIN-20221203043643-20221203073643-00717.warc.gz | en | 0.912379 | 1,323 | 2.53125 | 3 |
A Leap of Faith:
The Dunlap–Pattison Family of Maghera,
Northern Ireland (1740-1820)
by Dr. William M. Litchman, Ph.D., C.G.S.M.
If only all of our ancestors were kings and queens! Ordinary families always provide challenges. Families of Irish origin provide extra special challenges and Northern Irish families can try the patience of even the most dedicated family historians. Perhaps the most difficult part of coming to terms with family research in Ireland is finding the specific village or townland from which the family emigrated to North America.
Slaghtybogy, the townland of origin of the Dunlap-Pattison family near Maghera, County Derry, is given in an eighteenth century hand-made family book. It also details the structure of the family and their emigration from Ulster to America, see Figure 1. But the paucity of Ulster documents has forced a broadening of scope. The purpose of this article is to describe the living conditions of the Dunlap-Pattison family that sent them to America.
Schematic of the Family of Joseph and Margaret Pattison
of Slaghtybogy, Parish of Maghera, County Derry (1716-1820)
Joseph Pattison (b ca 1716) m Margaret (—) before 1740 X
1. Mariann (b ca 1743, d ca 1790) X(b ca 1741, d ca 1790)
m William Dunlap (b ca 1740, d ca 1805-10) X (b ca 1738...
1. Joseph (b ca 1765, d Jul 1802)
m Elizabeth Arbuthnot (ca 1789)
X remove Elizabeth m(2) John Divine (1 Feb 1805)
1. William (b Mar 1790)
2. Robert (b Sep 1792)
3. Jane/Jean (b Mar 1795)
4. Mary Ann (b Jun 1797)
5. Nancy (b Jun 1800)
6. Joseph (b Dec 1802)
2. William (b Apr 1770, d 1833)
m Elizabeth Middleton (14 Feb 1799, d Sep 1819)
1. Andrew (b Feb 1801)
2. Mariann (b Apr 1802)
3. Margaret (b Oct 1803)
4. William Middleton (b Feb 1805)
5. John (b Jun 1806, d Nov 1815)
6. Sarah (b Feb 1809)
7. Elizabeth (b Nov 1810)
8. Susannah (b Mar 1812)
9. Amelia (b Nov 1813)
10. Joseph Pattison (b Jan 1814)
11. John M. (b Feb 1818)
12. Harriet (b Aug 1819)
3. Sarah (b ca 1775-80, d ca 1840-50)
m James Carey (1798, d ca 1827)
X remove 1. William (b ca 1800-09)
4. Child (b and d ca 1790)
2. William (b ca 1747, d aft 1821)
X remove m Sarah Ford (1780)
X remove Children:
X remove 1. Joseph (m Mary (–)
3. Matthew (b ca 1749, d bef 1823)
X remove m Mary (–) (ca 1781)
X remove Children:
X remove 1. Joseph (b ca 1781, m Charity Voorhees)
X remove 2. William
X remove 3. Martin (the “wandering son”)
X remove 4. Elizabeth (b bef 1801, m Peter Welch bef 1823)
X insert “All data in this figure is from reference 1.”
Setting the economic stage for our story, a “Plantation” scheme was instituted by the English King James I in about 1609, in which the lands of Ireland, especially in Ulster, were offered to the London crafts guilds at a nominal rent. Recurring rebellions of the Irish were costing the English crown investment money as well as lost income. The plan behind this was that the guilds would find agents to recruit patriotic Scotsmen and northern Englishmen to bring their families to settle in Ireland. By this means the rebellious Irish population would be diluted and subdued, the guilds would also glean a profit by the rents gathered by their agents and the emigrants would find a better economic life.
Each layer of renters would subdivide their holding, rent smaller and smaller parcels of land for higher and higher rents until at the lowest level one would find the actual user of the land, the farmer, the tiller of the soil. The further up the ladder one went, the more removed from the land the landlord became (in general).
By the early eighteenth century, with the plantation program well underway, Ireland was an open country for the immigration of Scots, including, most likely, the ancestors of this Dunlap-Pattison family. There was pressure at home from increasing rents and the lack of market for home-made goods. It must have been very inviting for families to come to Ireland, acquire land (through paying rents, of course) and then to improve themselves financially. Certainly, the rebellions of the native Irish were not part of the publicity!
Two benchmark dates for the family provide the time period for records to seek in fleshing out this family’s Ulster experience: 13 Mar 1790, the birth date for William Dunlap, eldest known child of Joseph Dunlap and Elizabeth Arbuthnot, will [X remove will] allows us to extrapolate the first, an approximate beginning date, and the second is the voyage of the Ship Tristram taking the family to America and providing closure.
The average age for men (25) and women (22) at marriage, and the assumption that all marriages occurred during the year preceding the birth of the first child give us the framework for our extrapolation. Using these assumptions, Joseph and Elizabeth were probably married in 1789, Joseph was probably born in 1764, William, sr, and Mariann were probably married in 1763, and William, sr, was probably born no later than 1738 and Mariann Pattison about three years later.
Many Maghera-area Scots families came from County Ayr and there are certainly Dunlap and Pattison families present in that county throughout the 1700s.
No appropriate christenings are found for Joseph (ca 1764), William (Apr 1770), or Sarah Dunlap (1775-1780), nor are there baptisms for Mariann Pattison (ca 1741), William Pattison (ca 1746), or Matthew Pattison (ca 1748). William Dunlap is such a common name that it is impossible to know if our William is in the records. No marriage for Joseph and Margaret Pattison is found.
The townland of Slaghtybogy was the exclusive property of the Vintner’s company and the first known renter was John Elliott. Any further sub-renting of the land would have had to be through him or his successors and heirs. The Elliott family continued to control the townland for quite a number of years. Thomas Connolly, speaker of the Irish House of Commons, purchased the lease in the mid 1700s and his heirs continued there for many years thereafter.
Josh (Joseph?) Paddyson is listed as a resident of the Parish of Maghera in 1740, Joseph Patterson in 1796, and the name of Joseph Pattison [not Patterson] is found as a resident of Magherafelt, a small community about 10 miles from Maghera, and a part of the Salter’s plantation in 1766.
Harlan Page Dunlap about 1905 stated that William Dunlap, sr, married “in Ireland, Mary Ann, daughter of Joseph and Margaret Patterson [sic].” One Dunlap infant and the mother died and were buried in the “churchyard at Maghera” prior to the departure of the family in 1792.
There were two churches at Maghera, both with burial grounds, one the ancient (ca 1200) church of St. Lurach (originally Catholic but by the late 1700s, Church of Ireland) and the other, the recently finished (1785) Presbyterian church. No relevant entries have been found in a search of the records of the Maghera Presbyterian Church. There are no early records extant from the Church of Ireland in Maghera, nor were there any Dunlap names found on extant stones found [X remove “found”] in the old St. Lurach graveyard even though the Dunlap name was once known on those stones.
Since very few (7.7%) of the residents of Slaghtybogy were Church of Ireland and nearly half (46%) were Presbyterian in 1831, it seems most probable that the burial of Mariann Dunlap and her child took place in the Presbyterian churchyard. It also seems reasonable that the marriage of William Dunlap and Mariann Pattison took place in Slaghtybogy, at the bride’s home, and the marriage of William’s son, Joseph Dunlap, and Elizabeth Arbuthnot a generation later, possibly at the church.
Long leases “are the ruin of Ireland.” These lengthy leases, sometimes for 999 years, were very successful early in the eighteenth century but they led to fixed rents at a time of rising values and prices. Tenants were then able to sublet very profitably. When primary leases finally ended, however, landlords were able to deal directly with the sub-tenants, especially in the “linen triangle” which included the Parish of Maghera. From 1753 to 1791, the number of houses paying hearth tax in Ulster almost doubled, giving northern landlords a unique opportunity to “set” or lease estates to increase their income.
Especially toward the end of the eighteenth century, unrest, particularly first in Armagh and then spreading to other parts of Ulster, was growing more and more violent. Strife was mainly between individuals of the Protestant and Catholic faiths with atrocities committed on both sides.
Mariann Pattison had two brothers, William and Matthew, who emigrated to America some years prior to the Dunlap family, probably in the wave of emigrations during the early 1770s. Economic crisis struck Ireland about 1770 and emigration rose to 10,000 per year at that time. Emigration abruptly ceased with the American Revolution but the economic crisis continued.
To quote another writer, “the loss of people from the northern part of Britain – from northern England, Scotland, and Northern Ireland – sent shock waves throughout the kingdom. People had been leaving these areas, particularly Ireland, since the end of the seventeenth century, but after 1763 the pattern and intensity of the migration changed. ... Sometimes whole neighborhoods of families and friends would leave in associations large enough to found their own wilderness communities. ... These sudden changes led to a crisis in the early 1770s that was described variously as a ‘madness,’ a ‘contagion,’ a ‘frenzy,’ and an ‘evil’ that would have ‘ruinous’ and ‘dreadful’ consequences.”
Robert Johnston and several of his family members emigrated from Barley Hill, a farm in Slaghtybogy, to Pennsylvania in 1765. They wrote letters back home extolling the virtues of their new country and describing their new life in detail.
William Dunlap (sr) was more likely to have been a merchant or tradesman in Maghera or a nearby community rather than a farmer like his father-in-law, Joseph Pattison. William (jr) was trained in surveying even though he desired to learn navigation for a career at sea. His parents objected to the dangers of a nautical profession and he certainly became successful as a merchant and farmer in the new world. To be schooled in surveying, William (jr) would need to be apprenticed to a local surveyor or to attend a school to learn mathematics, geometry, and trigonometry. An apprenticeship is more likely since the state of schools in Northern Ireland at that time was deplorable.
A coincidental incident [X “event”] which might possibly have some relevance to the [Xurge of the] Dunlaps [XDunlaps’ urge] to migrate involves the change in leadership at the local Presbyterian church. The Rev. David Smylie of Finvoy came to Maghera in 1739 and served faithfully for many years until ill-health forced him to retire in 1778. He died 23 July 1780. At that time the position was filled by Mr. John Glendy, ordained on 26 Dec 1778 as Mr. Smylie’s assistant and successor. He had “warm sympathies with the [Irish] revolutionary movement of the period” and had to go into hiding when that effort failed in 1798. It seems that “he was, in fact, a well-known if not an avowed rebel.” If the Dunlap and Pattison families weren’t very sympathetic with the “revolutionary movement” and its methods, they may have been very uncomfortable in the community once Mr. Glendy was minister. With the increasing unrest of the people of Ireland, particularly in Ulster, the Dunlap family felt (probably with others) the need to emigrate to more propitious surroundings.
All these stresses (economic, social, and political) were wreaking havoc with personal lives. Thus, the advantages which drew the Dunlaps and Pattisons to Northern Ireland originally, deteriorated until the decision to emigrate to North America must have seemed a relief. It was made easier, of course, because William and Matthew Pattison were already established in New Jersey. It was to them that the little Dunlap family went upon landing at Philadelphia.
We can venture to guess that William Dunlap, sr, would have been about 52 years old at the time of his emigration from Ireland to America. It took a deal of bravery and courage to uproot his family from their home in Ireland to make such a lengthy and dangerous journey.
It is apparent from the tone of the writings of William Dunlap that the family were not indentured servants or redemptioners, as many were. Thus, they were able to pay their full passage, provide victuals for the passage, and have enough resources to sustain themselves through the first year(s) of living in the new world. The cost of passage averaged between 3 and 3.5 guineas per adult passenger. Only William (Joseph’s eldest, age 2) was a child so his passage was probably somewhat less. Sarah would have been 17, William, jr, 22. Thus, there would have been 5 adults and 1 child on this trip for a total passage amount of about 20 guineas or 21 pounds.
They sailed on the Ship Tristram.
“For Newcastle & Philadelphia
The fast sailing Ship
Burthen 300 tons
G. A. Hallowell, Master
Will be clear to sail for these Ports the 1st of April.
The Tristram is particularly well adapted for the Passenger Trade. Those who wish to embrace this favourable Opportunity of going in a strong, new Ship, will do well to make speedy Application, as but 150 Passengers will be received. For Freight or Passages apply to Mr Rob. Cochran, Strabane; Mr. King Barton, Nn Stewart; Mr. James King, Fintona; Mr. James Hamill, Coleraine; Mr. David Blair, Nn-Lemavady; or John Atchison Smyth and Co. Who engage that Plenty of Provisions and Water shall be laid in for the Voyage.
N.B. The above vessell will sail the 8th of May, at which Time the Passengers are requested to be on Board.”
“Schooner York, Stephenson, Liverpool
Capt. Stephenson, on the 5th July, spoke the Tristram, from Derry for Philadelphia, with passengers, lat. 29, 20, long. 68“
Latitude 29 degrees, 20 minuntes is on a parallel with St. Augustine, Florida, and longitude 68 degrees, places the ship south and east but still fairly close to Bermuda, when they were only five days out from New Castle. Ships generally followed the trade winds in crossing the Atlantic by moving clockwise around a circle going east across the north and west across the mid-Atlantic. This is exactly the pattern suggested by that single “speaking” of the Tristram by the Schooner York.
“The Ship Tristram, Capt. Hallowell, is arrived at New Castle from Londonderry, after a passage of 45 days with 150 passengers.”
“A very considerable number of Irish emigrants have arrived in this and other states during the present month. Report says that the spirit of emigration is so prevalent in Ireland; especially in the northern and eastern [regions] that the lower and middling classes would universally remove to this side of the Atlantic, could they find ships to bring them off.”
Back to publications | areas of interest | home | <urn:uuid:8ace9595-fd23-4060-9ebb-c4c77e220112> | CC-MAIN-2017-30 | http://www.unm.edu/~litchman/Pattison%20article.htm | s3://commoncrawl/crawl-data/CC-MAIN-2017-30/segments/1500549423716.66/warc/CC-MAIN-20170721042214-20170721062214-00078.warc.gz | en | 0.962688 | 3,671 | 2.8125 | 3 |
Heart Valve Problems - Get information and read articles on Heart Valve Problems signs, symptoms, causes, treatment, prevention and diagnosis at onlymyhealth.com, your complete health guide.
Mitral valve prolapse is one of the common heart problems that is typified by the displacement of a thickened mitral valve leaflet. Learn about its causes, symptoms and treatment.
There are four valves in the human heart, and they are very important for the blood flow in your body. Know what causes diseases in them and what the symptoms could be.
Your heart valves are important, and that is because they pump oxygen into the heart. If you do not strengthen them you may cause a lot of trouble for your heart. Know how you can keep your heart happy.
Cow Valve Heart Implant, Edwards Sapien Heart Valve: A new type of heart valve replacement using a bioprosthetic and a new catheter inserting technique shows promise. | <urn:uuid:8c15640f-7507-44de-a38c-619eca88a12d> | CC-MAIN-2018-17 | http://m.onlymyhealth.com/heart-valve-problems-1295953125.html | s3://commoncrawl/crawl-data/CC-MAIN-2018-17/segments/1524125948285.62/warc/CC-MAIN-20180426144615-20180426164615-00256.warc.gz | en | 0.9051 | 191 | 2.625 | 3 |
American Indian language
American Indian culture
What's new on our site today!
Yokuts Indian Language (Yokut, Yokutsan, Tachi, Chukchansi)
The Yokutsan languages are considered by most linguists to be part of the Penutian family
of languages, possibly related most closely to Miwok.
There were once between twenty and thirty Yokutsan languages spoken throughout the San Joaquin area
of Southern California. Language loss in California has been especially severe, however--the legacy of the Gold Rush days, in which massacres
and Indian slavery, while technically illegal, were not actively discouraged--and today only three Yokuts languages are still spoken, by only a handful
of elders apiece. The three surviving Yokuts languages are generally called Southern Valley Yokuts (with two surviving dialects, Yawelmani/Yowlumni and
Tachi); Northern Valley Yokuts (Chukchansi); and Foothill Yokuts (Choinimni.) Although the Yokuts languages are seriously endangered, there are language
programs in the Tachi and Chukchansi tribes, and some young Yokuts people are working to keep their ancestral tongue alive.
Yokuts language samples and resources.
Yokuts Culture and History
Information and links about the Yokuts tribe past and present.
Introduction to Yokuts mythology.
Our Online Yokuts Materials
Our list of vocabulary words in Chukchansi, Choinimni, and Yowlumne Yokuts, with comparison to words in other Penutian languages.
Yokuts Language Lessons and Linguistic Descriptions
Comparison of sounds in Chawchila, Choynimni, Chukchansi, Dumna, Gashowu, Tachi, Wikchamni and Yawelmani Yokuts.
Linguistics paper on Chawchila Yokuts.
Languages of the Coast of California
Language map showing the distribution of Yokuts, Salinan, Chumash, and other western California languages.
The Lord's Prayer in Chukchansi Yokuts.
The Yokuts Language of South Central California
Scanned-in copy of Kroeber's 1907 linguistics text. A little grainy, but complete.
Yowlumni: The Path to Revitalization Preserving a Native Tongue Lessons Bridge Past, Future
Articles about Yowlumni language preservation efforts.
Collection of traditional Yokuts stories with English translation.
Demographic information about Yokuts from the Ethnologue of Languages.
Survey of California Indian Languages: Yokuts:
Profile of the Yokuts languages from the University of California at Berkeley.
Yaudanchi Language Tree Yokutsan Language Tree Valley Yokuts Language Tree
Buena Vista Yokuts Language Tree Palewyami Yokuts Language Tree Wikchamni Language Tree:
Theories about Yokuts' language relationships compiled by Linguist List.
Yaudanchi Yokuts Language Structures: Yawelmani Language Structures Wikchamni Language Structures:
Abenaki linguistic profile and academic bibliography.
Yokuts Dictionaries, Audio Tapes and Language Resources
Collection of Yokuts-language legends and stories for sale online.
Yowlumni Yokuts linguistics book for sale.
In My Own Words
Fascinating collection of legends, oral history, songs, and anecdotes from a Yokuts elder, printed both in English and glossed Yokuts.
Links, References, and Additional Information
Wikipedia: Yokutsan Languages:
Encyclopedia articles on the Yokuts languages.
Information on the Yokuts language in Spanish.
Yokut Tachi Yokut Tribe:
Yokuts Indian books.
Native Languages of the Americas website © 1998-2015 Contacts and FAQ page
Back to the list of Native American Indian tribes
Back to our Native Americans websites for kids
Native American Crafts
Native American Indian Jewelry
Would you like to sponsor our work on the Yokuts Indian language? | <urn:uuid:9448e9ac-063b-4df3-803a-7238b177e82e> | CC-MAIN-2018-30 | http://www.native-languages.org/yokuts.htm | s3://commoncrawl/crawl-data/CC-MAIN-2018-30/segments/1531676594954.59/warc/CC-MAIN-20180723051723-20180723071723-00446.warc.gz | en | 0.834794 | 846 | 3.78125 | 4 |
Bees and wasps play an important role in our ecosystem and are a normal part of daily life. So how do you know when they’re dangerous? Yellow jackets are known to get more aggressive in the fall as their resources begin to diminish, which is why they’re frequently seen around outdoor barbecues and picnics seeking food. Even worse, they will sting more than once and without provocation, which is why it’s important to know how to protect your home and family from these stinging insects in the fall.
What Makes Yellow Jackets so Aggressive?
While yellow jackets and wasps are known to be somewhat hostile all the time, but they become especially more so in the late summer and fall. During the spring and summer when flowers are abundant, they have plenty of food sources. However, their populations grow throughout the summer, which forces some of the stinging insects out of their overpopulated nests and into residential areas. Some of the things yellow jackets will be attracted to outside your property include:
- Uncovered food or trash cans containing food
- Sources of standing water, such as fountains, swimming pools or hummingbird feeders
- Lawn insects such as grubs, which are fed on by stinging insects
- Eaves or holes that allow them to build new nests.
How to Prevent Wasps in the Fall
The best way to protect you and your family from yellow jackets is to know how to keep them away. Some of the ways you can lessen the risks of yellow jackets invading your outdoor events this fall include:
- Keep all food and trash covered with tight-fitting lids
- Don’t wear bright colors or fragrant perfumes
- Seal all holes and crevices around the home
- Get rid of sources of standing water, and place a cover over your swimming pool.
Professional Help to Prevent Wasps
When it comes to dealing with yellow jackets, it’s important to always take caution. Especially when nests are involved, it’s best to get professional help. Yellow jackets are especially aggressive in the fall, and will sting more than once even if they aren’t threatened. The experts at Pratt Pest Management know what it takes to protect your Everett WA home from yellow jackets all season long. | <urn:uuid:345cde52-1af1-4e53-a277-79f4c6fce57d> | CC-MAIN-2019-39 | https://prattpest.com/blog/are-yellow-jackets-more-aggressive-in-the-fall/ | s3://commoncrawl/crawl-data/CC-MAIN-2019-39/segments/1568514573759.32/warc/CC-MAIN-20190919224954-20190920010954-00163.warc.gz | en | 0.965688 | 473 | 2.796875 | 3 |
A compelling study from a team of researchers at the University of Copenhagen has demonstrated a way to completely stop a body’s ability to store fat. In experiments with mice, the team showed that genetically deleting a single enzyme resulted in the animal not being able to gain weight, even when fed a fatty diet.
An enzyme dubbed NAMPT has been connected to obesity in both human and animal models by several studies. Its presence in fat tissue has been found to increase metabolic functionality in numerous body tissues, including fat tissue, which enhances the body’s ability to store fat.
‘We gave the mice a diet that more or less corresponds to continuously eating burgers and pizza,” explains Karen Nørgaard Nielsen, first author on the study. “Still, it was impossible for them to expand their fat tissue. Our ultimate goal is that by understanding these fundamental underpinnings of how we become obese, we can apply our finding to the development of novel treatment strategies for metabolic disease.”
Further research is proposed to investigate exactly how a deficiency in NAMPT inhibits fat storage and obesity. It is hoped that understanding the mechanism at play could help researchers develop a more targeted treatment strategy that regulates fat storage without causing the broader systemic issues that would result from entirely eliminating NAMPT from a body.
Read full, original post: Deletion of single enzyme stops mice getting fat, no matter the diet | <urn:uuid:6a3ac589-4090-4521-8694-06d482864bf3> | CC-MAIN-2021-25 | https://geneticliteracyproject.org/2018/05/15/unable-to-gain-weight-mice-kept-thin-by-blocking-fat-storing-enzyme/ | s3://commoncrawl/crawl-data/CC-MAIN-2021-25/segments/1623488534413.81/warc/CC-MAIN-20210623042426-20210623072426-00356.warc.gz | en | 0.966971 | 290 | 3.625 | 4 |
Yes, hamsters can eat cucumber.
Cucumber contains a lot of water, but no other nutrients. It does not contain many vitamins or minerals, so should only be eaten occasionally as a treat.
It is not advised to feed your hamster cucumber on a regular basis, because it lacks the proper nutrition necessary for the hamster’s health.
It is not toxic to hamsters, so it is okay to feed it occasionally.
You can cut the cucumber up into bite-sized pieces for your hamster, but do not give too much because of its lack of nutrition.
Cucumbers are usually sold unrefrigerated, so they must be washed thoroughly before you give them to your hamster.
Make sure that all soap residue is washed off before you feed it to your hamster.
Wash and dry the cucumber before cutting it up into pieces for your hamster, so that no bacteria or germs are transferred from your hands to its food.
Make sure there is no dirt on the skin of the cucumber before giving it to your hamster.
When you are finished, throw out the leftovers because they will go bad quickly without refrigeration.
Make sure to clean any dishes or utensils that were used to cut up the cucumber before using them again for your other pets or for yourself, so that harmful bacteria do not transfer onto anything else.
How is cucumber good for hamsters to eat?
Cucumber is a good treat for hamsters because it gives them something to eat and does not have any harmful effects.
It contains a lot of water, so might hydrate a thirsty hamster.
Hamsters also love the taste of cucumbers, so they might enjoy eating it as a snack or as part of their regular food.
Is cucumber bad for hamsters to eat?
Cucumbers have very little nutritional value, so giving them to your hamster on a regular basis will not provide any of the vitamins or minerals that it needs to stay healthy.
Cucumber is mostly water, with very few vitamins, minerals, fats, protein, carbohydrates, or fiber.
For this reason, cucumbers are best eaten occasionally or given to your hamster in small pieces.
Cucumber skin might be toxic if ingested, so it should not be fed whole to a hamster. | <urn:uuid:0ca16995-6120-4b46-9c4f-969ad079eb41> | CC-MAIN-2022-49 | https://petfoodfuss.com/hamsters/can-hamsters-eat-cucumber/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-49/segments/1669446711221.94/warc/CC-MAIN-20221207221727-20221208011727-00467.warc.gz | en | 0.950811 | 491 | 2.9375 | 3 |
How the Sun and Moon Can Appear to be the Same Size
The diameter of the Sun is over 400 times the diameter of the Moon. So how
can they appear to be the same size? Try this experiment! You need three
people for this activity.
1.Have one person hold out the large ball, which will represent the Sun. Hold
it out away from your body so that your hands are on the top and bottom of
2.Have another person hold up the small ball (representing the Moon) directly
in front of the "Sun". Stand about 6 feet away and hold the ball out in the
same way the person is holding the "Sun".
3. The third person should stand in front of the person holding the "Moon", looking toward the person holding the "Sun". This person will represent what
someone on Earth would see. Have the Sun and Moon adjust themselves so that
they appear to be in a straight line, with the Moon between the Earth and
4.The person holding the Sun should begin moving away from the person holding
the Moon (again keeping the Earth, Moon, and Sun in a straight line) until
the Sun and the Moon appear to be the same size to the person representing
Measure and record the diameters of the Sun and Moon.
Measure and record the distances from the Earth to the Moon and the Sun when
they appear to be the same size.
- 1 dodge ball or beach ball
- 1 softball or tennis ball
- tape measure or meter stick
- Why do you think they look the same size to the Earth observer?
- What happens when you look at the values of distance/diameter for the Moon
- Given what you know about the relative sizes of the Sun and Moon, what
can you conclude about their relative distances from Earth?
The StarChild site is a service of the
High Energy Astrophysics Science Archive
Research Center (HEASARC),
Dr. Alan Smale (Director), within the
Astrophysics Science Division (ASD) at
StarChild Authors: The StarChild Team
StarChild Graphics & Music: Acknowledgments
StarChild Project Leader: Dr. Laura A.
Curator: J.D. Myers
Responsible NASA Official: Phil Newman
If you have comments or questions about the StarChild site, please
send them to us. | <urn:uuid:43f28a07-3734-4413-bc29-fa38efc29a72> | CC-MAIN-2016-40 | http://starchild.gsfc.nasa.gov/docs/StarChild/questions/understand_size.html | s3://commoncrawl/crawl-data/CC-MAIN-2016-40/segments/1474738662856.94/warc/CC-MAIN-20160924173742-00148-ip-10-143-35-109.ec2.internal.warc.gz | en | 0.861035 | 495 | 3.953125 | 4 |
Formative Assessment Wins Again
In recent weeks, we have been pleased to feature several CenterLine posts by Center associates and guest authors addressing how states, districts, and schools should consider using assessment to support instruction when school begins again in the fall. In this post, former Center Associate Susan Lyons shares her perspective on this important topic.
How do we begin fall 2020? How do we know where students are in their learning, given all the changes and uncertainties caused by COVID-19? We should resist the impulse to administer standardized interim assessments and instead begin with dialogue. Start the year in conversation with our students; listening, asking questions, and gaining insight into their lived experiences and learning over the past six months. Understanding their perspectives and experiences is the most valuable resource for planning and adjusting instruction in fall 2020. The job of educators is to help students build on their existing knowledge by connecting and integrating new ideas. Well-planned formative assessment practice is the most effective assessment tool for supporting the learning leaps we hope to enable this fall.
The recently released assessment guidance for fall 2020 from the Council of Chief State School Officers amplifies the importance of classroom-based pre-assessment. This formative assessment strategy is a way to gather information about what students know about a topic or its prerequisites before introducing new content. A pre-assessment need not be a formal test, but rather, it’s an umbrella term that encompasses any evidence-gathering activity related to prior knowledge.
For example, when beginning a unit on proportional reasoning, a teacher might put a fraction and a ratio on the whiteboard and ask students to explain in their own words what they are, how they are different, and how they are the same (a more in-depth discussion of this can be found in Heritage & Harrison, 2020, p. 98). This type of questioning will allow the teacher to gauge the level of knowledge and facility students have with the concepts and notation associated with proportionality. This practice has the added benefit of signaling to students the value of their prior knowledge for informing and advancing their current learning. Another example of pre-assessment is the use of a simple three-column chart that students can use at the start and throughout their learning to share what they already know about a topic, what they want to know, and to keep track of what they are learning as they progress through a reading, lesson, or unit of study (for an example see Ogle, 1986).
As measurement professionals, what advice should we be prioritizing for state and district leaders? How can they support high-quality formative assessment practices in schools (or remotely) this fall? My answer is the following:
- Ensure the intended learning goals for the upcoming academic year are clear and visible for all stakeholders.
Due to the disruption of COVID-19, it is likely necessary and important to reaffirm the commitment to students that they will be working toward learning the grade-level standards in the upcoming academic year. This unequivocal message will provide a clear and unchanged goal for teachers and students as they plan their instruction and learning this year and hopefully, side-step the temptation to spend the first months of the year remediating without introducing new content. Time spent measuring and remediating the knowledge gaps that exist from the lost instructional time and school building closures last spring is better used on grade-level instruction with a focus on embedded formative assessment practice. Let’s not lose the opportunity to bridge the gap to new, rigorous content for our students by spending the fall trying to squeeze even more content into too little time.
- Provide time and support for both teachers and students to discuss and reflect on the pathway to those goals and the evidence of progress along the way.
Grade level standards continue to provide clear learning goals, but the path for meeting those standards will inevitably look different this year. Teachers and students will be challenged to find new ways to build on prior learning, reveal misconceptions, provide individualized feedback, and construct knowledge. Teachers with domain expertise and the benefit of experience have at least a general, if not highly developed, idea of how learning progresses throughout a typical academic year in their course(s). Teacher expertise in the ways students gain understanding provides a framework—often implicit—for planning instruction and monitoring learning. This year, however, teachers will need additional time and support to discuss and adjust instruction to reflect the potential new pathways for developing the knowledge necessary for their students to achieve the grade-level content standards.
It may be worthwhile for teachers to explicitly write and revise learning progressions to serve as maps for guiding conversations among colleagues and with students about their learning. Learning progressions are useful tools for planning instruction, gathering evidence of learning, providing effective feedback, supporting self-assessment with students, and determining instructional next steps. Investing in educators to write and use learning progressions is one way to integrate many of the key elements of formative assessment practice into instruction for advancing student learning. Of course, creating the time and space for teachers to collaborate in this way will be an added challenge for districts that are universally facing extraordinary circumstances and constraints this year.
- Do not obfuscate high-quality classroom assessment practice by inserting external instruments that provide little insight into student understanding and offer no direction for moving students forward in their learning.
State, district, and school leaders are acutely aware of the importance of instructional time. School building closures last spring, and the potential for continued disruptions in the coming fall heighten this reality. Leaders must fully evaluate the benefits of any assessment instrument before adopting it or requiring its continued use.
There is little research to support the use of interim assessments for improving instruction. They are often marketed as useful for informing instruction, but generally lack the close connection to instruction and curriculum necessary to support learning (Penuel & Shepard, 2016). Student scores on interim assessments may provide reasonable measures of student achievement in the content area, but sub-score or standards-level interpretations are generally unreliable or not supported. Due to these limitations, the time and resources dedicated to external assessment products may be better invested in supporting teachers to cultivate formative assessment practices in their classrooms. Despite the limited immediate value interim assessments offer for daily instruction, interim assessments are often appropriately used to track trends in student achievement for program evaluation and inform school improvement efforts.
Given the unprecedented uncertainties and constraints on schools this fall, I, like many others, recommend that district leaders prioritize assessment practices closest to the classroom with the highest chances of improving student learning.
For high-quality information on formative assessment, you can visit PDK International’s website to request free access to a selected set of formative assessment articles written for teachers. This resource has been made publicly available for a limited time due to COVID-19.
Susan Lyons, Ph.D. is an independent consultant. Please submit comments to [email protected]. | <urn:uuid:44149833-41f1-4cb3-9c76-55a6b5c81678> | CC-MAIN-2022-40 | https://www.nciea.org/blog/how-should-we-assess-students-in-fall-2020/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-40/segments/1664030337339.70/warc/CC-MAIN-20221002181356-20221002211356-00350.warc.gz | en | 0.945078 | 1,401 | 3.015625 | 3 |
Our Center has just released my latest research presenting a new approach to the identification of middle-skill jobs, or relatively skilled occupations that do not typically require a bachelor’s degree for entry. I call these occupations Skilled Non-College Occupations (SNCOs). In comparison to empirical studies and measurement frameworks that use alternative definitions of middle-skill jobs, the findings show that SNCOs represent a much smaller proportion of jobs in the United States than prior research has shown. This new definition of middle-skill occupations is an attempt to provide a more accurate understanding of the nature of skilled non-college occupations in the U.S.
Middle-skill occupations are generally defined as those occupations that demand medium to relatively high skills but require less than a four-year college degree for entry, as measured by educational attainment, wages, or occupation-specific skill demands. There are three main approaches to identifying middle-skill occupations that use these variables to produce vastly different estimates of middle-skill jobs. Two widely cited studies yield employment estimates of middle-skill occupations between one-third (Holzer, 2015) to more than a half (National Skills Coalition, 2014). A third approach proposed by Jonathan Rothwell (2015) offers the most rigorous methodology, but only focuses on “skilled technical” occupations.
At the core of the estimates’ discrepancy are competing approaches to defining and isolating a quantitative measurement of skills. My method relies on a new skills index based on data from the Occupational Information Network (O*NET) program, sponsored by the U.S. Department of Labor. The new skills index, which aims at providing an improved measurement of skills, includes average scores from the O*NET knowledge, skills, training and experience categories. The new skills index is called the KSTE index. Skilled non-college occupations are defined as those occupations that report above-average values of the KSTE index and typically require less than a bachelor’s degree for entry. The methodology of the study is described in detail in the technical report.
This study estimates that the combined employment of Skilled Non-College Occupations (SNCOs) accounted for 16.2% of all jobs in 2016, in contrast to studies that estimate that the employment of so-called middle-skill occupations in the U.S. represent one third to nearly half of total employment. An exploratory analysis yields six important findings:
- In non-college occupations (i.e., those typically requiring less than a bachelor’s degree), one in five jobs belongs to a relatively skilled occupation. In contrast, for college occupations (i.e., those typically requiring a bachelor’s degree or more), four in five jobs belong to a relatively skilled occupation. This extremely large difference in the likelihood of getting into a relatively skilled occupation with or without a bachelor’s degree should be a warning sign for advocates of career paths associated with middle-skill jobs.
- The exploratory analysis across occupations and industries reveals a composition of SNCOs that defies stereotypes of middle-skill jobs. Skilled care workers and technicians in the health care sector and skilled production workers in manufacturing are part of the group, as expected. Other occupations like first-line supervisors of administrative support workers, police officers, and sales representatives in the service sector add new layers of complexity to the notion of middle-skill jobs.
- Employment in SNCOs is concentrated in a relatively small number of detailed occupations, led in size by Registered Nurses. For instance, nearly half of all jobs in SNCOs is concentrated in the top 10 detailed SNCOs, out of 179 detailed SNCOs. This high concentration of employment across occupations, which is also observable across industries, suggests that studies that focus on specific occupations, possibly also within specific industries, may shed more light on the nature and dynamics of SNCOs and the different educational and career paths associated with them.
- The correlation between median occupational wages and the KSTE scores is quite low, challenging in principle the central tenets of human capital theory, where “learning,” represented in this case by the average knowledge, skills, training, and work experience required in each detailed occupation, is supposed to keep pace with “earnings” (Brown, Cheung, & Lauder, 2015, p. 213). This interactive visualization plots median hourly wages, KSTE scores and employment level across SNCOs, by typically required education and NAICS sector.
(Click on the image below to launch the interactive visualization)
- The SNCO wage distribution is much more symmetrical and more compact or egalitarian than the wage distributions of all occupations, skilled occupations, and non-college occupations. Mean hourly wages of SNCOs are more frequent between the low $20s and the mid $30s, or between a lower bound that stands somewhat below and an upper bound that stands well above the overall mean hourly wage of $24 in 2016. The distribution of KSTE values across SNCOs is much more skewed than the wage distribution, with most values concentrated toward the lower end of the distribution. The observed low correlation between occupational wages and the KSTE scores is then explained by the important differences in the shapes of their distributions.
- There is a clear mismatch between the aggregated levels of educational attainment typically required by SNCOs and the aggregated levels of educational attainment of workers in SNCOs. While more than two-thirds of jobs require a high-school degree or less, an estimate of two-thirds of the workers in SNCOs report levels of educational attainment above a high school diploma. The aggregated excess of education effectively attained by workers relative to the education occupations require suggests that a significant proportion of workers in SNCOs are overqualified or underemployed in terms of educational attainment. This result is consistent with findings in recent research on the relationships among education, skills, and employment in the U.S. (see Abel & Deitz, 2016; Beaudry, Green, & Sand, 2015; Cappelli, 2015; Fogg & Harrington, 2011).
Summing up, SNCOs in the U.S. represent a much smaller mass of employment compared to existing definitions of middle-skills jobs. More specifically, SNCOs (a) represent only one in five jobs that do not require a 4-year college degree for entry; (b) encompass a wide variety of occupations and industries, even though the jobs are highly concentrated in a relatively small number of occupations and industries; (c) usually pay above-average wages; (d) show a quite low correlation between wages and skills; and (e) include a significant proportion of workers who are potentially underemployed in terms of educational attainment.
The study leaves some important questions unaddressed. These questions refer to the demographics of workers in SNCOs, the dynamics of SNCOs over time, and the variation in the dynamics and composition of SNCOs across subnational geographic areas. What is the composition of SNCOs in terms of age, sex, race, and ethnicity, and how has it changed over time? Have SNCOs expanded or contracted over the last decades, especially since the Great Recession? Are SNCOs expected to expand or contract in official employment projections? In terms of employment, which SNCOs have expanded or contracted, and which ones are projected to grow or decline? Do the relative size and composition of SNCOs vary significantly across states and metropolitan areas? Answers to these important questions should offer a more accurate understanding of the nature and dynamics of SNCOs in the U.S
Abel, J. R., & Deitz, R. (2016). Underemployment in the early careers of college graduates following the Great Recession (Working Paper No. 22654). National Bureau of Economic Research. https://doi.org/10.3386/w22654
Beaudry, P., Green, D. A., & Sand, B. M. (2015). The great reversal in the demand for skill and cognitive tasks. Journal of Labor Economics, 34(S1), S199–S247. https://doi.org/10.1086/682347
Brown, P., Cheung, S. Y., & Lauder, H. (2015). Beyond a human capital approach to education and the labour market: The case for industrial policy. In D. Bailey, K. Cowling, & P. Tomlinson (Eds.), New Perspectives on Industrial Policy for a Modern Britain (pp. 206–224). Oxford, U. K.: Oxford University Press.
Cappelli, P. H. (2015). Skill gaps, skill shortages, and skill mismatches: Evidence and arguments for the United States. ILR Review, 68(2), 251–290. https://doi.org/10.1177/0019793914564961
Fogg, N. P., & Harrington, P. E. (2011). Rising mal-employment and the Great Recession: The growing disconnection between recent college graduates and the college labor market. Continuing Higher Education Review, 75, 51–65.
Holzer, H. J. (2015). Job market polarization and U.S. worker skills: A tale of two middles (Brookings Institution Brief). Washington, D.C.: Brookings Institution.
National Skills Coalition. (2014, June 18). Discussion of methodology for 2014 middle-skill fact sheets. Available on request from the National Skills Coalition.
Rothwell, J. T. (2015). Defining skilled technical work (SSRN Scholarly Paper No. ID 2709141). Rochester, NY: Social Science Research Network. Retrieved from https://papers.ssrn.com/abstract=2709141
Matías Scaglione is a Senior Researcher at the Center for Research on College-Workforce Transitions (CCWT). Follow him on Twitter. | <urn:uuid:2a571461-e4e0-4481-ba8f-a06dbd5984cb> | CC-MAIN-2023-50 | https://ccwt.wisc.edu/skilled-jobs-that-do-not-require-a-bachelors-degree/ | s3://commoncrawl/crawl-data/CC-MAIN-2023-50/segments/1700679100909.82/warc/CC-MAIN-20231209103523-20231209133523-00683.warc.gz | en | 0.925093 | 2,045 | 2.59375 | 3 |
This essay has been submitted by a student. This is not an example of the work written by our professional essay writers.
Organisational structures includes creating the organisations structure, designing the best possible arrangement of tasks into jobs, and arranging the work processes. It is the organising function that provides an orderly framework for the tasks that need to be done, in a systematic and effective manner.
So, this topic covers organisational structure, the contingency factors that affect organisational design, and various structural configurations. It discusses the various options for how to structure the organization. It also considers how power, empowerment, delegation, and control are influenced or made possible by the Organising process.
The 'organising process' is how an organisation's structure is created. Organisational structure can play an important role in an organisation's success. Managers seek structures that will best support and allow employees to effectively and efficiently do their job. And today's changing, complex business environment means many organisations all over the world are experimenting with different approaches to organisational structure and design.
WHAT IS 'ORGANISING' & WHY IS IT IMPORTANT?
Put simply, Organising is the management function of choosing which tasks are to be done, who is to do them, who is to report to who and where decisions are to be made. Organising establishes relationships between activity and authority, and has four distinct areas:
It sets what work activities have to be done to accomplish organisational goals.
It classifies the type of work that needs to be done and groups the work into manageable work units.
It assigns the work to individuals and delegates the appropriate authority.
It defines the hierarchy of decision-making relationships (i.e., who is responsible to whom).
SOME BASICS: DEFINITIONS
Organising is the process of creating an organisation's structure. That process has several purposes.
An organisational structure means, the formal framework by which job tasks are divided, grouped, and coordinated.
Organisational design is the process of developing or changing an organisation's structure. It involves decisions about six key elements: work specialisation, departmentalisation, chain of command, span of control, centralisation/ decentralisation and formalisation.
Work specialisation - that is, the degree to which tasks in an organisation are divided into separate jobs. (Another term for this is division of labour).
Work specialisation can be traced back to the writings of Adam Smith. Work specialisation was seen as a way to make the most efficient use of workers' skills because workers would be placed in jobs according to their skills and paid accordingly. Other advantages of work specialisation included improvement in employees' skills at performing a task, more efficient employee training, and encouragement of special inventions and machinery to perform work tasks.
Work specialisation was viewed as a source of unending productivity improvements. And it was -up to a certain point. But, the human problems created by highly specialised jobs included boredom, fatigue, stress, lowered productivity, poor quality of work, increased absenteeism, and higher job turnover. So attention began to be paid to how to design jobs that were more satisfying and motivational for the job holder, and thus greater worker productivity.
THE ORGANISING PROCESS
The organising process starts with defining the work tasks. Once the work tasks have been defined, they must be grouped together in a logical way. Departmentalisation is the name given to this process. Departmentalisation groups the jobs in some orderly manner so as to accomplish organisational goals. There are five major ways to departmentalise:
1. Functional departmentalisation is grouping jobs by functions performed.
2. Product departmentalisation is grouping jobs by product line.
3. Geographical departmentalisation is grouping jobs on the basis of territory or geography.
4. Process departmentalisation is grouping jobs on the basis of product or customer flow.
5. Customer departmentalisation is grouping jobs on the basis of common customers.
All 5 methods are widely used.
BASICS OF ORGANISATIONAL STRUCTURE
The chain of command is the continuous line of authority that extends from the upper organisational levels to the lowest levels and clarifies who reports to whom. Three related aspects are authority, responsibility, and unity of command:
Authority is the right inherent as a manager to tell people what to do and to expect them to do it.
Responsibility is the obligation or expectation to perform.
Unity of command is the classical management principle that a subordinate should have one and only one superior to whom he or she is directly responsible; that is, a person should report to only one manager.
A simple structure is an organisational design with low departmentalisation, wide spans of control, authority centralised in a single person and little formalisation Its strengths are its flexibility, speed, clear accountability, and low cost to maintain. The major drawback is that the simple structure is most effective in small organisations. Simple structures become inadequate as organisation grows. A simple structure can overload the top; and managerial decision making slows as size increases. As an organisation grows, the structure tends to become more specialised and formalised.
THE "SPAN OF CONTROL" & ITS RELATIONSHIP TO COORDINATION AND MANAGERIAL EFFECTIVENESS.
The span of control is important because it determines how many levels and managers an organisation will have. "Span of control' is directly related to Controlling. If the span of control is too narrow, or, too wide, then either the manager will over-supervise their staff or, will have difficulty keeping track of all activities staff undertake. In either situation there are unnecessary potential costs and risks for the
What determines the 'ideal' span of control? Contingency factors, such as the skills and abilities of the manager and the employees; the characteristics of the work being done; similarity of employee tasks; the complexity of those tasks; the physical proximity of subordinates; the degree to which standardised procedures are in place; the sophistication of the organisation's information system; the strength of the organisation's culture, and the preferred style of the manager will influence the ideal number of subordinates.
The trend in recent years has been toward larger spans of control, primarily due to organisational de-layering - i.e. organisational restructuring that has removed hierarchical levels and created flatter organisational structures.
Centralisation and decentralisation are related to the span of control. These address who, where, and how decisions are made in organisations:-
Centralisation is the degree to which decision making is concentrated at a single point in the organisation, usually in the upper levels of the organisation.
Decentralisation occurs where decision-making authority is handed down to lower levels in an organisation. Today, the trend is toward decentralising decision making in order to make organisations more flexible and responsive.
Employee empowerment is another term for increased decentralisation and is the increasing of the decision-making discretion of employees.
These factors - the span of control, they way that centralisation or decentralisation operate, the degree of employee empowerment - all directly influence managerial coordination and effectiveness.
Other related factors include formalisation - the degree to which jobs within an organisation are standardised and the extent to which employee behaviour is guided by rules and procedures.
In a highly formalised organisation, employees have little discretion, and there is a high level of consistent and uniform output. Formalised organisations have explicit job descriptions, lots of organisational rules and clearly defined procedures.
Standardisation not only eliminates the possibility that employees will engage in alternative behaviours, it even removes the need for employees to consider alternatives.
In a less-formalised organisation, employees have a lot of freedom and can exercise discretion in the way they do their work.
The degree of formalisation can vary widely between organisations and even within organisations.
DIFFERENT ORGANISATIONAL STRUCTURES - ADVANTAGES & DISADVANTAGES
You have already learned about functional, divisional and matrix structures using different forms of departmentalisation. But these are not the only options. Organisations are not structured the same way- even companies of similar size do not necessarily have similar structures.
Organisations face dilemmas as to the best form of organisation structure. They have to balance the advantages of characteristics such as formal procedures, delegated authority, and specialised roles against their disadvantages. Although there are a number of typical organisation structures, such as functional, divisional, and matrix, there is no one best type of organisation structure. Most organisations have mixed structures, and structural design must closely match situation characteristics. Top managers put a lot of thought into how best to design the organisation's structure!
DECIDING THE ORGANISATIONAL DESIGN
There are two generic models for organisational design: mechanistic and organic.
A mechanistic organisational structure is characterised by high specialisation, rigid departmentalisation, narrow spans of control, high formalisation, a limited information network and little participation in decision making by low-level employees.
An organic organisational structure is highly adaptive and flexible with little work specialisation, minimal formalisation and little direct supervision of employees.
HOW STRATEGY, SIZE, TECHNOLOGY & ENVIRONMENTAL UNCERTAINTY MAY INFLUENCE STRUCTURE
The 'best' design - mechanistic or organic - is influenced by four variables: the organisation's strategy, size, technology and degree of environmental uncertainty.
The organisation's strategy influences organisational design. Alfred Chandler did the original work on the strategy-structure relationship, finding that structure followed strategy. This highlighted that as organisations changed their strategies, they had to change their structure to support that strategy. Organisational strategy is usually based on one or more of the following:
Innovation, which needs the flexibility and free flow of information of the organic organisation.
Cost minimisation, which needs the efficiency, stability and tight controls of the mechanistic organisation.
Imitation, which uses characteristics of both mechanistic and organic organisations.
There is considerable historical evidence that an organisation's size significantly affects its structure. Larger organisations tend to have more specialisation, departmentalisation, centralisation and formalisation, although the size-structure relationship is not linear.
Every organisation uses some form of technology to transform inputs into outputs. Technology also has been shown to affect an organisation's choice of structure. Back in the 1950's a British researcher Joan Woodward, found that organisations adapted to their technology. She showed that distinct relationships existed between the organisation's technologies, their subsequent structure and their effectiveness
d) Environmental uncertainty
The final factor that has been shown to affect organisational structure is environmental uncertainty. The more uncertain the environment, the more flexible and responsive the organisation may need to be. | <urn:uuid:b2a2205b-fde5-4b30-9751-2ea8b4000342> | CC-MAIN-2017-13 | https://www.ukessays.com/essays/business/what-is-organising-and-why-is-it-important-business-essay.php | s3://commoncrawl/crawl-data/CC-MAIN-2017-13/segments/1490218191984.96/warc/CC-MAIN-20170322212951-00046-ip-10-233-31-227.ec2.internal.warc.gz | en | 0.92677 | 2,229 | 3.65625 | 4 |
For the last few days I’ve been in DC, participating in the National Geographic’s Road Map to GeoLiteracy Project. What’s geo-literacy? Here’s how my colleague Danny Edelson defines it – understanding how the world works, how the world is connected, and how to make reasoned decisions. He has ambitious goals, to have a large proportion of young people develop geo-literacy competencies by 2025.
Towards these efforts, I participate as a member of the Road Map’s Education Research Group. We’ve been designing the framework for organizing our research agenda questions, likely to be grouped around our abilities to formulate geographic questions, analyze spatial variability, and construct and share accounts of our interpretations. We do these things as we understand our world in spatial terms. Focusing on a K-12 project is new for me, and only infrequently do I come into contact with geography’s well-crafted National Standards. However, our agenda reaches into higher education as well, especially as teacher preparation is concerned, and this is all highly relevant and significant for our Spatial Literacy for Educator’s program. | <urn:uuid:209702b3-64a7-4e36-84b4-d2d789d4cda0> | CC-MAIN-2017-34 | https://dianamaps.com/2011/06/18/framing-geo-literacy-research/ | s3://commoncrawl/crawl-data/CC-MAIN-2017-34/segments/1502886105455.37/warc/CC-MAIN-20170819143637-20170819163637-00499.warc.gz | en | 0.946129 | 242 | 2.671875 | 3 |
Fireworks, Freedom and Facts!
With the stroke of 56 pens the festivities followed.
Fireworks and freedom
That's what America does on the Fourth of July to celebrate the country's birthday, established with 56 founding father's pen strokes on the Declaration of Independence in 1776.
The American Flag is symbolic in many ways. The alternating red and white stripes represent the 13 British colonies that settled in America, while the stars represent each individual state. But what about the colors?
Why is the American flag red, white and blue?
When Congress adopted the American flag in 1777, to celebrate our country's unity and independence, the specific meaning behind the choice of red, white and blue was't revealed. Until five years later. On June 1782 when the seal for the United States of America was introduced, the significance of the colors on its flag was discussed.
Charles Thompson, who was Secretary of the Continental Congress at the time, told his assembled audience:
"White signifies purity and innocence, Red, bravery and valor, and Blue, the color of the Chief, and the placement of the broad band signifies, vigilance, perseverance and justice."
The colors were deliberately chosen to represent a theme that our founding fathers felt was important to the building of our nation.
- Red stands for courage, hardiness, and bloodshed to honor all those who lost their life for our freedom and our country.
- White stands for purity and vigilance.
- Blue stands for justice and perseverance: justice because it is the basis of our country.
Throughout history, the number of stars on the flag has changed. As each state joined the United States of America, another star was added. On July 4th, 1960, Hawaii was the final star that completed the flag we know today.
As for the stripes themselves, they stand for the first thirteen colonies. They include:
- New Jersey
- New Hampshire
- New York
- Rhode Island
- North Carolina
- South Carolina
Fourth of July Statistics
According to the statisticbrain.com the number of hot dogs consumed on July 4th each year is 150,000,000 (That's a LOT of hot dogs!)
Not to mention 33% of all hot dogs produced in the U.S. come from Iowa and the amount of chicken purchased in the week leading up to July 4th is a staggering 700 million pounds!
While only 26% of the population set off their own fireworks, 63% of them will attend a fireworks display. Will you be one of them
Our founding fathers carefully chose the colors of our flag to represent the fundamental values that were important to the building of our nation, but whether Americans today know the significance of the flag colors, or how many hot dogs are consumed on the 4th, it is not as important as the power of these colors that evoke our patriotic spirit and unify us as a country.
Happy Fourth of July Everyone! | <urn:uuid:683d8d2a-ae9f-49ed-b1af-505f5d0c3de7> | CC-MAIN-2019-30 | https://www.yayusa.com/news/fireworks-freedom-and-facts | s3://commoncrawl/crawl-data/CC-MAIN-2019-30/segments/1563195524111.50/warc/CC-MAIN-20190715195204-20190715221204-00224.warc.gz | en | 0.954908 | 602 | 3.1875 | 3 |
All cars today have a fuel pressure regulator. A fuel regulator maintains the appropriate fuel pressure to allow the fuel to atomize correctly and allows your car or truck to run smoothly.
The simple design makes this part very durable and incredibly long-lasting.
Learning exactly how regulators function, the symptoms your vehicle will experience when the regulator needs maintenance or replacement, and the basics of how the part operates will help you keep your engine running efficiently.
How a Fuel Pressure Regulator Works
Most trucks and cars, no matter the size of the fuel pump, must maintain a fuel system pressure of 28 psi. Fuel regulators contain a spring-loaded diaphragm and valve control system. When the valve opens, the fuel line releases and brings excess fuel back to the tank.
This helps the pump provide the exact amount of fuel need for combustion.
There is a vacuum hose attached to the fuel pressure regulator that will decrease the pressure level when the vehicle idles. This will suck a negligible amount of fuel into the regulator that will not harm the system.
Once you push down on the accelerator, it takes a few moments for the change in pressure to affect the injectors. The fuel pressure regulator temporarily shuts down the fuel return line during this interim phase. This boosts the fuel pressure quicker.
The truck’s computer uses the regulator information, along with information from various sensors providing data on air temperature and density to help the engine run more efficiently.
The fuel pressure regulator ensures the fuel pump functions at a consistent level, regardless of any changes in the amount of fuel or speed of the vehicle while driving. This helps to keep fuel from being wasted or expended for no reason.
Pressure regulators also help reduce the release into the atmosphere of carbon monoxide and other toxic gases produced by the engine. By saving fuel, fuel regulators that work correctly help improve your gas mileage.
Types and Locations of Fuel Pressure Regulators
The size and shape of the fuel pressure regulators depend on the type of fuel pump in your car or truck. A pressure regulator is not installed in the same location in each vehicle. It depends on the engine configuration and fuel injector location. However, no matter where the regulator is located, the basic operation does not vary.
Symptoms of Regulator Problems
Although fuel pressure regulators should last longer than most parts, they eventually begin to fail.
Six signs could indicate a problem with your pressure regulator:
#1 – Engine Runs Rough or Stalls
If your engine runs rough while idling, a bad fuel pressure regulator may be the cause. Sometimes you might have trouble starting the car, and it might take two or three tries before it starts. You may notice your engine has begun to stall on occasion.
#2 – Black Spark Plugs
If your vehicle has spark plugs, remove one and check to see if it is fouled with black soot. If so, check the rest. If they all appear black, your fuel regulator could be the cause.
#3 – Oil Dipstick Smells like Gasoline
If you smell gas when you check your oil, your fuel regulator may be at fault, allowing gas to leak into your oil system.
#4 – Black Smoke from Your Tail Pipe
If you see black smoke, you definitely have a problem. One possible cause is a bad fuel pressure regulator.
#5 – Gasoline Dripping from Your Tail Pipe
Sometimes gas drips from your tailpipe when you overfill your tank. However, if you notice fuel leaking, and you are sure you did not overfill, it may be the pressure regulator allowing gas to leak into the exhaust system.
#6 – Gasoline in the Vacuum Hose
If you notice gas in the vacuum hose with the engine off, or if gas starts to drip out of the hose when you turn the car on, the fuel pressure regulator has gone bad.
Testing Your Regulator
The simplest way to test whether your regulator works properly is to run a scan of the vehicle’s computer for an error code associated with the fuel system. The scanning tool will provide you with a detailed explanation of the error code and if it relates to the fuel pressure regulator.
You can also purchase a fuel pressure gauge to test the system. Unscrew the cap covering the pressure testing port and use the gauge to determine the exact psi of the fuel system. If the reading does not match the exact number provided in your car or truck manual, it may be the regulator or fuel pump.
To determine which, note the reading on the gauge, then remove the vacuum hose. The pressure should increase by 5-10 psi when you do so. If it doesn’t, then your fuel pressure regulator has failed. | <urn:uuid:09a37dd6-c804-4d26-8155-bcf6564a4de6> | CC-MAIN-2022-21 | https://blog.fordiesels.com/2018/02/02/fuel-pressure-regulator-demystified-restore-engine-performance-today/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-21/segments/1652663013003.96/warc/CC-MAIN-20220528062047-20220528092047-00112.warc.gz | en | 0.908308 | 968 | 3.4375 | 3 |
Meatless Mondays In Nashville? Here's Why & Where To Go!
The idea of Meatless Mondays is actually an international campaign that was introduced by the Johns Hopkins School of Public Health in 2003.
Today 36 countries from Australia and Bhutan to Taiwan and Turkey have jumped on the bandwagon and instituted their own version of this campaign.
The benefits of skipping meat just one day a week range from personal health effects to a larger scale impact on the planet. According to the campaign, if the world adopted Meatless Mondays we could reduced meat consumption by 15%, which would have the same impact on greenhouse gas emissions as taking 240 million cars off the road each year. For every burger skipped you can save enough water to drink for the next 3 years and enough energy to charge your phone for 4.5 years.
Environmental impact and politics aside, there are a ton of health benefits of skipping meat one day a week and increasing your intake of fruits and vegetables. Here in the US Johns Hopkins based their recommendations on USDA food guidelines. The most recent version of the national dietary guidelines came out just last month and was powered by data from the National Health and Nutrition Examination Survey. According to this data, we as a country are falling well below the recommended consumption of fruits and veggies, but most specifically dark green vegetables and legumes. The most commonly consumed vegetables are potatoes, tomatoes, lettuce, and onions. Does that sound like the description of the toppings on a burger and fries to anyone else? Most alarmingly people under 30 have the lowest rates of vegetable consumption, which can lead to long term health complications such as heart disease and type II diabetes if they instead are eating processed food high in saturated fat. According to the Mayo Clinic, eating more vegetables increased your intake of dietary fiber, which lowers cholesterol and helps control blood sugar levels.
Sure it would be ideal to just increase your intake for fruits and vegetables every day, but that can be an overwhelming task for some for us. Instead, picking a single today, like Monday, to just focus on eating more vegetables can make the overall goal of eating healthier more manageable.
To help you along I’m including a sampling of local restaurants who have amazing vegetable dishes or who focus mainly on vegetarian fare:
Sweet potato and black bean tacos
Chipotle black bean burrito
Kimchi spring rolls
Paper masala dosa
Paneer tikka masala
Heart of palm salad
Grilled kale salad
Trio de setas
Fried Brussels sprouts
For more time Under The Stethoscope, head here:
A native Californian, Andrei Javier is a physician and researcher who currently works at Vanderbilt University Medical Center. She holds a Bachelor's degree from Yale University and studied healthcare policy in Denmark and Italy. Before moving to Nashville, Andrei spent time in Washington D.C. working in health policy as an advisor to the Senate Finance Committee and the California State Legislature. She has an extensive clinical research background in cardiothoracic surgery and nephrology. In her spare time she loves rock climbing, traveling, exploring Nashville's culinary scene and community service. She is on the Speakers Bureau of the American Heart Association, develops community partnerships for the American Red Cross, and is a member of the Friends of the Food Bank, the young professionals group for Second Harvest Food Bank. | <urn:uuid:1b740667-d627-421d-a9f3-152ef43fa8d9> | CC-MAIN-2022-40 | https://www.tennessean.com/story/life/2016/02/04/meatless-mondays-nashville-heres-why-where-go/79813666/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-40/segments/1664030337371.9/warc/CC-MAIN-20221003003804-20221003033804-00685.warc.gz | en | 0.941063 | 756 | 2.640625 | 3 |
Australia’s national anthem tweak is inclusive of the aboriginals2 min readReading Time: 2 minutes
From January 1 onwards, the people of Australia will be singing a different version of their national anthem. Well, not entirely different, but with a small, yet significant tweak.
Owliver’s Obscure Facts
According to the United Nations, indigenous peoples are inheritors and practitioners of unique cultures and ways of relating to people and the environment. They have retained social, cultural, economic and political characteristics that are distinct from those of the dominant societies in which they live.
The first line of the anthem, “Australians all let us rejoice, for we are young and free”, will now end with “one and free”. The change in the anthem reflects the spirit of unity and Australia’s Indigenous population. The move, though a surprise, was welcomed by everyone in government. The anthem was composed by Peter Dodds McCormick, and was officially adopted as the national anthem in 1984.
Prime Minister Morrison said it was time to ensure that unity is reflected in the country. He added that Australia as a modern nation may be young, but its story is ancient. He said that in the spirit of unity, it is rightful that the national anthem of Australia represents this truth and appreciation.
Ken Wyatt, the Minister of the Indigenous Australians was consulted about the change in the anthem and he gave his complete support.
First people of Australia
Australia’s first people — known as Aboriginal Australians — have lived on the continent for over 50,000 years. Aboriginal Australians are split into two groups – Aboriginal peoples, who are related to those who already inhabited Australia when Britain began colonizing the island in 1788, and Torres Strait Islander peoples, who descend from residents of the Torres Strait Islands, a group of islands that is part of modern-day Queensland, Australia.
Watch this short animated video on the history of Australia and its people.
Sources: BBC.com, Jagran Josh, National Geographic | <urn:uuid:efc07d24-8b36-4027-ad42-f9257fcc60b1> | CC-MAIN-2022-33 | https://www.owliverspost.com/australia-tweaks-national-anthem-to-honour-indigenous-people/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-33/segments/1659882571538.36/warc/CC-MAIN-20220812014923-20220812044923-00626.warc.gz | en | 0.965007 | 419 | 3.015625 | 3 |
August 26, 2009
New fragile X retardation data obtained
U.S. scientists say they used a fruit fly's eyes to
see proteins necessary for memory in a study that provides new data on fragile X mental retardation.
Understanding translational control mechanisms in the brain teaches us how the brain learns and adapts, and will inform the design of treatments for specific types of neurologic disease, said Dr. Anne-Marie Cziko of the University of Arizona, co-author of the study.
The researchers said they discovered the fragile X mental retardation protein that also plays a role in learning and memory needs five other proteins to function normally. The scientists identified those proteins using an artificial system of increasing the fragile X protein in the eyes of fruit flies, which leads to visible deformities.
To test the requirement of various candidate proteins for function of the fragile X protein, the researchers genetically modified the flies to prevent them from making each candidate protein. They found loss of any one of the five proteins caused the fruit fly's eye to be significantly less deformed, revealing that each protein contributes to the harmful effects of the fragile X mental retardation protein.
The researchers said their findings give new insight into additional and alternative functions of the fragile X mental retardation protein and also indicate the need for more study into the fragile X protein's function itself.
The findings are detailed in the journal Genetics. | <urn:uuid:95aacb20-ddd7-4825-8c4c-53fd95b2c08d> | CC-MAIN-2015-35 | http://www.redorbit.com/news/science/1743380/new_fragile_x_retardation_data_obtained/ | s3://commoncrawl/crawl-data/CC-MAIN-2015-35/segments/1440644064865.49/warc/CC-MAIN-20150827025424-00333-ip-10-171-96-226.ec2.internal.warc.gz | en | 0.912452 | 284 | 3.359375 | 3 |
The sovereign debt crisis is not European: it is global. And it is not over. The European sovereign debt crisis of spring 2010 was a misnomer in more ways than one: there was not one crisis but two. And it will continue well beyond 2010, in our view. The first crisis was, and remains, an institutional crisis of the euro, caused by a flawed multilateral fiscal surveillance framework. Steps have been taken towards a correction of the flaws with a move from peer pressure to peer control of fiscal policy. This is reflected by the acceptance by the Greek, Spanish and Portuguese governments of fiscal measures largely dictated from Berlin and Brussels. The second crisis was, and remains, a sovereign debt crisis: a crisis caused by sovereign balance sheets being overstretched, to the point where insolvency ceases to be merely possible and becomes plausible. This crisis is not limited to the periphery of Europe. It is a global crisis and it is far from over. We take a high-level perspective on the state of government balance sheets and conclude that debt holders have to be prepared to enter an age of ‘financial oppression'.
Debt/GDP has been higher before, so why worry? As government debt and deficits have swollen to levels for which there exist few recent references, all eyes have turned to a more distant past in the hope of finding some guidance as to what future awaits bondholders. At first glance, history appears to be reassuring, though that is deceptive, in our view. Several advanced countries have experienced debt/GDP levels well in excess of current ones. The US emerged from Word War II with a public debt/GDP ratio of approximately 110%, and the UK with a ratio of 250%. The UK national debt has averaged almost 100% of GDP since its creation in 1693. Yet the UK government never defaulted through that period. France's public debt stood at about 280% of GDP at the end of World War II. It did not default either. As a matter of fact France defaulted only once - in 1797 - since the creation of its own national debt in 1789. This is remarkable, considering the number of political, military and economic crises the country went through. So why worry now?
Four reasons why debt/GDP misses the point. The problem with these historical comparisons is not the reference: how governments dealt with their war debt burdens sheds useful light on what might be in store for coming years. Rather, the problem lies with the measurement tool: debt/GDP is the most widely used debt metric, but we believe that it is a very inadequate indicator of government solvency. There are four reasons for this: | <urn:uuid:0f4937b5-1493-4885-b106-3a6160e588f5> | CC-MAIN-2017-22 | https://www.freedomsphoenix.com/News/074959-2010-09-06-ask-not-whether-governments-will-default-but-how.htm | s3://commoncrawl/crawl-data/CC-MAIN-2017-22/segments/1495463607593.1/warc/CC-MAIN-20170523083809-20170523103809-00118.warc.gz | en | 0.956742 | 539 | 2.671875 | 3 |
80 years ago this week.
The Salem Flour Mills, Salem, Ohio, offered the following feeds in an advertisement: ground oats, $1.80/hundredweight; corn meal, $1.80/hundredweight; cottonseed meal, $1.90/hundredweight; oil meal, $2.40/hundredweight; cracked corn, $1.80/hundredweight; corn, 90 cents (10 bushels or more, 85 cents).
A 98-year-old Ohio man, Jacob Harner, took up his team’s reins to plow a field on his farm near Riven Rock, Fairfield County – just as he has for the past 80 years, except that he is breaking in a team of 4-year-old colts. He challenges any man in America to a day’s plowing contest, his only stipulation being that it shall not be “any newfangled eight-hour day, but a regular farmer’s day, from sunrise to sunset.” His rules for longevity are: “Be moderate in all things, and don’t worry.”
50 years ago this week.
One way to make farming pay is to have another source of income. Dick Gidley may thus be classified for he barbers in Salem five days a week. But by plowing before he goes to work and having a cooperative family, the 100 acre farm manages to support a number of income-producing animals. On his day off last Wednesday, Mr. Gidley began harrowing for three hours with a team. Not only would a tractor and all implements cost more than he would care to spend, but as he can get into the fields earlier, he is inclined to believe he is ahead of neighbors who are 100 percent mechanized.
Due to the high cost of feed, the low price that milk brings and the amount of work connected with dairying, Mr. Gidley often wonders why he keeps 33 head of cattle. His 11-year-old son, Hickorie, not only plows after school, but with his 12-year-old sister, Susie, feeds the cattle and milks 10 head of Ayrshire.
25 years ago this week.
On March 8, 1976, USDA reported 16 new outbreaks of cattle scabies in the USA. Scabies is a highly contagious form of mange that affects cattle and sheep caused by the psoroptic mange mite. Mites cause economic losses from hide damage and reduce feed efficiency, but they do not affect the wholesomeness of the meat. There is no public health hazard to this skin disease of livestock. | <urn:uuid:c9e9d707-b875-4bad-9214-e93429c149f7> | CC-MAIN-2015-06 | http://www.farmanddairy.com/columns/read-it-again-week-of-april-26-2001/6816.html | s3://commoncrawl/crawl-data/CC-MAIN-2015-06/segments/1422115860277.59/warc/CC-MAIN-20150124161100-00164-ip-10-180-212-252.ec2.internal.warc.gz | en | 0.971928 | 557 | 2.6875 | 3 |
In the 18th century, largely English Quakers who were opposed to violence and armed conflict inhabited Salem County. Yet many supported the cause. This stance inevitably brought the tragedy of war to hearth and home.
The winter of 1777 found George Washington and his Army encamped at Valley Forge, Pennsylvania. The British occupied Philadelphia. Both armies needed food and supplies. In February of 1778, General Washington ordered General “Mad” Anthony Wayne to forage for food, cattle and horses in South Jersey. A month later, Sir General William Howe dispatched 1500 British troops and loyalists under General Charles Mawhood to do the same.
Mawhood’s foraging activities met with considerable resistance from the Salem County militia and local patriots. Repulsed at the Battle of Quinton’s Bridge, a key transportation link to the fertile fields of Cumberland and Salem Counties, the British were frustrated and angry with the people of Salem County for their support of the Continental Army.
On March 20, 1778, Mawhood issued the following mandate to his British troops: “Go - spare no one - put all to death - give no quarters.” At approximately five o’clock in the morning of March 21, 1778, these orders were carried out.
With local Tories (British Loyalists) and their slaves acting as guides, Major John Graves Simcoe and approximately 300 troops attacked the Hancock House where they knew the local militia was stationed. Everyone inside was bayoneted; not a shot was fired. Among the 10 killed and five wounded, was Judge
William Hancock. He died several days later.
View the British Routes taken on March 21 1778 Map courtesy of Lauren G. Wood
Victims of the Hancock House Massacre on 21 March 1778*
*You will need Adobe Acrobat reader to view this file
download the free pdf reader | <urn:uuid:01eddc2a-e80b-4196-b5b1-09d43b817ef4> | CC-MAIN-2017-04 | http://nj.gov/dep/parksandforests/historic/hancockhouse/hancockhouse-revolutionary.htm | s3://commoncrawl/crawl-data/CC-MAIN-2017-04/segments/1484560279189.36/warc/CC-MAIN-20170116095119-00543-ip-10-171-10-70.ec2.internal.warc.gz | en | 0.967185 | 387 | 3.328125 | 3 |
Following a meal, an animal can exhibit dramatic shifts in physiology and morphology, as well as a substantial increase in metabolic rate associated with the energetic costs of processing a meal (i.e. specific dynamic action, SDA). However, little is known about the effects of digestion on another important physiological and energetically costly trait: immune function. Thus, we tested two competing hypotheses. (1) Digesting animals up-regulate their immune systems (putatively in response to the increased microbial exposure associated with ingested food). (2) Digesting animals down-regulate their immune systems (presumably to allocate energy to the breakdown of food). We assayed innate immunity (lytic capacity and agglutination) in cornsnakes (Pantherophis guttatus) during and after meal digestion. Lytic capacity was higher in females, and (in support of our first hypothesis) agglutination was higher during absorption. Given its potential energetic cost, immune up-regulation may contribute to SDA.
Although animals must consume and digest food to survive, they all incur energetic costs during digestion (i.e. specific dynamic action, SDA) (Secor, 2009). SDA is defined as the accumulated energy expended from the ingestion, digestion, absorption and assimilation of a meal, and it varies in magnitude (increase in metabolic rate of 25% to over 4000%) and duration (hours to weeks) depending on taxon and meal size (Secor, 2009). The SDA is caused by an up-regulation in absorptive processes, characterized as increases in gut size and enzymatic activity in addition to other morphological and physiological changes (McCue, 2006). However, other energetically costly physiological processes that are not directly associated with digestion or metabolism may be concurrently up-regulated and, thus, contribute to SDA.
The immune system is energetically costly to maintain and up-regulate (Martin et al., 2003), and it may be particularly important during increased exposure to foreign material in the gut (Barboza et al., 2010). Microbes are ubiquitous in and on food items (Barboza et al., 2010), and the immune system is critical for microbial defense (Ponton et al., 2013). Yet, although studies have examined the effects of nutrition (nutrient composition, Moret and Schmid-Hempel, 2000; Cotter et al., 2011; food limitation, Kristan, 2007; hydration, Moeller et al., 2013) on immunity, the effects of the digestive process itself are unknown.
We used cornsnakes (Pantherophis guttatus), which have a large SDA response (Crocker-Buta and Secor, 2014), to examine the effects of absorptive state on two immune metrics (hemoagglutination and hemolysis) to test two competing hypotheses. First, digesting animals up-regulate their immune systems during meal processing, presumably to combat the increased microbial load associated with ingested food (Madsen et al., 2007; Conway, 1997). Under this hypothesis, increased immune activation would contribute to the SDA response. Second, animals down-regulate their immune systems during digestion, presumably to allocate more energy to the SDA response. Testing these hypotheses will elucidate interactions between two important and widespread physiological processes – digestion and immunity.
MATERIALS AND METHODS
Study species and husbandry
Pantherophis guttatus (Linnaeus 1766) are non-venomous, medium-sized colubrid snakes that are native to the southeastern USA (Gibbons and Dorcas, 2005). A captive sample of 32 P. guttatus, aged 14–16 months, was used to address our hypotheses. Snakes were the offspring (1st–3rd generation) of wild-caught individuals from Beaufort County, SC, USA. Snake husbandry has been described previously (Stahlschmidt et al., 2015). Briefly, snakes were kept individually in translucent plastic enclosures (27×41×15 cm) in a room with a 12 h:12 h light:dark cycle. Enclosures had subsurface heating elements that allowed snakes to thermoregulate along a gradient of temperatures from 24.5 to 33°C. This thermal gradient encompasses the preferred temperature range for P. guttatus, 26–29°C (Roark and Dorcas, 2000; Stahlschmidt et al., 2015). Snakes had ad libitum access to water. All snakes were well fed and in good body condition as they were offered food (frozen/thawed adult mice that were 15–20% of their body mass) every 2 weeks throughout the study.
Over the course of the 8 week study, blood from each snake (N=32: 18 females and 14 males) was sampled at two time points: 1 and 7 days post-feeding (dpf). These time points were chosen because the metabolic rate of P. guttatus peaks at 1 dpf (absorptive) and declines back to pre-feeding levels at approximately 4 dpf (non-absorptive) when fed 15–20% of their body mass (Crocker-Buta and Secor, 2014). Snakes do not exhibit starvation stress until >112 days without food (colubrids: >150 days) (McCue, 2008); thus, at 7 dpf, snakes in our study were non-absorptive but not starving. It is highly unlikely that non-absorptive snakes were resource-limited; colubrid snakes store excess energy in abdominal fat bodies (Weatherhead and Brown, 1996; Bonnet et al., 1998), lipid can account for over 30% of dry body mass in colubrids (McCue, 2008), and prolonged fasting (40 days) does not significantly influence either body mass or immune function in colubrids (Neuman-Lee et al., 2015). Thus, regardless of absorptive state, the snakes in our study had abundant resources available for physiological processes.
Sampling order was randomized (i.e. 16 of the 32 snakes were first sampled during the absorptive state), and samples were separated by at least one full meal. To control for effects of date, snakes that were 1 and 7 dpf were sampled (intracardiac blood draws of 0.3 ml) during each sampling period. Samples were placed on ice prior to centrifugation at 2350 g for 5 min. Plasma was removed, and an aliquot of 35 μl was stored at −80°C prior to immune assays (see below). All procedures were approved by the Institutional Animal Care and Use Committee at Georgia Southern University (protocol no. I14004).
Assays of innate immunity
Innate immunity is the first line of defense against foreign microbes in the body (Matson et al., 2005), and most vertebrates rely upon it more heavily than adaptive immunity (Sandmeier and Tracy, 2014; Pap et al., 2015). Hemoagglutination is mediated by natural antibodies (NAbs; poly-reactive immunoglobulins), which can opsonize foreign microbes. Because of their structure, NAbs can also promote agglutination and initiate the complement enzyme cascade (Matson et al., 2005). Complement activation can reduce the integrity of cellular membranes, resulting in hemolysis of foreign erythrocytes (Trouw and Daha, 2011). Hemoagglutination and hemolysis assays were performed at an incubation temperature of 26.5°C (preferred body temperature of study animals: Stahlschmidt et al., 2015) using previously described methods (Butler et al., 2013). Assays were scored blind to treatment independently by R.L.L. and Z.R.S. Because scores were highly correlated (Pearson correlation: R=0.7, P<0.001), the mean value of the scores was used to perform statistical analyses (see ‘Statistical analyses’, below).
Total protein assays
To validate that animals were in either the absorptive or non-absorptive state at sampling, we quantified plasma protein concentration using the Coomassie Plus (Bradford) Assay (no. 23236, Thermo Scientific, IL, USA) by combining 10 µl of a sample that was diluted 1:100 with ddH2O with 300 µl reagent, incubating at room temperature for 10 min, and then measuring the absorbance at 595 nm. Plasma protein concentrations (in µg ml−1) were calculated relative to a standard curve using bovine serum albumin (no. 23209, Thermo Scientific).
Linear mixed models were performed in SPSS (v.22, IBM Corp., Armonk, NY, USA), and two-tailed significance was determined at α<0.05. Absorptive state (1 versus 7 dpf), sex and absorptive state×sex were included as fixed effects. Animal ID was included as a random effect. To determine relationships between hemoagglutination and hemolysis during each stage of absorption, Pearson correlation analyses were performed.
RESULTS AND DISCUSSION
Being in the absorptive state increased hemoagglutination (1 dpf>7 dpf; F1,29=11, P=0.003) by approximately 50% based on the serial dilution nature of the assay (e.g. a difference of 1 in agglutination titer is equivalent to a 100%, or twofold, difference in agglutination capacity; Fig. 1A). Hemoagglutination was not affected by sex (F1,30=1.1, P=0.30) or an absorptive state×sex interaction (F1,29=0.039, P=0.84). Hemolysis differed by sex (females>males; F1,30=7.7, P=0.007; Fig. 1B), but not by absorptive state (F1,30=1.1, P=0.31) or an absorptive state×sex interaction (F1,29=0.045, P=0.83). The amount of protein in plasma was affected by absorptive state (19.8% higher at 1 dpf; F1,23=65.84, P<0.001) but not by sex or an absorptive state×sex interaction (both F1,24<0.92, both P>0.35). Hemoagglutination and hemolysis were statistically correlated at 1 dpf (N=30, r=0.69, P<0.001) and at 7 dpf (N=29, r=0.64, P<0.001; Fig. 2).
We found that hemoagglutination was significantly higher during the absorptive state (Fig. 1A), supporting our hypothesis that an animal's innate immune system is up-regulated during digestion. Food is covered with potentially pathogenic microbes and live prey can bite snakes, facilitating the transmission of pathogens. The potential pathogenicity of food can be an important predictor of immune function. Scavenging vultures ingest more microbes than eagles, and they have evolved specialized genetic responses to enhance gastrointestinal immune capacity, including positive selection on genes that promote complement activity, natural killer cell-mediated cytotoxicity, and leukocyte migration (Chung et al., 2015). Thus, an allocation toward immune function – particularly an up-regulation of NAbs in snakes – may be an adaptive response to eating (Conway, 1997; Barboza et al., 2010). Most NAbs are of the pentameric immunoglobulin M (IgM) isotype (reviewed in Matson et al., 2005), and IgMs can respond rapidly to microbial components (reviewed in Nguyen et al., 2015). Yet, the cells that produce natural IgM antibodies (B-1 cells) also facilitate oral tolerance (lymphocyte suppression upon repeated exposure to an orally administered antigen) (De-Gennaro et al., 2009). Clearly, future work is required to better understand the role of NAbs in acute (e.g. individual feeding events) and chronic (e.g. tolerization) immunological responses to eating.
We further demonstrate that regulatory shifts in innate immunity can happen very quickly (i.e. agglutination increased within 24 h of the onset of absorption), which is in accordance with previous work (e.g. hemolysis and hemoagglutination are reduced after a flight lasting ≤4 h in European starlings, Sturnus vulgaris: Nebel et al., 2012). These findings suggest a temporally dynamic innate immune system (sensu Zylberberg, 2015) that responds to food consumption. Fine-scale resolution of the speed with which the peak increase occurs and the time until returning to baseline levels will further elucidate the relative importance that eating-induced immune activation has on the energetic budget for consuming food (SDA). In some endothermic vertebrates (e.g. mammals), rapid eating-induced shifts in immune function are likely regulated by the relative activity of each branch of the autonomic nervous system (e.g. parasympathetic control of digestion, Rogers et al., 1996; sympathetic activation of immune activities, Bellinger and Lorton, 2014), but in ectothermic vertebrates, eating-induced shifts in physiology (heart rate) are regulated by both autonomic and non-autonomic factors (snakes: Wang et al., 2001; frogs: Claësson et al., 2015). Thus, we advocate for further inquiry into the interactions among nervous, immune and digestive systems across taxa.
Up-regulation of innate immunity appears to be a component of the integrated response to digestion. Many organs in the gastrointestinal, pulmonary and cardiovascular systems undergo dramatic shifts in size and function due to the demands of digestion (McCue, 2006). Our results indicate that SDA-associated energy may also be allocated toward at least one component of immune function, putatively because immune activation is important for fitness and survival (Martin et al., 2003; Lochmiller and Deerenberg, 2000; Graham et al., 2011). While the energetic costs of NAb up-regulation are unknown, the costs of antibody production by vertebrates, in general, are high (Sandmeier and Tracy, 2014). Additionally, we examined just two facets of immunity, and energy devoted to other components of the immune system (e.g. increasing protein catabolism to provision hyper-metabolic macrophages: Lochmiller and Deerenberg, 2000) could substantially affect an individual's energy budget. Thus, to fully appreciate the amount of SDA devoted to immune activation, we advocate research into how eating influences other aspects of the immune system (a) that may be even more energetically demanding than NAb up-regulation (e.g. cell-mediated and adaptive immunity: Sandmeier and Tracy, 2014), and (b) in taxa capable of substantially increasing energy expenditure during innate immune activation (e.g. immune-challenged ducks can increase metabolic rate by over 33%: Marais et al., 2011).
Our results add to the growing literature on the interplay between food and immunity. Previous work has shown that caloric restriction alone or in combination with chronic stress decreases immune function and bactericidal activity in insects and reptiles (Siva-Jothy and Thompson, 2002; Ayres and Schneider, 2009; Chambers and Schneider, 2012; Neuman-Lee et al., 2015), while diet composition (e.g. proportion of protein or carbohydrate) can also affect immune function in insects (Cotter et al., 2011). Here, we show that the mere act of eating a meal can, within 24 h, significantly increase immunity by approximately 50%. This up-regulation may be directly related to ingestion-dependent changes in circulating levels of hormones or nutrients, the bacterial load of the meal, or changes in the microbiota that may subsequently affect an organism's immunity. Post-prandial immune regulation may also be influenced by the contents of the meal. For example, the magnitude of immune up-regulation may match the size of the meal (sensu SDA: Secor, 2009) or the microbial load on/in the meal.
Hemoagglutination and hemolysis were correlated at each absorptive state (Fig. 2), likely due to the linked mechanism of complement activation by NAbs via the classical pathway (Matson et al., 2005). Despite this statistical correlation, there were still notable differences between hemoagglutination and hemolysis. For example, only hemolysis was affected by sex (potentially due to the immunosuppressive effects of testosterone: Schuurs and Verheul, 1990; Folstad and Karter, 1992) (Fig. 1B), and eating affected only hemoagglutination (likely due to the high responsivity of NAbs to microbes: Madsen et al., 2007). Differences between hemoagglutination and hemolysis in response to treatments have also been detected in other experimental contexts, including temperature (Butler et al., 2013) and reproductive status (Stahlschmidt et al., 2013). These differences between lysis and agglutination may be due to lysis activation that is independent of NAbs. For example, our study animals may also use lectin or alternative pathways to activate complement (Trouw and Daha, 2011); thus, increased NAbs would not always obligate increased lysis.
Our study represents an important first step to better understand digestion–immunity interactions because (to our knowledge) we are the first to demonstrate that the act of eating directly affects immunity. Our results indicate that some SDA-associated energy is likely devoted to up-regulating the immune system, potentially to combat increased foreign microbial exposure. This allocation of energy provides evidence that the definition of SDA may need to be expanded to include other physiological responses associated with eating (e.g. antioxidant defenses may need to be up-regulated to offset oxidative damage associated with meal processing, as discussed in the companion paper: Butler et al., 2016).
We thank Lindsey Holcomb for animal husbandry, Thomas J. Lutz for assaying total protein, and Tony Mills at the Low Country Institute for the loan of animals. We also appreciate insightful comments on the manuscript from Marshall McCue and one anonymous reviewer.
R.L.L. and Z.R.S. were responsible for the conception and design of the experiment. R.L.L., M.W.B. and Z.R.S. performed the experiment and prepared the manuscript. Z.R.S. carried out statistical analyses.
This study was funded by Georgia Southern University (to R.L.L. and Z.R.S.) and Lafayette College (to M.W.B.).
The authors declare no competing or financial interests. | <urn:uuid:291df110-1ded-4e12-b192-341fa5700ab2> | CC-MAIN-2022-27 | https://journals.biologists.com/jeb/article/219/13/1965/15209/Plasticity-of-immunity-in-response-to-eating | s3://commoncrawl/crawl-data/CC-MAIN-2022-27/segments/1656104054564.59/warc/CC-MAIN-20220702101738-20220702131738-00076.warc.gz | en | 0.931098 | 4,014 | 2.65625 | 3 |
Join Ben Long for an in-depth discussion in this video Focal length multipliers, part of Photography Foundations: Lenses.
For more than 70 years, 35mm film was the dominant photographic medium.…Then digital photography came along.…35mm film is still used for some still photography and used a lot for motion…picture photography.…Like a digital sensor, a piece of 35mm film crops a specific sized rectangular…image out of the image circle projected by a lens.…After 70 years of using 35mm film people got used to specific focal lengths…having specific fields of view.…So photographers became accustomed to the idea that a 50mm lens was a normal lens,…because when used with 35mm film a 50mm lens has roughly the same field of…view as the human eye.…
Anything longer than 50mm is telephoto. Anything shorter is wide-angle.…With 35mm film a 28mm lens is pretty wide.…A 16 or 24 millimeter lens is ultra-wide.…Conversely, 300mm has a good amount of telephoto power and 600mm puts you in the…realm of serious surveillance.…Most digital cameras had image sensors that are smaller than a piece of 35mm film.…That means they crop a narrower rectangle from the circle projected by the lens.…
- Understanding field of view and camera position
- Depth of field and lens choice
- How to choose a lens
- Examining lens features
- Using specialized lenses such as fisheye and tilt/shift lenses
- Focusing techniques
- Using filters
- Camera maintenance
Skill Level Beginner
Photography Foundations: Compositionwith Ben Long5h 29m Intermediate
Douglas Kirkland on Photography: A Photographer's Eyewith Douglas Kirkland41m 55s Appropriate for all
2. What Is a Lens?
3. Focal Length, Camera Position, and Composition
4. Depth of Field
5. Choosing a Lens
6. Advanced Autofocus
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June 18, 2009
Autonomous Robot Detects Shrapnel
Bioengineers at Duke University have developed a laboratory robot that can successfully locate tiny pieces of metal within flesh and guide a needle to its exact location -"“ all without the need for human assistance.
The successful proof-of-feasibility experiments lead the researchers to believe that in the future, such a robot could not only help treat shrapnel injuries on the battlefield, but might also be used for such medical procedures as placing and removing radioactive "seeds" used in the treatment of prostate and other cancers.In their latest experiments, the engineers started with a rudimentary tabletop robot whose "eyes" are a novel 3-D ultrasound technology developed at Duke. An artificial intelligence program served as the robot's "brain" by taking the real-time 3-D information, processing it and giving the robot specific commands to perform. In their simulations, the researchers used tiny (2 millimeter) pieces of needle because, like shrapnel, they are subject to magnetism.
"We attached an electromagnet to our 3-D probe, which caused the shrapnel to vibrate just enough that its motion could be detected," said A.J. Rogers, who just completed an undergraduate degree in bioengineering at Duke. "Once the shrapnel's coordinates were established by the computer, it successfully guided a needle to the site of the shrapnel."
By proving that the robot could guide a needle to an exact location, it would simply be a matter of replacing the needle probe with a tiny tool, such as a grabber, the researchers said.
Rogers worked in the laboratory of Stephen Smith, director of the Duke University Ultrasound Transducer Group and senior member of the research team. The results of the experiments were published early online in the July issue of the journal IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.
Since the researchers achieved positive results using a rudimentary robot and a basic artificial intelligence program, they are encouraged that simple and reasonably safe procedures will become routine in the near future as robot and artificial intelligence technology improves.
"We showed that in principle, the system works," Smith said. "It can be very difficult using conventional means to detect small pieces of shrapnel, especially in the field. The military has an extensive program of exploring the use of surgical robots in the field, and this advance could play a role."
In addition to its applications recovering the radioactive seeds used in treating prostate cancer, Smith said the system could also prove useful in removing foreign, metallic objects from the eye.
Advances in ultrasound technology have made these latest experiments possible, the researchers said, by generating detailed, 3-D moving images in real-time. The Duke team has a long track record of modifying traditional 2-D ultrasound "“ like that used to image babies in utero "“ into the more advanced 3-D scans. Since inventing the technique in 1991, the team has shown its utility by developing specialized catheters and endoscopes for real-time imaging of blood vessels in the heart and brain.
In the latest experiments, the robot successfully performed its main task: locating a tiny piece of metal in a water bath, then directing a needle on the end of the robotic arm to it. The researchers had previously used this approach to detect micro-calcifications in simulated breast tissue. In the latest experiments, Rogers added an electromagnet to the end of the transducer, or wand, the device that sends out and receives the ultrasonic waves.
"The movement caused by the electromagnet on the shrapnel was not visible to the human eye," Rogers said. "However, on the 3-D color Doppler system, the moving shrapnel stood out plainly as bright red."
The robot used in these experiments is a tabletop version capable of moving in three axes. For the next series of tests, the Duke researchers plan to use a robotic arm with six-axis capability.
The research in Smith's lab is supported by the National Institutes of Health. Duke's Ned Light was also part of the research team.
On the Net: | <urn:uuid:5e461b9d-2d5a-4fce-a332-28f5145a0446> | CC-MAIN-2016-50 | http://www.redorbit.com/news/technology/1708066/autonomous_robot_detects_shrapnel/ | s3://commoncrawl/crawl-data/CC-MAIN-2016-50/segments/1480698543316.16/warc/CC-MAIN-20161202170903-00034-ip-10-31-129-80.ec2.internal.warc.gz | en | 0.961697 | 852 | 3.125 | 3 |
Catalogue Number: 1707
Our eyes and how to preserve them from infancy to old age, with special information about spectacles
Sub-Category: Book of historical note
Author: BROWNING, John
Year Of Publication/Manufacture: 1886
Edition: 5th Edition
Time Period: 19th C
Place Of Publication/Manufacture: London
Publisher/Manufacturer: Billing and Sons, Printers
Description Of Item: Original printed buff cloth, 108 pages plus 16 unnumbered pages of advertisements and testimonials plus 32 pages of book advertisments. Illustrated throughout with sketches illustrating correct reading position, reading by lamp light and firelight and numerous illustrations of spectacles.
Historical Significance: John Browning (1835-1925) is described on the title page as FRAS (Fellow of the Royal Astronomical Society) and FRMS (Fellow of the Royal Meteorological Society?) and optician to her Majesty's government. He had shops in the Strand, London and in Kensington. The one in the Strand was at No 63. An advertisment published in 1891 describes Browning as an ophthalmic optician and states he may be consulted personally at that address, 'free of charge, respecting spectacles for all forms of defective vision between the hours of ten and four daily, except on Saturday, when his hours will be ten to twelve' The advertisment refers to this book. The chapters of the book include those on the human eye, light, colour blindness, colour, how to preserve eyesight, care of the eyes, use of coloured glasses, old sight, long sight, short sight with a number of chapters on various kinds of spectacles. The archive holds the 7th edition of 1898 held in the Aitken collection Cat No 49. The first edition was probably published in 1883. Each ediiton is claimed to have been revised and enlarged.
How Acquired: Donated by Peter Dywer
Date Acquired: Nov 2010
Condition: Good, but bottom half of title page excised
Location: Archive room. East wall. Books of historical note | <urn:uuid:250d6b39-7634-432f-aae6-efba558769af> | CC-MAIN-2020-05 | https://museum.aco.org.au/archive/811-our-eyes-and-how-to-preserve-them-from-infancy-to-old-age-with-special-information-about-spectacles | s3://commoncrawl/crawl-data/CC-MAIN-2020-05/segments/1579250592394.9/warc/CC-MAIN-20200118081234-20200118105234-00038.warc.gz | en | 0.922626 | 439 | 2.609375 | 3 |
One of the "rules" of distance running is that you must run lots of miles. Indeed, most runners link their fitness level to the number of miles they run, inevitably believing that more is better. A friend of mine who missed the 2004 U.S. Olympic trials in the 1500 meters by four seconds ran 100 miles per week. Frankly, I thought he was nuts. And I began to wonder, is it really necessary to run 100 miles per week to run a race that takes less than four minutes?
As legendary coach Arthur Lydiard so ardently claimed, lots of aerobic running forms the basis of any distance runner's training program. Whether you're training for the mile or the marathon, it all starts with mileage. That's because endurance training stimulates many physiological, biochemical and molecular adaptations. All of these adaptations can be thought of as your body's attempt to cope with the demand placed on it by running every day. For example, endurance training:
- stimulates more fuel (glycogen) to be stored in your muscles
- increases the use of intramuscular fat at the same speed to spare glycogen
- improves your blood vessels' oxygen-carrying capability by increasing the number of red blood cells and hemoglobin
- creates a greater capillary network for a more rapid diffusion of oxygen into the muscles
- increases mitochondrial density and the number of aerobic enzymes through the complex activation of gene expression. This increases your aerobic metabolic capacity.
The link between an increase in mitochondrial enzyme activity and an increase in mitochondria's capacity to consume oxygen, first made in 1967 in the muscles of rats, has provided much insight into the adaptability of skeletal muscle.
Generally, the greater the demand, the greater the adaptations. Although many scientists have acknowledged there is an upper limit to the volume of training that will cause further adaptations, research has not documented at what point these adaptations stop occurring in response to the demand. In other words, how much mileage is enough?
How Many Miles Are Enough?
The answer depends on a number of factors, primary among them your genetically determined propensity to adapt continually to greater amounts of running. In other words, how much running can you physically and psychologically handle? "It's very hard to say how much mileage is ideal to maximize the various cellular adaptations that take place as a function of time spent running," says exercise physiologist and coach Jack Daniels, Ph.D., author of Daniels' Running Formula. "The best answer might be to do as much as you can without losing interest or getting sick or injured." | <urn:uuid:db34898f-9837-427d-9bc4-74e862254c28> | CC-MAIN-2019-39 | https://www.active.com/running/articles/distance-running-how-many-miles-should-you-run | s3://commoncrawl/crawl-data/CC-MAIN-2019-39/segments/1568514575674.3/warc/CC-MAIN-20190922201055-20190922223055-00272.warc.gz | en | 0.955204 | 520 | 3.4375 | 3 |
An escapade isn’t one without hazards that are life altering. In “The Adventures of Huckleberry Finn” by Mark Twain. is a book about the battle of moral ambiguity. and how it transforms Huckleberry Finn into a better individual compared to his corrupt society and despite his past influences. Huck’s male parent. Pap. wantonnesss him at a immature age and he his female parent passed. so a widow takes him in as her ain to “sivilize” him ; nevertheless. when his alky male parent comes back he locks Huck up and about putting to deaths Huck. So one time Huck had the chance to get away. he faked his decease so no 1 would come seeking for him. and no 1 had to worry about him one time people thought he died. That’s when the escapade starts – the river and him. but shortly he encounters a friend and outlaws to take hazards and brush determinations that shape him to be empathic. open-minded. and have a type of higher equity. As Huck travels down the river he has to halt to kip and garner nutrient. On one twenty-four hours he happens to catch person else in the forests. it turned out to be Jim. Jim is the widow’s slave. Meeting Jim is a surprise for Huck. but an even larger amazement for Jim to see him alive. Soon as their impersonal friendly relationship progresses Huck says to Jim. “This is nice I wouldn’t want to be nowhere else but here…” ( 49 ) .
Huck is to the full enjoying and loosen uping through the company of Jim and nature. Because they are both stray and outlaws they have a common involvement and have a natural motive to maintain each other at float instead than hold concerns of the society beyond the forests. Leting Jim to label along with him isn’t such a concern to Huck at first. but shortly a guilt of assisting belongings flight eats him up indoors. The patterned advance of the relationship between Huck and Jim shows Huck how to handle a friend and shortly handle one of colour as equal to those of white. Huck’s past experience with Tom Sawyer is a changeless fooling around with one another and doing pathetic prevarications. So certain plenty a twosome times Huck musss around with Jim. The first clip of Huck’s hocus-pocus is when he placed a dead serpent under Jim’s screens to give him a fear nevertheless Huck forgot that their couples crawl following to them when they die. The mate ends up seize with teething Jim on the pes that same dark. but Huck ne’er admits to puting the dead serpent there and provinces that he will ne’er. non if he could assist it. Huck doesn’t halt there though… . One twenty-four hours a atrocious fog blows by that separates Jim and Huck.
Of class Jim feels highly nervous and scared that Huck might non come back. When Huck does comes back he sees Jim sleeping. and decides to gull him once more stating that the fog was all merely a dream. Jim doesn’t take it so easy because he doesn’t desire to be a possesion Huck messes around with. and hurt that Huck could state such a barbarous prevarication. Huck noticed that he hurt his friend severely. and that it’s incorrect to make that: “It made me experience so average I could about snog his pes to acquire him to take it back… [ I ] low myself to a nigga. . and I warn’t sorry for it subsequently. neither. ” ( 86 ) . However stating sorry to Jim back so when bondage is largely seen as moral. is like stating sorry to an animate being. and the fact that he would of kissed his pess takes empathy farther. Huck grows enormously compared to the remainder of the society that see those of colour to be of about no value to society. and have no rights. The escapade starts to develop outside of Jim and Huck’s community when “Huck must do [ a pick ] between his bosom and his scruples. “
At first Kastely explains this through Huck’s observation over his determinations those he encounters. This does travel back to opportunism ; as. it wasn’t Huck’s involvement to assist free Jim. he did this in an act of his bosom. Huck observes a batch of condemnable Acts of the Apostless from two new characters that hop on board with Jim and Huck. They are known as the King and the Duke. and ab initio are con-men robbing crowds and households. Kastely puts their visual aspect as “…the [ full force ] insufficiency of Pap’s rule of self involvement. ” though Huck knows how to handle these people because they are really egoistic like his male parent. In the beginning Huck doesn’t mind them so much. merely every bit long as it benefits him. If robbing multitudes benefites him he went along with it and experience a type of haste and exhilaration in watching the con-man work their thaumaturgy. Huck even considered victimizing for a life. nevertheless the tabular arraies shortly turned against the Duke and the King. Once they decided to steal from the Wilks sisters. who starts a bond with Huck. particularly Mary Jane. is when he realizes the Wilks are worlds excessively ; who are being injured by these frauds. His guilt Ate at him till one twenty-four hours he had adequate – I say to myself. this is another 1 that I’m allowing him rob her money. And when she got through they all jest laid theirselves out to do me experience at place and know was amongst friends.
I felt so cantankerous and low down and intend that I say to myself. my mind’smade up ; I’ll hive that money for them or break. ” ( 175 ) . Huck is really scruples that what the con work forces are making isn’t right. and stating “this is another that I’m allowing him rob” is a determination he has made. Mary Jane has made Huck’s eyes open to the generousness and earnestness of worlds in the society. by handling him nicely all he wants to make is the same for them. Because he doubted any justness in society he felt highly guilty in exposing this corruptness to the Wilks sisters. So he does what he needs to make and do things right for their protection non his. and is non out of opportunism because he’s more concern of their safety than anything else. This action is a immense portion of what changes him and the hazard he took for their safety. He could hold been hanged. he diminishes the trust between the con work forces and himself. and he risks the remotion of Mary Jane’s trust. Harmonizing to Kastely. “ Huck’s find of true feelings reestablishes the tenseness between ego and communal ( or homo ) involvement. ” Huck refuses to be as selfish and egoistic as the Duke and King.
This does transform Huck’s character to a more sentimental 1. The most of import factor of this narrative is how Huck additions moral justness in a corrupt society. The major scruples struggle through out most of the text is if he is bloody for assisting a slave flight. “If we rejoice that Huck eventually can non turn Jim in. we should instantly hesitate. for Huck has now decided to run into the universe the was Pap does. ” What Kastely states is really interesting because Huck’s moral determinations are from the bosom. to assist a friend despite the colour of his tegument. There is this unusual paradox when Huck damns himself because Huck isn’t a felon or ego centered character. like most of the characters in the text. He understands people sorrows even in the really get downing. how he didn’t want the widow to worry about him so it would be better to do her think he is in Eden. Huck easy forms into a really compassionate character which is the complete antonym of what Pap is. Pap robbed people. he wanted to steal from his ain boy merely to purchase more liquor. That isn’t all though. Pap permitted Huck from acquiring an instruction because he didn’t desire his boy to be smarter than him.
Through the hallow eyes of community. Huck is seen as a felon to assist Jim. but it’s merely because to the community Jim is belongings. Huck is nil like his male parent. because before Huck ran off. Pap told him this large talk of when he saw a coloured adult male expression better than a white adult male: “…when they told me there was a province in this state where they’d allow that nigger ballot. I drawed out. I says I’ll ne’er vote ag’in. ” ( 27 ) . In this clip period the impression of slaves were still really strong and is why the male parent is so strongly against it. but Huck ne’er said anything about slaves or discriminated them more because of what his male parent has told him.
In Huck’s perceptual experience he trusts and respects Jim in the center of this escapade and beyond. which is a batch more virtuous by handling people as equal instead than belongings. It’s a higher justness. Through out the text Huck is in changeless ambiguity with his scruples and societal ethical motives. As the escapade unravels he becomes more empathic and has more of an unfastened head compared to a bulk of the characters in the text. A friendly relationship with an escaped slave has open his eyes to understanding people of colour are still people. Then he experiences a eldritch turns of ethical motives. but one time he considers himself and society morally pervert he sees that there is more to people than the selfish demands. An escapade he’ll ne’er bury and put on the line that transformed him into a wise immature grownup by the terminal of this novel. | <urn:uuid:d2e27994-c2e2-4f83-afad-a9a3659f22cd> | CC-MAIN-2020-29 | https://writingbro.com/a-moral-paradox-essay-sample/ | s3://commoncrawl/crawl-data/CC-MAIN-2020-29/segments/1593657142589.93/warc/CC-MAIN-20200713033803-20200713063803-00158.warc.gz | en | 0.974808 | 2,132 | 3.0625 | 3 |
- Can exercise unblock arteries?
- Can heart patients drink milk?
- Can you be cured of heart disease?
- Can you reverse heart disease through diet?
- Can you reverse heart disease with exercise?
- How does exercise prevent heart disease?
- What 3 foods cardiologists say to avoid?
- How can I strengthen my heart valve naturally?
- Are eggs bad for your heart?
- What diet do cardiologists recommend?
- What is the best exercise for heart disease?
- Can you reverse heart disease?
- How long can I live with heart disease?
- How can I strengthen my heart?
- What are the 3 foods to never eat?
Can exercise unblock arteries?
For now, research doesn’t support the use of specific foods to unclog arteries, though small studies in animals show promise for the future.
Losing weight, exercising more, or eating less cholesterol-rich foods are all steps you can take to reduce plaques, but these steps won’t remove existing plaques..
Can heart patients drink milk?
The Heart Foundation recommends that milk, yoghurt and cheese can be eaten as part of a heart-healthy diet, but most of the fat in the diet should come from fish, nuts and seeds, and healthy oils. Choosing unflavoured milk, yoghurt, and cheese also helps limit the amount of added sugar in your diet.
Can you be cured of heart disease?
A: Although we can’t cure heart disease, we can make it better. Most forms of heart disease are very treatable today. There is some evidence that normalizing high blood pressure and lowering cholesterol to very low levels will partially reverse plaques in the coronary arteries.
Can you reverse heart disease through diet?
Diet may be the biggest thing you’d change. The shift will be drastic if you’re used to a typical American diet. “Just making moderate changes in your diet may be enough to prevent heart disease, but it won’t be enough to reverse it,” Ornish says. He puts foods in five groups, ranging from healthiest to least healthy.
Can you reverse heart disease with exercise?
Summary: Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure — if it’s enough exercise, and if it’s begun in time, according to a new study by cardiologists.
How does exercise prevent heart disease?
Exercise also increases your levels of HDL cholesterol, the “good” cholesterol that lowers heart disease risk by flushing the artery-clogging LDL or “bad” cholesterol out of your system. Along with lowering your risk for heart disease, exercise: Keeps your weight down. Improves your mood.
What 3 foods cardiologists say to avoid?
Here are eight of the items on their lists:Bacon, sausage and other processed meats. Hayes, who has a family history of coronary disease, is a vegetarian. … Potato chips and other processed, packaged snacks. … Dessert. … Too much protein. … Fast food. … Energy drinks. … Added salt. … Coconut oil.
How can I strengthen my heart valve naturally?
7 powerful ways you can strengthen your heartGet moving. Your heart is a muscle and, as with any muscle, exercise is what strengthens it. … Quit smoking. Quitting smoking is tough. … Lose weight. Losing weight is more than just diet and exercise. … Eat heart-healthy foods. … Don’t forget the chocolate. … Don’t overeat. … Don’t stress. … Related Stories.
Are eggs bad for your heart?
Most healthy people can eat up to seven eggs a week without increasing their risk of heart disease. Some studies have shown that this level of egg consumption may even help prevent certain types of stroke and a serious eye condition called macular degeneration that can lead to blindness.
What diet do cardiologists recommend?
“Stick to baked things like chicken or deep-sea fish like salmon and tuna, and avoid rich cream sauces,” Dr. DeVane says. “Think about the Mediterranean style of eating—minimal red meat, lots of fresh fruits and vegetables, and olive oil and nuts [which contain the good fats], plus a glass of wine, if you enjoy that.”
What is the best exercise for heart disease?
Choose an aerobic activity such as walking, swimming, light jogging, or biking. Do this at least 3 to 4 times a week. Always do 5 minutes of stretching or moving around to warm up your muscles and heart before exercising.
Can you reverse heart disease?
Is it only a matter of time before you have another heart attack or cardiac issue? Does heart disease mean your heart is “diseased” forever? According to researchers and dieticians, the answer is no—heart disease can be reversed, and one of the best ways to reverse heart disease is through cardiac rehabilitation.
How long can I live with heart disease?
Although there have been recent improvements in congestive heart failure treatment, researchers say the prognosis for people with the disease is still bleak, with about 50% having an average life expectancy of less than five years. For those with advanced forms of heart failure, nearly 90% die within one year.
How can I strengthen my heart?
Examples: Brisk walking, running, swimming, cycling, playing tennis and jumping rope. Heart-pumping aerobic exercise is the kind that doctors have in mind when they recommend at least 150 minutes per week of moderate activity.
What are the 3 foods to never eat?
20 Foods That Are Bad for Your HealthSugary drinks. Added sugar is one of the worst ingredients in the modern diet. … Most pizzas. Pizza is one of the world’s most popular junk foods. … White bread. … Most fruit juices. … Sweetened breakfast cereals. … Fried, grilled, or broiled food. … Pastries, cookies, and cakes. … French fries and potato chips.More items…• | <urn:uuid:72f3ec86-e912-4261-b8dd-76854dfd337b> | CC-MAIN-2021-10 | https://3iccacs.com/qa/quick-answer-can-heart-disease-be-cured-by-exercise.html | s3://commoncrawl/crawl-data/CC-MAIN-2021-10/segments/1614178366477.52/warc/CC-MAIN-20210303073439-20210303103439-00173.warc.gz | en | 0.921953 | 1,281 | 2.546875 | 3 |
Tiny "bio-bots" inspired by sperm could swim inside the human body to deliver drugs or target cancer someday. The swimming bio-hybrid machines move by combining live heart cells with the flexible body of a synthetic polymer.
Past research has spawned a magnetic cork-screw swimmer and a flagellar swimmer made of magnetic beads and DNA molecules—both engineered creations dependent upon an outside magnetic force to move. By comparison, the new bio-bots represent the first swimming machines based on the flagellar movement of sperm that can propel themselves by harnessing the contractile power of the heart cells.
"It's the minimal amount of engineering—just a head and a wire," said Taher Saif, a professor of mechanical science and engineering at the University of Illinois, in a news release. "Then the cells come in, interact with the structure, and make it functional."
Movement of the 2-millimeter long bio-bots relies upon a small cluster of heart cells grown where the flexible tail meets the rigid head. The heart cells synchronize to beat together and create a wave motion in the tail that propels the bot forward at speeds of 5 - 10 micrometers per second.
The researchers from the University of Illinois and Arizona State University also created a two-tailed bio-bot capable of swimming even faster—81 micrometers per second. Their work is detailed in the 17 January issue of the journal Nature Communications. (The team previously created tiny "walking" robots made from 3-D printed hydrogel and rat heart cells.)
Such engineered creations still pale in comparison to their biological counterparts. For instance, a 70-micrometer long bull sperm can swim at speeds of 97 micrometers per second—139 percent of its body length per second—because it moves its entire tail. But the single-tailed and two-tailed bio-bots can only swim at 0.5 percent and 8.3 percent of their body length per second, respectively.
Still, the work marks a good first step in harnessing biological motion for a new class of bio-hybrid machines. The researchers hope to eventually use optogenetically enhanced muscle cells for light-actuated swimming, as well as a combination of neurons and muscle cells for "intelligent swimming" based on sensing.
Images: Alex Jerez Roman/Beckman Institute for Advanced Science and Technology | <urn:uuid:90fe8b16-c760-417b-9b50-2dc769a696f8> | CC-MAIN-2017-09 | http://spectrum.ieee.org/tech-talk/biomedical/bionics/tiny-biobots-powered-by-heart-cells-can-swim-like-sperm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+IeeeSpectrumFullText+%28IEEE+Spectrum+Full+Text%29 | s3://commoncrawl/crawl-data/CC-MAIN-2017-09/segments/1487501170569.99/warc/CC-MAIN-20170219104610-00472-ip-10-171-10-108.ec2.internal.warc.gz | en | 0.915535 | 492 | 3.25 | 3 |
ECZEMA Psychological interventions for atopic eczema. Educating parents about atopic eczema can help them to cope with their child's disease
Ersser, S. (2006) ECZEMA Psychological interventions for atopic eczema. Educating parents about atopic eczema can help them to cope with their child's disease. MIMS Dermatology, 2, (3), p.25.
Full text not available from this repository.
Atopic eczema affects up to 15 per cent of schoolchildren and can have a signficant impact on quality of life.
Psychological approaches can help parents to break the itch-scratch cycle and improve treatment adherence.
Educational videos and other media can be useful.
Improving parents' confidence in the treatment is beneficial.
Teaching relaxation techniques can lower stress.
The itchy rash of atopic eczema is a major problem for children and their parents. Psychological and educational interventions have been used to complement medication in helping to manage the condition, by promotion relatxation and helping parents and children to understand the condition and their role in its effective management. Parents need support on breaking the itch-scratch cycle, reducing stress and improving adherence.
|Keywords:||atopic eczema, psychological, children, itch-scratch cycle, parents|
|Subjects:||R Medicine > RL Dermatology
B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
|Divisions:||University Structure - Pre August 2011 > Superseded (SONM) > Superseded (LCHN)
|Date Deposited:||19 Dec 2006|
|Last Modified:||31 Mar 2016 12:15|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
Actions (login required) | <urn:uuid:e8e3e552-3073-40b3-a7be-6a31d2885c2f> | CC-MAIN-2016-30 | http://eprints.soton.ac.uk/42468/ | s3://commoncrawl/crawl-data/CC-MAIN-2016-30/segments/1469257828283.6/warc/CC-MAIN-20160723071028-00010-ip-10-185-27-174.ec2.internal.warc.gz | en | 0.813241 | 409 | 2.5625 | 3 |
Like other aspects of malay culture, the language was first influenced by indian what this means is that we have accepted words that contain an arabic origin . Islam & malay culture by yaacob harun introduction article 160 of the malaysian constitution defines malay, as “a person who. Which there is no clear dominant or neutral culture, and in which continuous oscillation of ethnic status occurs without direct as- similation what is a malay 331. Malays are an austronesian ethnic group that predominantly inhabit the malay peninsula, the srivijayan era is considered the golden age of malay culture during the pamalayu expedition (pamalayu means war against the malays.
Word was accepted as part of the malay vocabulary, its meaning was extended ethics as well as intellect and reason, in order to accommodate the culture and. What the malay race have reflected upon them as a whole right now is also, malays have no claim to a substantial cultural heritage of their own and a large. Malay culture has been strongly influenced by the cultures of other areas, including thailand, java, and sumatra the influence of hindu india was historically.
Budi-islam is found to play a significant role in defining ideas, progress and actions by the malay the close association between budi and the malay cultural. If you can't understand all the 20 malaysian slang on this list, you're probably not a true blue malaysian malaysian culture leng zai (or leng chai) meaning: leng zai comes from the cantonese word 靚仔 which means. Cultures have been meeting and mixing in malaysia since the very beginning of its history more than fifteen hundred years ago a malay kingdom in bujang.
“malay” means a person who professes the religion of islam, a term so charged with ethnic, religious and cultural connotations has been to. In order to engage in this work, researchers must get inside the defining definition of useful terms the malay cultural traits as a front-stage performance. In other words, the development of culture and technology is can we come up with a definition of high culture in the malaysian mould. Their understanding of malay culture affects their islamic practices recent definition says muallaf are those who persuaded and the heart is. Typically attributed to the malay language, alamak is often used to express a word of kristang origin (meaning mother of god) that the japanese samantha is a walking pop culture encyclopaedia with a thing for the.
Concept of privacy related to the cultural, behavioral, built environment, (1997) define that malay customs in mtd functions and culture is in line with the. Malay definition: malay means belonging or relating to the people, language, or culture of the largest | meaning, pronunciation, translations and examples. The third requirement when defining malay identity is that the person conforms to malay custom'' the malay people, like all cultures, have various traditions and . Malaysian culture and lifestyle is unique to the region thanks to its the indigenous people are known as 'orang asli' which means “original people” however.
Traditional cultural practices in the malay communities can be observed through traditionally, malay food can be defined as varieties of food. Hence, from a wider socio-cultural perspective, the definition of “malay” includes people from peninsular malaya and the malay archipelago. The 'cape malay' community is rich in culture and religious traditions that has been negatively defined and did not fit the classificatory schemes created by the .
As much as the cape malay identity is a definition of an ethnic group to suit by people who are not familiar with a culture other than their own. Animals this research is conducted in order to reveal the concept of culture described by western, malay and tamil scholars in an effort to find the definition of. Within malaysian society there is a malay culture, a chinese culture, an indian could only be settled with a legal definition of who was considered malay. | <urn:uuid:4dfd3f7f-bd64-476c-939f-41082bb10179> | CC-MAIN-2018-43 | http://jpessaybgkk.cardiffbeekeepers.info/definition-of-a-malay-culture.html | s3://commoncrawl/crawl-data/CC-MAIN-2018-43/segments/1539583510749.37/warc/CC-MAIN-20181016093012-20181016114512-00440.warc.gz | en | 0.957983 | 871 | 3.078125 | 3 |
Here’s a common mistake, and a very understandable one, too. Students need to combine two negative numbers, and they, of course, wind up with an answer that’s positive. Why? Because, they’ll say — pointing out that you yourself have told them this — “Two negatives make a positive!”
This video gets to the root of this common misunderstanding by helping students understand exactly when two negatives make a positive, and when they don’t.
Make sure you watch the whole video, as there are practice problems at the end, along with their answers. | <urn:uuid:a7531d26-3b3e-4041-bde3-a5a6a171074e> | CC-MAIN-2018-39 | https://mathchat.me/tag/combining-positive-and-negative-numbers/ | s3://commoncrawl/crawl-data/CC-MAIN-2018-39/segments/1537267156622.36/warc/CC-MAIN-20180920214659-20180920235059-00450.warc.gz | en | 0.958855 | 125 | 4.09375 | 4 |
Many people take pills to help manage or cure serious illness, and some of these life-saving drugs can only be absorbed in very specific parts of the intestine. The problem with oral administration is that pills often don’t dissolve at exactly the right site in the gastrointestinal tract where medicine can be absorbed into the bloodstream. A new drug delivery system developed by scientists at Brown University uses a magnetic gelatin capsule and an external magnet that can precisely sense the force between it and the pill and vary that force, as needed, to hold the pill in place. The team has successfully used the technology with rats and in future it could provide a new way to deliver many drugs to humans, including those with cancer or diabetes.
The system is not the first attempt to guide pills magnetically – Gizmag recently reported on the use of magnetically guided pills to conduct endoscopes – but it is the first in which scientists can control the forces on a pill ensuring it is safe to use in the body. The system was designed to sense the position of pills and hold them there with a minimum of force.
Edith Mathiowitz, professor of medical science in Brown’s Department of Molecular Pharmacology, Physiology, and Biotechnology, said: “With this technology you can now tell where the pill is placed, take some blood samples and know exactly if the pill being in this region really enhances the bioavailability of the medicine in the body.”
The team knew that it was critical to monitor how much force was being exerted on the pill to avoid damaging the surrounding tissue. Just a little more force than necessary could pull the pill to the external magnet.
To prevent this happening, the team including lead author and former graduate student Bryan Laulicht, built the external magnet system with sophisticated computer control and feedback mechanisms.
“The greatest challenges were quantifying the required force range for maintaining a magnetic pill in the small intestines and constructing a device that could maintain intermagnetic forces within that range,” said Laulicht.
Even after holding a pill in place for 12 hours in the rats, the pressure on the intestinal wall was less than 1/60th of what would be damaging.It could also act as a powerful research tool to help scientists understand exactly where in the intestine different drugs are best absorbed.
The external magnet can sense the pill’s position, but because the pill is opaque to x-rays, the researchers were also able to see the pill in the rat’s bodies during their studies
The next stage of the research is to measure the absorption of drugs delivered via the system. They will then move to larger animal models and ultimately into the clinic.
“It is my hope that magnetic pill retention will be used to enable oral drug delivery solutions to previously unmet medical needs," said Laulicht.
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Try New Atlas Plus. Learn more | <urn:uuid:43b689ef-e561-4409-be59-faa89886708f> | CC-MAIN-2018-39 | https://newatlas.com/magnet-pill-drug-delivery/17606/ | s3://commoncrawl/crawl-data/CC-MAIN-2018-39/segments/1537267156418.7/warc/CC-MAIN-20180920062055-20180920082055-00441.warc.gz | en | 0.953049 | 601 | 3.75 | 4 |
"The Princess Casamassima" is a novel by Henry James.
The novel is set in London in the 1880s in which different kinds of characters from all social classes are portrayed.
Hyacinth Robinson, an orphan boy, is the hero of the story. He has been brought up by Miss Pynsent, a quiet spinster who makes a living as a dressmaker. She lives in a lower-class district of London. Hyacinth hardly saw his mother, perhaps just once, and this is in prison. The meeting is depressed and sad because her mother is dying, condemned for the murder of his father, 'Lord Frederick.'
Hyacinth is apprenticed to the book-binder Eustache Poupin, a French Communist in exile. While he is learning the ropes of the trade in bookbinding he meets a proletarian revolutionary by the name of Paul Muniment. He joins a secret society becoming active to the movement. In the society, he comes into contact with Christina, the Princess Casamassima, who, being separated from her Italian husband, finds the revolutionary movement a good respite for her energies.
Hyacinth Robinson decides to travel to Europe when Miss Pynsent dies.
Somehow, his travel changes the way he sees the world around him and most importantly, he has a change of heart about the movement. He finds himself no longer supportive and committed of it. Despite his distancing from the movement, he still receives a summon to carry out the assassination of a duke.
Princess Casamassima plans to offer herself as a substitute for him and decides to go to his apartment. When she arrives, Hyacinth Robinson has already killed himself. | <urn:uuid:b3e6dd26-ea2f-487d-a663-98d2b54cb09e> | CC-MAIN-2013-48 | http://www.shvoong.com/books/classic-literature/1775238-princess-casamassima/ | s3://commoncrawl/crawl-data/CC-MAIN-2013-48/segments/1386164931675/warc/CC-MAIN-20131204134851-00048-ip-10-33-133-15.ec2.internal.warc.gz | en | 0.978163 | 352 | 2.84375 | 3 |
RACIAL & ETHNIC DIFFERENCES IN DISTRIBUTION OF HUMAN ABO BLOOD TYPE GROUPS; DIFFERENT COUNTRY - DIFFERENT ABO GROUPING; INDIVIDUAL RACES HAVE COMMON BLOOD TYPES.
There are racial and ethnic differences in Blood type and composition. The ABO Blood group system was discovered in 1901 and since it is of major importance in medicine, samples have been diligently collected from the most remote of people groups for a century. Of no other human characteristic is so much data available. Most populations have migrated and mixed. Unfortunately the reliability of the Blood data for assessing relationships between population groups is very limited. This is mostly due to the lack of availability and interchange of this important data. As the chart below reveals, the frequency and purity of the four main ABO Blood groups varies in populations throughout the world. Great variation occurs in different groups within a given country; even a small country, as one ethnic group mixes, or not, with another. Blood type purity depends on migration, disease, interrelational-reproductive opportunity, traditions and customs, geography and the initial Blood type assigned.
Publishing the ethnic differences in Blood type and the racial differences in Blood type is not, in the present-day world, considered to be politically correct. We compile and maintain this database through often times confidential sources. Every Blood gathering entity in the world must gather this information to stay in business, but almost every one of them is afraid to publish the racial and ethnic differences in Blood type, given the emotionally charged political climate. Discount Cord Blood Registry.
For example, early European races are characterized by a very low type B frequency, and a relatively high type A frequency while the Asiatic races are characterized by a high frequency of types A and B. The following chart does not consider Rh factor and may vary in specific regions. It is also different for some very particular racial or ethnic groups. We have highlighted interesting pure anomalies.
Rare blood types can cause Blood supply problems for unprepared Blood banks and hospitals. For example, the rare Blood type Duffy-negative Blood, occurs much more frequently in people of African ancestry. The relatively rarity of this rare Blood type in the rest of the North-American population can result in a shortage of that rare Blood type for patients of African ethnicity, in need of a Blood transfusion. Keep in mind, if you have a rare Blood type, there may be some risk in traveling to parts of the world where your rare Blood type may be in short supply. Knowledge of ABO Blood type frequency can be life saving information. Blood test results, Blood tests, Rare Blood types, blood disorders.
The frequency with which Blood types are observed is determined by the frequency with which the three alleles of the ABO gene are found in different parts of the world. Variation in this allele frequency of the ABO gene reflects the social tendency of populations to marry and reproduce within their national, regional, or ethnic group. As people throughout the world intermingle to a greater degree, the distribution of the different Blood types will continue to become more uniform. Red cell antigens are the pheno-typical expression of our inherited genes. One of the most common questions that we get is about the the ethnic and racial distribution of human Blood groups. In response, following here is our collection of basic ABO Blood group data, sorted by people groups.
One note; we do not consider the very small percentage of individuals who inherit unusual combinations of "minor" antigens. Everyone carries substances on their red Blood cells, called antigens. In addition to the well known ABO classified groupings, and Rh factor, there are over 260 "minor" antigens that have been identified. These antigens may appear in varying combinations. The presence or absence of these specific "minor" antigens single out that particular Blood type as being "rare." All Blood types are inherited and therefore certain rare Blood combinations are more common in specific ethnic and racial groups. We review this subject HERE. Discount coupons for DNA tests.
Pharmacy shelves are stocked with do-it-yourself home tests for Blood glucose, Blood cholesterol paternity tests and pregnancy tests. OraSure Technologies Inc., makes and sells a 20-minute, at-home test that screens for two HIV strains using a swab device that tests saliva, awaiting the FDA.
There is precise and up-to-date data available. These racial and ethnic Blood typing and population migration statistics are important in modern medicine for many reasons. The overriding problem in obtaining and publishing this information in the United States, and to a slightly lesser extent in Western Europe, is political correctness. It is not nice to talk about the ways that I may be different from you!
This data has some holes in it; there are national and/or ethic groups whose statistics are not known to BloodBook.com. Those are noted with a . If you can contribute accurate data to BloodBook.com, please click HERE. We encourage to visit the Bloodmobile. Free discount coupons for DNA testing.
We are grateful for the many recent updates from Blood professionals and Blood Banks and DNA parental test facilities around the world. This program is working well, thanks to you
A Word about Blood-related DNA Genealogy and Anthropological Sampling - The relatively new science of DNA research applied to full-blooded, indigenous populations from around the world has led to the discovery and documentation of genetic markers that are unique to populations, ethnicity and/or deep ancestral migration patterns. The markers having very specific modes of inheritance, which are relatively unique to specific populations, are used, among other things, to assess ancestral and kinship probabilities. The following chart considers only these full-blooded, indigenous groups.
A Contribution to the Physical Anthropology and Population Genetics
L. Beckman - *as revised by BloodBook.com 12/07/2000; 07/22/2001; 04/10/2002; 05/22/2004; 07/13/2008.
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last updated 07/13/2008 bloodbook.com | <urn:uuid:18cead0f-eabf-4208-ac5c-b762c1484e24> | CC-MAIN-2017-43 | http://familymatrix.blogspot.com/2009/02/racial-ethnic-distribution-of-abo-blood.html | s3://commoncrawl/crawl-data/CC-MAIN-2017-43/segments/1508187823630.63/warc/CC-MAIN-20171020025810-20171020045810-00553.warc.gz | en | 0.91597 | 1,341 | 3.4375 | 3 |
Today marks the start of the first John Kelly’s Washington “Squirrel Week”: an entire week’s worth of columns devoted to that most common of mammals.
Common the squirrel may be — at least around these parts — but full of mystery, too. Come with us this week as we travel from the Great Plains of America to the jungles of Southeast Asia, from the arid foliage of western Africa to the snowy reaches of the Rocky Mountains — all squirrel stomping grounds.
But let us start right here in the nation’s capital, with a feature of Washington that impresses visitors as much as our glorious architecture and our bad traffic: black squirrels.
In a nutshell: Where did Washington’s black squirrels come from?
They came from Canada, specifically from Rondeau Provincial Park, a peninsula in Morpeth, Ontario, that juts like a uvula into Lake Erie.
The first batch of black squirrels — eight in number — was sent to the National Zoo in 1902 by Thomas W. Gibson, Ontario’s superintendent for parks. Smithsonian secretary Samuel P. Langley, in his report to Congress that year, wrote that the squirrels were accepted “in exchange,” and, indeed, checking Canadian records, Answer Man discovered that Rondeau park received an unspecified number of gray squirrels from the Smithsonian. (They are “doing nicely,” reported park caretaker Isaac Gardiner.)
The black squirrel and the gray squirrel are the same species of squirrel: Sciurus carolinensis, a.k.a. the Eastern gray squirrel, the only difference being a color variation. The black squirrels evince a “melanistic color phase,” the recessive gene for black coloration coming to the fore.
The Canadian squirrels were released in the northwestern part of the zoo, “where they were very much at home,” according to the 1923 Proceedings of the Biological Society of Washington. “They have since been constantly in the Park, especially from the vicinity of the great flight cage to the Klingle Valley, and they have spread northward to Cleveland Park and nearly to Chevy Chase.”
The zoo also released a second batch of black squirrels, which arrived in May 1906.
Black squirrels were enough of a rarity in these parts that The Washington Post felt compelled to describe them: “The pair at the Zoo are jet black — so black that they appear shiny.”
Answer Man is pretty sure that if the National Zoo received a bunch of wild animals today, it would not do what it did then: release them into the neighborhood. Although the species was already here — and so wasn’t technically an invasive — it is kind of irresponsible, don’t you think? And yet there was precedent: Smithsonian scientists had also been releasing gray squirrels.
As the Biological Society reported: “The late Dr. Wm. L. Ralph purchased many gray squirrels and liberated them in the Smithsonian grounds, where up to the time of his death in 1907, he fed and cared for them in both fair and stormy weather with keen interest and enjoyment.” Grays were also released on the grounds of the U.S. Capitol and Department of Agriculture.
Although gray squirrels were native to this area but not as common as today (until 1906 it was legal to hunt squirrels in the District), black squirrels were new. It is likely that every black squirrel you see today is related to those Canadian immigrants.
In some areas, black squirrels compose up to 25 percent of the population.
Why has the black squirrel done so well? There are theories, but no definitive answer. Richard “Thor” Thorington Jr., curator of mammals at the Smithsonian’s National Museum of Natural History, thought it might be due to the dusky animals’ greater visibility. Many squirrels end up flattened under steel-belted radials. Could black squirrels be easier for motorists to avoid? But a check of roadkill found no discrepancy in the squash rates of black vs. gray squirrels.
Could black fur retain heat, making it easier for darker squirrels to survive a cold winter? Again, the results are “ambiguous,” Thorington reports in his classic work, “Squirrels: The Animal Answer Guide” (co-authored with Katie Ferrell).
A century after their introduction, these ebony imps are still something of a novelty. Not all neighborhoods in our area have black squirrels. (Reader Dave Martin reports that he has never seen one where he lives, in Chantilly. Have you?)
As for the appeal of squirrels, Answer Man will simply quote the Biological Society’s Vernon Bailey, who wrote this in 1923: “The psychological value of a defenseless wild animal in our midst to be protected, fed and guarded by the people through interest rather than by force of law, cannot be overestimated.”
All this week we’ll be exploring the wide world of squirrels. For more coverage, go to washingtonpost.com/washingtology. You can send us photos you’ve taken of squirrels. Share your squirrel tales in the comments below. Or tweet your story (in 140 characters or less) on Twitter. Use #DCSquirrelWeek.
Send questions to [email protected]. | <urn:uuid:503af9a2-4eca-4fe1-b0be-2495e5ffc493> | CC-MAIN-2018-13 | https://www.washingtonpost.com/local/squirrel-week-where-did-dcs-black-squirrels-come-from-blame-canada/2011/03/30/AFgnPaHC_story.html?utm_term=.d2358556346f | s3://commoncrawl/crawl-data/CC-MAIN-2018-13/segments/1521257644701.7/warc/CC-MAIN-20180317055142-20180317075142-00779.warc.gz | en | 0.95986 | 1,132 | 3.296875 | 3 |
If you have ever struggled to learn a tonal language like Cantonese, you are probably (painfully) aware of how difficult it can be. In tonal languages, the same syllables can have different meanings if spoken with an increasing, neutral, or decreasing pitch. But xenoglossophobes, fear not — these researchers are here to help! They guessed that learning words in Cantonese would be easier and faster if students were first taught to distinguish different tones. To test this idea, they compared students (both musicians and non-musicians) who were first trained to hear tonal differences. Guess what? It worked! Both musicians and non-musicians learned new words faster when first taught to distinguish the different tones. Now all we need is something to make learning all those Chinese characters easy…
“The present study examined the effect of improving lexical tone identification abilities on Cantonese tone-word learning. Native English non-musicians received training on Cantonese tones before learning the meanings of words distinguished by these tones. Their results were compared to English non-musicians and musicians who received no tone training. The tone-trainees obtained a similar level of word identification proficiency as musicians by the end of training and were significantly better than non-tone trained non-musicians. These results lend support for phonetic-phonological-lexical continuity in learning because enhancing listeners’ perception of lower-level tonal information significantly contributed to success in a higher-level linguistic task.”
NCBI ROFL: Consequences of erudite vernacular utilized irrespective of necessity: problems with using long words needlessly.
NCBI ROFL: Eating behavior and obesity at Chinese buffets.
NCBI ROFL: How many f**king cuss words are in these sh**ty video games, anyway? | <urn:uuid:24488198-dc23-4ed5-9dad-71ca63a00eb2> | CC-MAIN-2016-30 | http://blogs.discovermagazine.com/seriouslyscience/2014/04/23/want-learn-chinese-read-first/ | s3://commoncrawl/crawl-data/CC-MAIN-2016-30/segments/1469257831769.86/warc/CC-MAIN-20160723071031-00060-ip-10-185-27-174.ec2.internal.warc.gz | en | 0.959282 | 379 | 3.515625 | 4 |
How Supervolcanoes Shaped Earth
From the Series Earth Shapers
In this book, early fluent readers will learn about the features of supervolcanoes, how they have shaped Earth’s surface in the past, and the possibilities of them changing the future of life on Earth. Vibrant, full-color photos and carefully leveled text will engage young readers as they learn more about supervolcanoes and their impact on our planet.
A Take a Look! infographic, sidebars, and STEM activity aid understanding and allow readers to explore further. Children can learn more about supervolcanoes using our safe search engine that provides relevant, age-appropriate websites. How Supervolcanoes Shaped Earth also features reading tips for teachers and parents, a table of contents, a glossary, and an index.
How Supervolcanoes Shaped Earth is part of Jump!’s Earth Shapers series.
|Interest Level||Grade 2 - Grade 5|
|Reading Level||Grade 2|
|Subject||Science and Math|
|Number of Pages||24| | <urn:uuid:860fd954-2ec8-47a3-bd1f-cdf7c34b86aa> | CC-MAIN-2022-05 | https://brainstormlibrary.com/shop/show/16263 | s3://commoncrawl/crawl-data/CC-MAIN-2022-05/segments/1642320301720.45/warc/CC-MAIN-20220120035934-20220120065934-00205.warc.gz | en | 0.839041 | 260 | 3.78125 | 4 |
What Are the Question Types in WISEflow?
The authoring module gives the author of a digital exam full control in the structuring of tests in WISEflow. As an author, you have the possibility of mixing a wide array of question types, thereby creating the digital exams you deem best suited to test the students’ skills.
WISEflow: More Than 50 Question Templates in Different Subjects
With WISEflow you will gain access to more than 50 advanced question type templates in a wide range of subjects, such as maths, language, biology, chemistry, geography, computer programming etc. The templates thoroughly ease the creation of questions and you will always find a template that suits your specific needs.
The templates are pooled in different themes, according to their structure:
- 6 Multiple-choice question templates: students choose between a set of predetermined options. The options can be everything from pictures and sound clips to standard text
- 6 “Fill in the blanks” question templates: students fill in the missing text, image, graph, formula, or sound clip
- 4 “Written and Spoken” question templates: students write short or long answers to essay questions or record sound clips as answers to language tests
- 5 “Classify, Match and Order” question templates: students’ exam answers consist of an arrangement of objects
- 9 Math question templates: questions and students’ answers can contain formulae (LaTeX and MathML)
- 8 Graphing question templates: questions and students’ answers can contain graphs
- 5 Charts question templates: questions and students’ answers can contain charts
- 4 Highlighting question templates: students’ answers consist of their choice in highlighting objects or words
- 4 Chemistry question templates: questions and students’ answers can contain chemical symbols and formulae
Possibility of Mixing Media in Digital Exams
To further customise your digital exams to your specific needs and desires, you have the possibility of adding different media to the digital exam. If you wish, you can embed images or add video or audio players to each and every question you want to. This goes for all question types – no exceptions.
You can choose to add the media directly in the question text or to be available beneath the question as appendix material. If you choose to embed it directly, this is done easily by simply uploading the chosen material directly in the module.
- You might be interested in this: What Kind of Marking Does WISEflow Support?
The amount of audial and visual media you can add or attach to your exams are virtually limitless.
Adding Tools and Resources to Digital Exams
When you are creating digital exams, you also have the possibility of making advanced tools and media available for the students. These can be advanced scientific calculators for maths, input fields for different mathematical formulae using the built-in editor, audio and video players to record the student’s answer etc.
In short, the high customisability of the WISEflow author module lets you create exactly the exam you want. | <urn:uuid:650276a0-2596-4463-942b-858e2c31ff08> | CC-MAIN-2019-18 | https://uniwise.dk/2018/01/13/question-types-wiseflow-support/ | s3://commoncrawl/crawl-data/CC-MAIN-2019-18/segments/1555578806528.96/warc/CC-MAIN-20190426133444-20190426155444-00507.warc.gz | en | 0.880936 | 638 | 2.953125 | 3 |
Most new owners are delighted by puppy antics, but a puppy that eats poop prompts anything but smiles. It could be any animal's feces, too. From its stool to your cat's litter box deposits to a neighboring horse's or cow's manure, some puppies don't discriminate when it comes to poo they're willing to eat. Although many puppies grow out of this phase at least to some extent, there are steps you can take to discourage and even stop the behavior.
Watch Now: Why Do Some Puppies Eat Poop?
Why Do Puppies Eat Poop?
Dogs often eat their own or another animal’s droppings, no matter what species of animal does it. There's even a technical term for it: coprophagia.
This behavior typically is normal for very young puppies, possibly to colonize the gastrointestinal tract with normal bacteria, and for their mothers to keep the "den" clean. The good news is that most pups outgrow the habit. The bad news is that some dogs hang on to the nasty practice throughout their lives.
There are a variety of reasons why your puppy eats poop:
- When you wave your hands, shout with disgust, and chase the puppy all over the yard, that’s great puppy entertainment. Chasing can reward the behavior and encourage your puppy to play poopy-keep-away.
- Poor quality diets may lead to puppies snacking on their waste. For instance, if the dog's food is not being digested fully, the dog may look to its feces as a supplement because it's nearly the same as when it was eaten.
- Some health issues may cause coprophagia as well. Diseases in the small intestine or pancreas may cause malabsorption or maldigestion. Also, conditions such as diabetes and thyroid disease often increase a dog's appetite and, if its regular diet isn't filling, it may resort to whatever's available.
- It's also possible that a dog is simply not eating enough and its daily food intake needs to be increased.
- Eating other animals’ waste may have to do with taste. Cow and horse manure may contain undigested grains or other ingredients that are appealing to your pup.
- The cat’s litter box may as well be a puppy snack bar! Not only is this unsanitary, but it also puts kitty's tail in a twist to have a dog messing with its personal toilet. A cat that's pestered in its bathroom may look for another place to "go," such as behind the sofa.
- Other times, poop eating stems from boredom. If a pup left out in the yard alone has little to occupy its time, it may turn to the one available thing.
- Stress can also lead a dog to eat their feces, especially major stressors like coming to a new home after being adopted.
How to Stop Poop Eating
It's best to put a stop to this behavior before it gets out of hand. Parasites are often transmitted through feces, so having a dog that sees it as a treat puts the pup's health at risk. There are several things you can do to put an end to this nauseating habit:
- Puppies may eat waste to get your attention, which means that even yelling may reward their behavior. If you catch your pup in the act, don’t make eye contact or speak. Instead, interrupt the act by shaking a can full of pennies or clapping your hands loudly.
- For bored pups, increase playtime to a minimum of 20 minutes several times a day or try aerobic exercise twice a day. If you leave your puppy in the yard while you're away, increase the number of toys available. A treat-spiked toy such as a Kong filled with peanut butter offers a tastier, healthier alternative.
- If you believe stress may be playing a role in your dog's habit, try to offer some relief. This will entail addressing the reason for its anxiety and calming products such as Adaptil may help in the interim while you work on correcting that issue. Speak to your veterinarian for help with diagnosis and treatment.
- Prevent access by walking your puppy on a leash and leading it away from a pile once the business is done. Offer it rewards for leaving stool alone. Teach the puppy to "come" and sit in front of you after each bowel movement—its own or another dogs’—and offer a fantastic treat while you pick up the waste.
- Some dogs may eat their stool when it hasn’t thoroughly "processed." In these instances, a more digestible food that offers all the nutrients your dog needs may help. Ask your veterinarian for a recommendation. Remember to make a gradual change to the new food as a sudden change could prompt tummy issues.
- Get your puppy to the vet for regular check-ups and keep an eye out for signs of intestinal parasites. For instance, rice-like segments in stool are a sign of tapeworms and diarrhea can be a signal of whipworm, roundworm, or hookworm infections. Taking stool samples to your vet will help detect a parasite's presence as not all are visible without a microscope or special tests.
- Check with your vet to see if it's OK to experiment with using a commercial product, such as Dis-Taste Chewables or For-Bid, to make stool less appetizing.
- Some products can be given to cats to reduce the odor of their feces and, therefore, its appeal to dogs. Again, it's best to consult your vet before trying them.
- Scoop and clean the cat box as often as possible. Leaving droppings for any length of time is asking for trouble. Automatic cat boxes sweep the feces into a bin within 10 minutes of the cat’s deposit.
- Place the litter box on a table or counter out of the dog's reach. If the cat doesn’t object, a covered litter box might deter the dog while allowing the cat access and privacy.
- Use a baby gate to keep the dog out of the cat’s domain. Some cats can jump over the standard gates, or you can install it a couple of inches off the floor so your kitty can slink underneath while the jumbo-size pup can’t get through.
- Finally, when you can’t be around to supervise, muzzle (only cage muzzles that allow dogs to pant and drink are safe for long term use) or crate your pup. | <urn:uuid:b5e97bb1-307c-490a-bb7a-9af92fd9ef36> | CC-MAIN-2021-39 | https://www.thesprucepets.com/why-do-dogs-eat-poop-2804569?utm_source=emailshare&utm_medium=social&utm_campaign=shareurlbuttons | s3://commoncrawl/crawl-data/CC-MAIN-2021-39/segments/1631780055808.78/warc/CC-MAIN-20210917212307-20210918002307-00589.warc.gz | en | 0.952803 | 1,350 | 2.78125 | 3 |
This course is designed to serve as first course inElectronics for Physics, Computer Science, Electrical and ElectronicsEngineering Curriculum.
This coursewill help to understand the basics as well as advance electronics such asAnalog and Digital Electronics, Linear and Digital Integrated Circuits,Communication Electronics, Microprocessors, Microcontrollers etc.
Afterfinishing these courses, you should be able to
1.Identify different components of Electronics
2.To analyse different electrical and electronic circuits
3.Understand basic concepts of Electronics
4.Implement electronic circuits such as rectifier, amplifier etc. for practicalproblem solving.
5.Write and execute program using Microprocessors and Microcontrollers.
6.Understand modern communication system.
12thstandard Physics and Mathematics.
1.Dr. Liton Balo, Fakir Chand College, Diamond Harbour
2.Mr. Debashis Duttagupta, Fakir Chand College, Diamond Harbour | <urn:uuid:4e9f4704-d79f-43bf-bab1-3a284b41bfe4> | CC-MAIN-2023-50 | https://fccollege.ac.in/SubjectWiseDetails?id=11 | s3://commoncrawl/crawl-data/CC-MAIN-2023-50/segments/1700679100739.50/warc/CC-MAIN-20231208081124-20231208111124-00779.warc.gz | en | 0.81281 | 201 | 3.109375 | 3 |
This section contains sites with information on multiple board games. Examples would include but be limited to comprehensive game directories with unique content, game reviews, and game strategies for multiple games. Resources Board Games Games.
A resource is a source or supply from which benefit is produced. Typically resources are materials, energy, services, staff, knowledge, or other assets that are transformed to produce benefit and in the process may be consumed or made unavailable. (wikipedia)
- Resource A source or supply from which benefit is produced.
- Natural resource Natural resources are resources that exist without actions of humankind.
- Web resource The concept of a web resource is primitive in the web architecture, and is used in the definition...
- Water resources Water resources are sources of water that are potentially useful.
- Resource (biology) A substance or object in the environment required by an organism for normal growth, maintenance...
- Resource (economics) In economics, factors of production, resources, or inputs are what is used in the production...
- Human resources The people who make up the workforce of an organization, business sector, or economy.
- Resource (project management) In project management terminology, resources are required to carry out the project tasks.
- Resource (computing) Physical or virtual entities of limited availability (e.g., memory, processing capacity, and...
- Computational resource A resource used by some computational models in the solution of computational problems.
- Resource fork A fork or section of a file on Apple's classic Mac OS operating system, which was also carried...
- A History of Traditional Board Games www
Contains information on old traditional board games. History of Traditional Board Games.
- BoardGameGeek www
A database of player reviews, BoardGameGeek, session reports, images, and news.
- Database Luding www
Database of games that includes to reviews, Luding, variants, and biographies on the designers. [English and German] Luding.
- Board Yehuda www
Board games and gaming weblog from Jerusalem, Yehuda, Israel. Yehuda.
- Rankings Avalon Hill Reliability, Experience and Ability Scoring System www
Rankings for players in around 200 different games (primarily wargames). Avalon Hill Reliability, Experience and Ability Scoring System.
- Covers Kulkmann's G@mebox www
Covers on old and new German and English boardgames. G@mebox. Features articles about Games Workshop, Talisman, Tolkien boardgames, the SPIEL convention at Essen and others. Kulkmann's G@mebox.
- Alphabetical Traditional Games Database www
Alphabetical listing of traditional games. Games Database. Listings include publisher and developer details, as well as the year each game was published. Traditional Games Database.
- Presents Brett and Board www
Presents information and news about German family board games. Brett and Board.
- Gaming Brett Spiel Welt www
Gaming portal for playing board games over the internet. Brett Spiel Welt.
- Michael How To Publish Board Games www
Michael Mindes from Tasty Minstrel Games describes how he started publishing games. How To Publish Board Games.
- Forum The Board Game Designers Forum www
Forum for board game designers. Board Game Designers Forum. Includes downloadable resources and game design journals. The Board Game Designers Forum.
- Categorized Globetrotter Games www
Categorized directory of board games. Games. Includes game descriptions and rules. Swedish/English. Globetrotter Games.
- Features Board Games Pub www
Features articles, Games Pub, reviews, lists, and instructions for multiple games. Also includes a glossary and recommendations by genre. Board Games Pub.
- Features About.com: Board Games www
Features news, Board Games, free games, articles, rules, and a discussion forum. About.com: Board Games.
- Presents Board Games Fan Page at Graceful Boot www
Presents a board game journal, Games Fan Page at Graceful Boot, rules clarifications and variants, and strategy articles. Board Games Fan Page at Graceful Boot.
- Chess Adam's Page www
Chess and word game resources, Page, including a Scrabble solver, word lists, and chess puzzles. Adam's Page.
- FAQs Board Games FAQ www
FAQs on board games from rec. Games FAQ.games.board on Usenet. Board Games FAQ.
- Errata, Spotlight on Games www
Errata, Games, variants, analysis, rules summaries, reviews, charts and background information for a variety of board games and simulations. By Rick Heli. Spotlight on Games.
- Features The Game Crafter www
Features a web based app for designing components. Game Crafter. Users can upload their artwork and then have their game assembled. The Game Crafter.
- Features The Games Forum www
Features descriptions, Games Forum, rules, and variants for multiple games. Also features a gamer database, articles, swap and sell, and online gaming. The Games Forum.
- South South Devon Gamers Table Football Club www
South Devon, Devon Gamers Table Football Club, England. Description of the club and directions to the venue. South Devon Gamers Table Football Club.
- Gaming Got Dice? www
Gaming group based in the Northeast Illinois / Southeast Wisconsin area. Dice?. Mainly plays European style board and card games. Includes game reviews, ratings and session reports. Got Dice?.
- A Online Games Network www
A selective directory of online games which is heavily focussed on adventure games, Games Network, MUDs and roleplaying games. Online Games Network.
- Contains Tané, Sam and Arthur's (mostly board) Games www
Contains a personal game collection with reviews and comments. Sam and Arthur's (mostly board) Games. Tané, Sam and Arthur's (mostly board) Games.
- Alexa: Resources Board Games
Alexa Directory Top Sites: Resources Board Games
- DMOZ: Resources Board Games
dmoz.org Directory: Resources Board Games | <urn:uuid:56f89fbf-9713-4e69-b8d4-9b8f405e0acb> | CC-MAIN-2017-43 | http://games.interactiva.org/Board_Games/Resources/ | s3://commoncrawl/crawl-data/CC-MAIN-2017-43/segments/1508187820927.48/warc/CC-MAIN-20171017052945-20171017072945-00298.warc.gz | en | 0.852622 | 1,273 | 3.09375 | 3 |
Subsurface data and AI in Equinor
Binge watch online from 3,000 meters below ground? You can if you are a subsurface specialist turned data scientist.
Are you able to watch and follow the action in two movies at the same time? Probably not for long. What about 10,000 Netflix movies per second? Of course not. Too much for our natural intelligence. On our fields we generate such amounts of data from our operations every day, all day long. Now engineers and geoscientists are turning to data science to get more out of the subsurface.
Equinor has placed fiber optic cables, the very same type of cable that delivers the Internet to your home, along all the wells at the giant Johan Castberg field. While there’s little need for Netflix in the middle of a reservoir, there is a need for data and that is why we are using these cables. With slight modifications, the fiber now works as microphones and temperature sensors which create enormous amounts of data.
Taber Hersum, a geologist turned data scientist, can “binge” watch this and other huge data sets that are being generated with new technology and sensors in our operations, and make sense of it.
“My eyes have been opened to data-driven approaches. It is so intriguing because we can make insight into complex relationships which might otherwise be impossible without data science”, Taber says.
When all this data is gathered in one place, 10,000 “movies” can be made into 1 that our engineers can watch. Process capabilities of the subsurface is translated into information with the help of machine learning. What used to take 2-3 weeks and involved flying hard disks to shore with helicopter for analysis, can now be done in seconds and livestreamed. And when the data is live, it opens for automation. There is no need to watch all the data as it comes up from the deep below. The fiber team is developing machine learning algorithms to make it easier for the engineers to view the right data.
“The implementation of a real-time data streaming pipeline for fiber optic data has enabled much more efficient interpretation of the vast amounts of data we have. Many observations can readily be interpreted by subject matter experts, and we reuse those interpretations as training data to build machine learning models. This is a critical step towards automated interpretation and will be increasingly important as the data continues to grow,” Taber explains.
AIM to please
It is not only drilling operations and monitoring that is changing because of new digital technology and data science. The work done before the drilling can begin, the well planning phase, is also transformed by AI. A project called AIM – Artificial Intelligence Maturation – is changing well planning from a several months long and difficult manual process for one drilling operation to field development scenarios with thousands of well alternatives. With AIM, we can auto-generate well paths and get suggestions from the software regarding the optimal solutions. Then we can use the natural brain power of our specialists to decide which one of the options offered by artificial intelligence is best. The expert is still best at making the interpretations, but the computer can increase the data coverage, build new models for prediction and help validate concepts and ideas better and faster than before.
“If we can better represent the complexity of well planning including the available slots, the targets, and all the constraints, then this means value creation and efficiency with our precious time. For me, in AIM, that means working across subsurface and drilling and well challenges – I have to understand each other's data and knowledge in order to get the cheapest and least risky well paths”, Roy explains.
The huge data potential
Before well planning and drilling, we need seismic data. In fact, we already have 50 petabytes of it from around the world. That is more than double the amount of digital content held by the US Library of Congress, the world’s largest library. We are on a journey to standardise our data and make it easily available through the cloud. When historical data can be combined with newer data, geology from different geographies can be analysed and compared to look for patterns and potential, and when a geologist can use software to analyse vast amounts of data that would take years to go through manually, it changes the game.
Renaud Laurain, a geophysicist who has also upskilled himself into data science has been working in several projects where the aim is to make seismic analysis easier:
“Moving from seismic data acquisition to data analytics has given me a completely different point of view of the importance of data in the modern world. Here is one example: In the past our work processes were focused on reducing the amount of data so that a human being can handle it. Data analytics and machine learning change that entire objective – shifting to focus on how to capitalize on the whole data amount,” he explains. | <urn:uuid:948dec0e-7c41-40fd-b6ee-77c4e1db8807> | CC-MAIN-2023-40 | https://www.equinor.com/energy/data-in-equinor | s3://commoncrawl/crawl-data/CC-MAIN-2023-40/segments/1695233510427.16/warc/CC-MAIN-20230928162907-20230928192907-00087.warc.gz | en | 0.942685 | 1,018 | 2.796875 | 3 |
Why does America celebrate its independence on the Fourth of July? Mainly because it works.
It isn't the day we achieved our independence. That was Nov. 3, 1783. It isn't the date of the first battle of the Revolutionary War. That was over a year before July 4, 1776. And it isn't the date of the last decisive battle.
We chose the day the Declaration of Independence was signed because that was a magical moment that unquestionably led to the foregone conclusion of American independence.
Or so the story goes. Actually, it was much more difficult than that. Members of the Continental Congress seriously debated whether there was much chance of winning a revolution against the crown.
The rebels had a rag-tag army, not much of a navy and no alliance with any country that could be of help.
But the decision to proceed was made and most of them signed a document pledging their lives, their fortunes and their sacred honor to each other. They knew they were guilty of treason and, if captured, were likely to be hanged.
Were it not for some freelance help by European military officers such as Lafayette, von Steuben, de Kalb and others, they would have been in serious trouble.
For the past several years, friends have sent me an essay describing the fate of the signers of the Declaration of Independence, suggesting that I use it in a July 4 column. Somehow the fate of the signers seemed too grim to be accurate.
So, this year, I searched Google for "Declaration of Independence signers" and quickly learned that the essay has made quite an impact. No authorship is claimed, but it appears to be a rewrite of an essay by Rush Limbaugh Jr., father of the radio personality.
The fates claimed for the 56 signers all had grains of truth but all were considerably overstated. Nine of them did die during the Revolutionary War, but none of them at the hands of the British.
Many did have their homes ransacked, vandalized and occupied by the British, but that was because they were in the path of the war. Theirs were mostly big homes that were likely targets for both sides to use as local headquarters or plundered for supplies. Many lost much of their property and had to sell assets after the war in order to cover debts, but none of them died in rags, as claimed.
In short, all the signers took a huge risk and had every reason to believe that they might well be hanged. Today, we should all take time to honor their courageous act. And we also should honor all the colonists who endured hardships and losses, including loss of life, in the cause of the revolution.
The actual stories of the 56 signers of the Declaration of Independence are sufficiently compelling without embellishment. In our comfortable society of today, it is difficult to imagine the hardships they all had to endure. We easily could call that "our greatest generation."
Biographies have been written for all the signers of the Declaration of Independence. I'm sure they are all good reads. If you don't have time for that, my suggestion is a recent book by Roswell's Dave Clary titled "Adopted Son" that describes the friendship between Gen. George Washington and the young Marquis de Lafayette. It is a brilliant and inspired argument for overthrowing tyranny that captured imaginations not just here, but in Europe and the rest of the Americas.
Upon winning our independence, we became the world's first revolutionary power, making us the oldest revolutionary government on earth, with the oldest written constitution.
Americans have much to be proud of on this day.
Let us not forget the sacrifices of our forbearers to obtain freedoms we now sometimes want to limit.
Contact columnist Jay Miller at [email protected] | <urn:uuid:78c0c8ed-ae14-47ae-879f-d0a824ddeaa8> | CC-MAIN-2014-42 | http://www.alamogordonews.com/alamogordo-columnists/ci_23586113/our-forefathers-took-great-risks-july-4 | s3://commoncrawl/crawl-data/CC-MAIN-2014-42/segments/1414119648891.34/warc/CC-MAIN-20141024030048-00094-ip-10-16-133-185.ec2.internal.warc.gz | en | 0.98344 | 785 | 3.34375 | 3 |
Has Cubed by Nikil Saval been sitting on your reading list? Pick up the key ideas in the book with this quick summary.
Sitting at work, you use your brain to solve problems and think about all sorts of things. But how often do you ponder why it is that so many people spend upwards of eight hours in an office, each day? The thought probably never entered your head.
Don’t fret if how your workplace came to be never crossed your mind. This book summary will enlighten you by exploring how the modern office space developed into its current, cubed form.
The cubicle-packed office is a recent concept that evolved over many historical shifts. From clerks crammed into small and dim spaces in the mid-nineteenth century to carefully designed skyscrapers complete with amenities like barber shops, this book summary will guide you through the history of the office.
In this summary of Cubed by Nikil Saval, you’ll also find out
- how a man named Taylor tamed office mayhem;
- how a bomb caused the segregation between office and factory workers; and
- how the invention of the cubicle arose from a new concept of movement.
Cubed Key Idea #1: Industrialization inspired the rise of the clerk and a distinct workplace, separate from manual workers.
You know how receipts and personal documents often pile up on your desk? It takes a lot of work to keep track of all that paper, even when it belongs to just one person.
Now, imagine the amount of work it would take to organize documents for multiple employees, or even keep track of every business transaction within an organization!
Administrative jobs that deal with filing papers, paying bills and organizing accounts are common, so much so that they’re considered a standard, entry-level position in any firm.
Historically, however, it wasn’t until the advent of industrialization in the mid-nineteenth century that such positions became required posts in the workplace.
The people assigned to these jobs were called clerks. Initially, clerks worked alongside their bosses in so-called counting houses. These “offices” consisted of nothing more than a dark, tightly packed room. As a clerk, you were lucky if you even had a window!
One New York office, for example, housed ten people, six of which were clerks, in an office of 25 square feet – that’s the size of a modest bathroom by today’s standards.
By 1855, clerks had become New York’s third-biggest group of workers. The sudden growth in the number of clerks meant people needed more space to work, a development which coincided with a spacial separation between manual and non-manual workers.
For instance, you’d often find non-manual workers in a separate office space downtown, apart from a factory where manual workers toiled. Or, if a business was under one roof, the physical separation of clerks and manual workers would be distinct, such as by having separate entrances for each.
Another key factor about the workplace in this era was that clerks and bosses usually worked together in close proximity. Consequently, they often developed good relationships with one another, with a clerk often becoming a trusted, “right-hand man” for a boss.
This workplace model wouldn’t last long, though. We’ll explore what happened as businesses grew in the next book summary.
Cubed Key Idea #2: As business advanced, the office space expanded, giving rise to the science of work efficiency.
Imagine a clerk writing, copying and filing in his office in 1860. He suddenly travels through time to arrive in the year 1920. What changes would he see in the office?
Though our clerk may have taken a leap forward chronologically, we can’t say the same for working conditions.
Granted, the workplace did change significantly over those 60 years, as gone are the calm days of working with a single boss and a few coworkers. Now non-manual workers seem to resemble factory workers, with hundreds of clerks clacking away on typewriters, and men with stopwatches recording how long it takes a clerk to perform a task.
How did it come to this? From 1860 to 1920, the advance of technology was correlated with the growth of business and office space.
In a sense, technology had made the world smaller. Railroads enabled markets to expand across the continent, and the telephone and telegraph enabled the exchange of information at faster speeds and further distances.
More and bigger businesses were now possible, and they created a demand for more workers, such as errand boys, typists and messengers.
All of these office workers, in turn, needed a place to work, and quickly. Without much thought put into how to scale the workplace for the growth of business, workers were simply stuffed into big office spaces with vast rows of desks.
This expansion gave rise to much confusion, however. No one really knew who did what, when and where, as management was still many years away from becoming an established field of knowledge.
Thankfully, this changed when the American engineer Frederick Taylor (1856-1915) developed a solution that would be eponymously named Taylorism.
Taylorism divided work into segments, with each worker carrying out specialized tasks. Everyone knew what to do, and they knew they needed to do it as fast as possible. Taylorism soon became synonymous with efficiency and mass production.
The development of management ideas translated into burgeoning administrative branches in business. So, what happened next?
Cubed Key Idea #3: The skyscraper was developed to stack offices on top of each other and offered amenities for workers.
Think about it: When we grow from babies into adults, we grow outwards, but mostly upwards. And that’s what happened to the modern office, too!
By the mid-twentieth century, buildings had become so tall they appeared to scrape the sky. Skyscrapers thus heralded a workplace design in which multiple offices were stacked on top of one another.
As new managerial ideas flourished in the United States, administrative branches grew subsequently, and eventually, this dynamism formulated itself in the image of the skyscraper – to many, a symbol of both aspiration and success.
Chicago and New York, in particular, saw the growth of tall office buildings skyrocket. From 1871 to 1923, approximately 74 million square feet of office space was constructed in New York alone.
The workers’ offices inside these buildings were not as grandiose as the building’s facades, however. In fact, offices were normally quite dull, but to make office workers feel special and distinct from the lowly factory worker, a wide range of amenities was offered in these new spaces.
The need to distinguish office workers from factory workers emerged as labor movements began to criticize big business and the capitalistic system in general. In Chicago, for instance, an active labor movement gained traction as businesses drove up rents in their acquisition of office space, pushing up the cost of living for working class people such as factory workers.
This hostility between labor and capital culminated in 1886 with a bomb explosion in a Chicago skyscraper that was connected to a labor union gathering. As a result, business leaders decided that the behavior of the working class was an obstacle to their goals for new offices and growing enterprises.
Thus, to make office workers feel prized and socially distinct from factory workers, many office buildings were designed with amenities such as libraries, dentists, barbershops and so on.
This served the purpose of having the workers feel well-off and working together as a new class of people for a grand enterprise.
Cubed Key Idea #4: In post-war years, a new office design was born, the organic office landscape.
In European offices, American workplace designs had long been dominant. But in the 1940s, as war raged across the continent, cities and the buildings in them were destroyed.
As the war wound down, new ideas started to grow about how workers should be organized in office spaces.
In post-war Germany, where bombed cities offered a clean slate for urban design and a new thinking, one of the ideas to emerge was a human-based office design called the Bürolandschaft, or “office landscape.”
German brothers Wolfgang and Eberhard Schnelle emerged as leaders of innovative office design, founding a space-planning firm called Quickborner.
Rather than relying on the hierarchical structures of Taylor’s rows of tables and efficiency-based office design, the Schnelle brothers thought office space should be more organic in its layout.
They argued that office space should rely on the flow of human interaction and how different parts – such as communication and paper flow, varying needs of privacy and interaction – were linked.
The brothers would measure those factors within an office and design accordingly. This is how they came up with the Bürolandschaft concept. The idea caught on, and soon, major firms in Europe wanted to integrate this concept in their offices.
The architectural press began to report on this innovative German idea, and soon organic office designs started popping up in Sweden.
The concept even traveled across the Channel to England and across the Atlantic to the United States, where companies were eager to get rid of dingy offices and adopt more open, flexible office spaces.
Cubed Key Idea #5: The office landscape’s noisiness eventually gave rise to cubicle-filled open offices.
Imagine walking into a big office with an open floor plan, with desks and workers everywhere typing, walking and chatting. How noisy do you think this space would be?
Probably pretty noisy, right? To remedy the issue of noise in the workplace, in the 1960s designers tried placing sound screens between desks. This wasn’t entirely successful, however.
Why? Well, whether you were given a sound screen depended on your position in the office hierarchy. For instance, executives definitely had a screen; supervisors sometimes had one; but usually secretaries and other general workers didn’t.
In terms of function, the screens didn’t work that well. High-pitched sounds or ringing phones could still be clearly heard, for instance, so screens ended up serving merely as a status symbol.
Other attempts to improve office space proved similarly well-intentioned, but not totally effective.
In the late 1950s, for instance, the US firm Herman Miller Furniture Company hired art professor Robert Propst to help expand its office manufacturing business.
Propst held that office work was mental work, which correlated closely with the physical environment. As such, he believed that an office should facilitate health and movement, which resulted in his concept of the Action Office.
The Action Office centered on promoting both standing and sitting for workers, while also integrating elements such as movable display surfaces and shiftable, modular walls to provide privacy when necessary.
But the Action Office, like many other attempts to improve the workspace, was too expensive – which is how the cubicle was invented.
Despite innovative attempts at office design, the demand for cheap solutions was always more pressing. Ultimately, it turned out that companies didn’t care much for progressive ideas such as workspace mobility or employee health.
Instead of spending money on carefully designed offices, companies wanted cheap solutions. And that’s how the cheap, small, enclosed cubicle came to be.
In Review: Cubed Book Summary
The key message in this book:
The standard office didn’t always look as it does today. Rather, the cubicle is a product of many years of changes, such as technological advances and economic necessity, as well as different beliefs of how workers should be organized in a space. | <urn:uuid:1f8a45f4-9d0b-4657-9902-037719a39c5f> | CC-MAIN-2023-14 | https://lifeclub.org/books/cubed-nikil-saval-review-summary | s3://commoncrawl/crawl-data/CC-MAIN-2023-14/segments/1679296949678.39/warc/CC-MAIN-20230331175950-20230331205950-00799.warc.gz | en | 0.972892 | 2,439 | 3.1875 | 3 |
Machine and surveying applications aimed at boosting mine productivity and efficiency rely on accurate Real-time Kinematic (RTK) GPS positions. Accomplishing this typically requires tracking of a minimum of four satellites with good "geometry", a condition often not met in deep, open-pit mines.
GPS is a proven utility for determining positioning on the Earth's surface. However, in certain cases it requires augmentation in areas with obstructed views of the sky, such as near high walls in open pit mines and areas with overhead obstructions. A variety of technologies have been implemented to augment GPS, including the development of receivers that track GPS along with additional GNSS signals such as GLONASS, Galileo, and Compass, and the use of Terralite XPS technology, optical technology, inertial systems, laser augmented GPS and others . Open pit mining operations can enhance the continuity, efficiency and productivity of GPS applications by deploying the Terralite technology to have direct control of positioning coverage in their area.
Terralite XPS works by installing up a network of 4 or more Transmit Stations, or "Terralites," around the rim of the pit. Terralites broadcast a new positioning signal, called XPS, to mobile receivers mounted on machines.
These unique GPS+XPS receivers are capable of processing XYZ position data using a combination of GPS and Terralite signals. Terralite XPS can provide accurate data even with fewer than 4 satellites in view.
A complete Terralite XPS System consists of: | <urn:uuid:54fbdb52-eb14-4e93-9798-838c97c678df> | CC-MAIN-2016-36 | https://www.trimble.com/mining/Terralite-XPS-Solutions/TerraLite-XPS-System-Overview.aspx | s3://commoncrawl/crawl-data/CC-MAIN-2016-36/segments/1471982984973.91/warc/CC-MAIN-20160823200944-00251-ip-10-153-172-175.ec2.internal.warc.gz | en | 0.932219 | 315 | 2.6875 | 3 |
By PATRICIA GRAHAM
IT IS no secret that today's grade schoolers are much more technologically savvy than their parents.
THE WORLD of technology can open doors for both young and old. Games, information and long lost friends may be right at your fingertips.
T-L Photo/ERIC AYRES
I, like many, find the need to turn to my children whenever I have a question concerning anything connected to computers, cell phones and the like. Heck, I have a difficult time trying to get my DVD player to work!
With technology making advances, literally at the speed of light, keeping up can be quite a chore. The following is an attempt to explain about these technological advances and help you amaze the younger members of your family with your insights into today's technology.
E-mail stands for electronic mail. While it originated as an after thought to the beginnings of the Internet, it is currently one of the most popular services of the Internet. Internet e-mail can be sent to anyone in the world who has an Internet e-mail address.
Messages are posted electronically to individuals at specific addresses much like conventional mail. The address denotes the computer that the individual employs as a mail server. A mail server is like a local post office: it is a computer that sends and receives electronic mail for a specific network.
Unlike conventional mail, e-mail is much faster. Conventional mail is sometimes called "snail mail" by e-mail users.
Multiple copies of a given message can be sent to different parties automatically with no more effort than indicating the distribution list of addresses. Replies to e-mail can be automatic too. Most mail programs allow the user to reply to the sender and include part or the entire original message. A major difference between e-mail and conventional mail is that while postal letters are not entirely secure, e-mail is even less secure. Unless the message has been encoded, it could be intercepted without your knowledge. For this reason, ordinary e-mail should never be used for sensitive communication.
Searching the web can be overwhelming to beginners who don't know where to start, what's the best stuff to look at, or even how to navigate the web successfully.
The first thing one should realize is that the Web is huge and contains vast amounts of information. Virtually any topic one can think of is covered in detail somewhere, and finding information about anything is easy if you know where to look.
There are services on the web where one can go to retrieve this information that's somewhere out there on the web, and these services are better known as search engines. Basically, search engines are just huge databases of indexed information. They don't necessarily contain the information itself, but they have the addresses (or URLs) where it can be found.
Search engines are out to make money, so while they offer a search service for free, they have to sell ad space to various companies in order to pay the bills, according to About.com. Search engines are also intensely competitive, and are constantly updating the way they index their information in order to market themselves as more efficient than the next guy.
Most search engines will give great information; however, if specific information can not be located on one engine, simply try another.
Shopping on the web is extremely popular, and is easy, secure, and convenient. Shoppers can find great deals, search for obscure items, and order in complete privacy. One of the best ways to shop online is to use a shopping search engine.
Other things to do on the web include getting local news, locating people, playing games, furthering education, check local weather and get free software updates.
Here's a little trick from About.com: when using a search engine to look up something on the web, use quotation marks.
When one uses quotation marks around a phrase, the user is telling the search engine to only bring back pages that include these search terms exactly how they were typed in-order, proximity, etc. This could save loads of time!
Two of the newest phrases in the English language these days seem to be "Follow me on Twitter" and "Didn't you get my tweet?".
In order to understand these phrases one must understand Twitter .
Twitter is a free social networking and micro-blogging service that asks one question: "What are you doing?" It enables its users to send and read messages known as tweets. Tweets are text-based posts of up to 140 characters displayed on the author's profile page and delivered to the author's subscribers who are known as followers.
Senders can restrict delivery to those in their circle of friends or, by default, allow open access. Users can send and receive tweets via the Twitter website, Short Message Service (SMS) or mobile texting, instant message or the web. While the service costs nothing to use, accessing it through SMS may incur phone service provider fees.
According to Twitter.com, Twitter is a privately funded startup with offices in the SoMA neighborhood of San Francisco, Calif. Started in March of 2006, Twitter has grown into a real-time short messaging service that works over multiple networks and devices.
In countries all around the world, people follow the sources most relevant to them and access information via Twitter as it happens-from breaking world news to updates from friends.
Twitter is ranked as one of the 50 most popular websites worldwide by Alexa's web traffic analysis. Although estimates of the number of daily users vary because the company does not release the number of active accounts, a February 2009 Compete.com blog entry ranked Twitter as the third most used social network based on their count of 6 million unique monthly visitors and 55 million monthly visits.
In March 2009, a Nielsen.com blog ranked Twitter as the fastest-growing site in the Member Communities category for February 2009 with a monthly monthly growth of 1,382 percent, Zimbio of 240 percent, followed by Facebook with an increase of 228 percent.
And, if all else fails, just ask a third grader. I'm sure they can help out even the most technologically-challenged adult.
Contact Graham at [email protected] - she'll respond as soon as she figures out how to use her email. | <urn:uuid:5571847c-b42c-445b-866f-77b4a782fef4> | CC-MAIN-2015-11 | http://timesleaderonline.com/page/content.detail/id/512981/Technology-for-dummies.html?nav=5177 | s3://commoncrawl/crawl-data/CC-MAIN-2015-11/segments/1424936462577.56/warc/CC-MAIN-20150226074102-00334-ip-10-28-5-156.ec2.internal.warc.gz | en | 0.947416 | 1,287 | 2.59375 | 3 |
The bottle brush plant, Callistemon, is a genus of flowering plants in the family Myrtaceae, native to Australia. The genus comprises about 40 species, all of which are endemic to Australia. The plants are shrubs or small trees, growing to 3–15 m (10–50 ft) tall, with evergreen leaves and clusters of bright red, pink, or white flowers. The flowers are produced in spring and summer, and are followed by woody fruits.
How to care:
-Water bottle brush regularly, especially during the warmer months.
-Feed bottle brush with a native plant fertilizer twice a year.
-Prune bottle brush after flowering to maintain a compact shape.
-Protect bottle brush from frosts, as they can damage the leaves.
Bottle brush are relatively easy to care for and make a great addition to any garden. With their bright flowers, they are sure to add a splash of colour.
Type of Soil:
The Callistemon is an Australian native that can be found in a variety of habitats across the country. They prefer well-drained soil and full sun, but will also grow in partial shade.
Bottle brush can be propagated from seed or cuttings.
-Collect seed heads from the plant in late summer or early autumn.
-Place the seed heads in a paper bag and allow them to dry out for 1-2 weeks.
-Rub the seed heads gently to release the seeds.
-Plant the seeds in a well-drained seed raising mix and cover with a thin layer of sand.
-Water the seeds lightly and keep them moist.
-Germination should occur within 4-6 weeks.
-Take stem cuttings from the plant in late spring or early summer.
-Cut a 10-15cm (4-6in) piece of stem from the plant, making sure to include a few leaves.
-Remove the bottom leaves from the cutting and dip the cut end in rooting hormone.
-Plant the cutting in a well-drained potting mix and water lightly.
-Place the pot in a warm, sheltered spot and keep the soil moist.
-Roots should develop within 8-12 weeks.
Callistemon are popular landscaping plants due to their hardiness and showy flowers. They can be used as feature plants, hedges, or screening plants.
Pest and Disease:
Callistemon are generally resistant to pests and diseases, but can be susceptible to root rot if they are overwatered. | <urn:uuid:bf41a7d1-912a-46e8-88dd-819b019aa8f4> | CC-MAIN-2022-49 | https://greenroute.pk/product/bottle-brushcallistemon/ | s3://commoncrawl/crawl-data/CC-MAIN-2022-49/segments/1669446711218.21/warc/CC-MAIN-20221207185519-20221207215519-00347.warc.gz | en | 0.933426 | 572 | 3.1875 | 3 |
What did the USPSTF review find?
The task force focused on five clinical trials, including two large studies from the U.S. and Europe. The American study included more than 76,000 men and the European trial involved 182,000 men from seven countries; both trials compared outcomes in men who received routine PSA tests and those who did not. Overall, during a decade of follow-up, the data showed that there was no reduction in death rates from prostate cancer in men who got screened versus those who didn’t. In the European study, however, there was a slight benefit in mortality among men aged 55 to 69.
The USPSTF’s recommendation against routine screening applies only to healthy men without symptoms of prostate cancer. The panel didn’t look at the value of testing in men with other symptoms or in those who have already had prostate cancer.
Who follows the USPSTF’s advice?
Most medical groups follow the task force’s advice, and federal programs like Medicare rely on its conclusions when deciding whether to pay for screening tests. However, in 2009, when the USPSTF rolled back its recommendations for routine breast cancer screening — advising against routine mammograms for women under 50 — the federal government said it would continue paying for the test for women in their 40s.
Since the PSA test is a blood test, what’s the harm in getting tested?
The test itself doesn’t pose any danger, but it’s the decisions that doctors and patients make based on its results that can be potentially harmful. More than 33 million men over age 50 have already received a PSA test during routine physicals, and many have gone on to have biopsies, surgery or radiation treatment based on the results. But because the PSA test carries a relatively high false positive rate, many of these procedures — and their side effects — have been unnecessary.
For example, the USPSTF’s draft report notes that between 1986 and 2005, one million men had surgery, radiation or both because of positive PSA results, who would not have been treated if they hadn’t gotten the test. Up to 300,000 of them suffered from impotence, incontinence or both as a result of complications from these procedures, and 5,000 died soon after their surgeries. | <urn:uuid:49302606-0134-4d2e-ad83-0fd5393bbaf9> | CC-MAIN-2015-22 | http://healthland.time.com/2011/10/07/prostate-cancer-screening-what-you-need-to-know/2/ | s3://commoncrawl/crawl-data/CC-MAIN-2015-22/segments/1432207932705.91/warc/CC-MAIN-20150521113212-00014-ip-10-180-206-219.ec2.internal.warc.gz | en | 0.977682 | 489 | 2.671875 | 3 |
Hidden Benefits of Nutcracker: Resilience
When it comes to resilience, the dictionary defines it in two ways: 1) the power or ability to return to the original form, position, etc., after being bent, compressed, or stretched; elasticity. 2) the ability to recover readily from illness, depression, adversity, or the like; buoyancy.
At Gotta Dance!, we explain resilience as a combination of both definitions. We like to think of it as the ability of a dancer to bounce back after being faced with a challenge, experiencing an unexpected outcome, going through a difficult time, or being stretched past where they thought they could reach.
For our Nutcracker dancers, developing resilience isn’t just a perk; it’s a necessity. Throughout dance practices and performance events, we know there will be times when their ability to be resilient will be tested. There is a choice in those times to either give up or grow, and we’re teaching our students how to choose growth! With that in mind, here are some of the ways we are developing resilience in the team:
- Understanding the importance of your self-talk
We discuss how self-talk can build people up or tear them down. Our goal is to help the dancers recognize this influence and practice positive self-talk. A growth mindset comes from the self-talk that says every mistake or failure is an opportunity to learn.
- Learning how to handle outcomes you didn’t think were fair
As a team, we discuss healthy ways for the dancers to express their disappointment when they don’t receive the award or recognition they wanted. An important part of this conversation is how they manage their expectations, remembering that our purpose for competing/performing is not about the trophies; it’s about doing our best work.
- Owning your behavior toward others
In moments of high emotion, it can be easy for dancers to lash out at friends (or other teams or judges) for problems that happened in practice or performance. As leaders, we are committed to teaching our students that placing blame doesn’t serve anyone well. It’s key for everyone to accept responsibility for their own actions and reactions.
- Getting back in class or on stage with a clear mind
One of the hardest parts about developing resilience is letting go of past troubles. We’re striving to teach our students how to leave grudges behind and come into every rehearsal and performance with a fresh perspective and an open heart.
We want our Nutcracker students to know that you don’t become a resilient adult overnight; you must practice the behaviors that build resilience in order to reap the benefits. We’re proud of the way our competition team students are growing stronger in this way, and we appreciate all you do as parents to support these lessons at home. We are all in this together! | <urn:uuid:5318d5af-aab2-48ee-a0d1-7a09a49fb21f> | CC-MAIN-2024-10 | https://www.gottadancetucson.com/hidden-benefits-of-nutcracker-resilience | s3://commoncrawl/crawl-data/CC-MAIN-2024-10/segments/1707947476397.24/warc/CC-MAIN-20240303174631-20240303204631-00639.warc.gz | en | 0.954799 | 594 | 2.65625 | 3 |
What is encapsulation?
Wrapped in a protective coating, these encapsulated islets (insulin-producing cells) would be able to do the same job as healthy islets in the pancreas: detecting changes in glucose levels, and producing insulin on demand.
This works because the protective capsule is a little like a sieve – tiny holes in the coating allow nutrients to fit through, enabling the cells to live and work well, but are not big enough to allow anything as big as an immune cell to get close to the precious islets.
What are these special capsules made of?
The first projects we funded on encapsulation used a gel-like material called ‘alginate’ to protect the beta cells. Because you can only see this sort of capsule using a microscope, this approach is sometimes called ‘micro-encapsulation’. Alginate is ‘biologically inert’, which means that the immune system doesn’t respond to it – it’s essentially creating an invisibility cloak for the cells inside!
But alginate doesn’t provide all the answers, so we’re testing other materials as well. We’ve been working with biotechnology company ViaCyte to help drive the development of a physical device to protect and contain new cells. Called the ‘Encaptra’ system, the device is designed to be surgically implanted into the abdomen. The advantage of a much bigger capsule like this one is that it can be retrieved from the body if needed – which is particularly important during the early stages of research when we want to be able to see how well the cells inside are doing. As this approach involves a device big enough to hold in your hand, this is known as ‘macro-encapsulation’.
And in London, Professor Peter Jones completed a project in 2016 to develop coating for cells as thin as possible – this technique is known as ‘nano-encapsulation’. This approach involves weaving a web of different molecules around each set of islets, creating an ultra-fine coating that would still protect the islets from immune cells, but could also incorporate drugs that would keep the cells inside healthy for longer. Find out more about this project.
Where do you get the cells to go inside the capsules?
The beauty of the idea of encapsulation is that as the cells are contained and protected from the rest of the body, a wider array of cells can be placed inside them than would be safe for ‘normal’ transplantation.
For the micro-encapsulation approach, we’ve been working with New Zealand-based company Living Cell Technologies. The islet cells encased in alginate in these studies have come from specially-bred pigs. Having been shown to be safe in the first phase of clinical testing, the DIABECELL product has now entered phase 2 trials, investigating whether it is effective at helping people with type 1 to control their glucose levels.
The ViaCyte Encaptra device has been developed to contain PEC-01 cells. These cells are grown from human embryonic stem cells to become immature pancreatic cells. Once implanted into a person with type 1, the cells, held safely inside the Encaptra device, develop into fully functional islets. The combination of the Encaptra device and the specially grown cells is known as VC-01 and began the first phase of clinical testing in late 2014. | <urn:uuid:e9452b35-5302-43b0-8a70-1908c7acebfb> | CC-MAIN-2021-17 | https://jdrf.org.uk/our-research/about-our-research/cure-research/encapsulation/ | s3://commoncrawl/crawl-data/CC-MAIN-2021-17/segments/1618039594341.91/warc/CC-MAIN-20210422160833-20210422190833-00134.warc.gz | en | 0.948755 | 717 | 3.5625 | 4 |
Nepal: Flash flood tests disaster preparedness
Nepal is one of the world’s 20 most disaster-prone countries. It faces the threat of devastating floods, landslides, windstorms, hailstorms, fires, glacial lake floods, avalanches and earthquakes. Preparedness is vital in a country where natural disasters claimed more than 27,000 lives and affected more than 5 million people between 1971 and 2007.
The valleys below the Himalayas in north-western Nepal are particularly vulnerable. The Annapurna range, where the Seti River originates, is extremely prone to avalanches between March and mid-June.
At the beginning of May, a flash flood along the Seti killed about 40 people and left 30 missing. Houses, farms, trucks and trailers were swept away when the river, flooded with snow, ice and mud from an avalanche, burst through a snow blockage and sent water gushing through villages along its banks, affecting millions of people downstream. The flooding came with little warning on a Saturday (5 May), which is the day when villagers traditionally wash clothes, bathe in the Seti, and picnic with family and friends along the river.
Preparedness measures by humanitarian agencies and the national disaster agency allowed emergency response operations to begin immediately, despite the area’s remoteness. The Nepal Security Forces began search-and-rescue efforts. The District Disaster Relief Committee led the response operation in coordination with the security forces, the Nepal Red Cross Society and other humanitarian agencies.
In the last six years, OCHA has worked with Government authorities to develop Nepal’s national disaster response contingency plan. It has also worked closely with the district authorities and local communities to develop district preparedness strategies to ensure readiness-and-response plans are in place before a disaster strikes.
“Our investment in disaster response is paying off,” said OCHA’s Disaster Response Adviser in Nepal, Andrew Martin. “While we cannot mitigate the number of disasters that occur in Nepal each year, we can make sure that when they happen we all work together to save lives and reduce suffering.”
Four days after the flash flood, a damage assessment was completed. In total, 20 houses, two temples, one community building and three suspension bridges were swept away by the water and debris. Two water-supply systems, which provide more than 80 per cent of water to the Pokhara valley, were damaged. This raised major health and sanitation concerns.
Reporting by OCHA Asia and the Pacific | <urn:uuid:37fd1c28-8184-4297-9651-08bf15d62b1f> | CC-MAIN-2014-35 | http://www.unocha.org/top-stories/all-stories/nepal-flash-flood-tests-disaster-preparedness%20%20 | s3://commoncrawl/crawl-data/CC-MAIN-2014-35/segments/1409535920849.16/warc/CC-MAIN-20140909052359-00388-ip-10-180-136-8.ec2.internal.warc.gz | en | 0.953944 | 525 | 3.28125 | 3 |
Delaware • New Jersey • Pennsylvania
New York • United States of America
A drought is simply a long period (usually a season or more) of dry weather where less than normal or no precipitation falls. Precipitation is any form of moisture such as rain, snow, sleet, etc. Droughts are a natural and frequent occurrence in the Delaware River Basin (the basin contains 13,539 square miles and drains portions of Delaware, New Jersey, New York, and Pennsylvania). How bad a drought is usually depends on how little precipitation falls, how long the drought lasts, and the size of the area that is affected. The next time you hear someone talk about a drought where you live, play detective and look for some of the many signs that may be telling you the lack of precipitation is taking its toll:
LOW WATER IN STREAMS, RIVERS, LAKES, AND PONDS - While visiting your favorite park, you may have noticed how little water you found in the rivers, streams, lakes and ponds. Low flow in water bodies may be one sign of drought. Water levels fall when there is not enough precipitation to replenish water evaporated from streams and other bodies of water. For example, when it rains, water bodies may be replenished by surface water runoff (the water running downhill into lakes, streams, etc.) or by ground water (water that has seeped into the ground and created a saturated layer of soil). Ground water is the reason why some bodies of water can remain flowing during long periods without precipitation. (If you would like to learn more about ground water and rivers/streams, go to the United States Geological Survey's (USGS) Water Science for Schools web pages.)
DECLINES IN WATER LEVELS IN WELLS - You may be watching the news or listening to the radio and hear about concerns over wells becoming depleted and unusable. Wells get their water from aquifers. An aquifer is simply a geologic formation that stores and transmits ground water. Aquifers are recharged as precipitation is absorbed into the soil. With little or no precipitation to replenish the ground water lost through use, water levels in a well may be significantly lowered. During especially dry periods of heavy use, some wells may completely dry up. Water levels in a well also may drop due to heavy use of nearby wells that depend on the same aquifer.
DRIED-OUT, BROWNING VEGETATION AND EARLY LEAF LOSS - During especially dry summer months, you may notice farm fields turning brown and trees dropping their leaves. The grass on your front lawn may turn brown and lifeless looking. Every living thing needs water to survive. This includes trees and the plants found in farm fields, pastures, home gardens, and meadows. The stress of drought causes soil to dry out. With little or no moisture to replace what is lost through the growing process, plants wilt and begin to turn brown. Some plants, such as the grass outside your home, may attempt to survive the drought by becoming dormant (a period of inactivity, slow or no growth). Unfortunately, if relief in the form of rain does not happen soon enough, many crops and other plants are lost to the dry conditions.
Many trees and shrubs respond to drought conditions through an early dormancy. To do this, trees and shrubs drop their leaves earlier in the season than normal. Leaf drop is a tree's survival tactic to reduce the amount of water that otherwise might have been lost through the leaf surface by a process known as transpiration. Despite this tactic, many trees and shrubs die during droughts, or are so weakened by the dry conditions that they may die the following growing season after a drought. (See "What About Plants and Wildlife During A Drought" for more information.)
Physical signs of a drought can be very alarming. Many people take abundance of water for granted and only in its absence do we realize just how important it is to every living thing on the planet. During a drought, it is very important that everyone does their best to conserve water. Of course, it shouldn't take a drought to make people conserve water. Water is such an important resource and water conservation should be practiced every day of our lives. Water conservation consists of eliminating wasteful practices of water use, such as allowing a faucet to drip, toilets to leak, or taking baths instead of showers. See "What You Can Do to Save Water During A Drought" for more tips on how you and your family can save water each and every day. | <urn:uuid:2d88be0c-eead-4503-9629-109fc2797fff> | CC-MAIN-2015-18 | http://www.state.nj.us/drbc/hydrological/drought/4kids/what.html | s3://commoncrawl/crawl-data/CC-MAIN-2015-18/segments/1429246635547.24/warc/CC-MAIN-20150417045715-00172-ip-10-235-10-82.ec2.internal.warc.gz | en | 0.95771 | 942 | 3.703125 | 4 |
Oil spills have been on my mind lately as I’ve caught some of the overage about the BP (British Petroleum) oil spill in the Gulf of Mexico. One leak (the smallest) has been fixed according to a news item on physorg.com
Days of work off the coast of Louisiana with underwater submarines nearly a mile below the surface finally bore fruit as a valve was secured over the smallest of the three leaks and the flow shut off.
The feat does not alter the overall amount of crude spilling into the sea and threatening the fragile US Gulf coast, but is significant nonetheless as the focus can now narrow on just two remaining leaks.
“Working with two leaks is going to be a lot easier than working with three leaks. Progress is being made,” US Coast Guard Petty Officer Brandon Blackwell told AFP.
More than two weeks after the Deepwater Horizon rig exploded, the full impact of the disaster is being realized as a massive slick looms off the US Gulf coast, imperilling the livelihoods of shoreline communities.
The news item goes on to detail how much crude oil is still being lost, the oil slick’s progress, the probable impact on the shoreline and animals, and the other efforts being made to ameliorate the situation.
With all the talk there is about nanotechnology’s potential for helping us to clean up these messes, there’s been no mention of it in the current efforts as Dexter Johnson over at the IEEE’s (Institute of Electrical and Electronics Engineers) Nanoclast blog pointed out the other day. From Dexter’s posting which features both a discussion about patents for nanotechnology-enabled clean up products and an interview with Tim Harper,
So to get a sense of where we really are I wanted to get the perspective of my colleague, Tim Harper (principal of Cientifica), who in addition to being a noted expert on the commercialization of nanotechnologies also has devoted his attention to the use of nanotechnologies in cleantech including its remediation capabilities, leading him to his presentation this week in Australia at the conference Cleantech Science and Solutions: mainstream and at the edge.
“If you are looking for a quick fix from nanotechnology, forget it,” says Harper. “Nanotech is already making an impact in reducing energy, and therefore oil use, it is also being used to create stronger lighter materials that can be used for pipelines, and enabling better sensors for early warning of damage, but in terms of cleaning up the mess, the contribution is minor at best.”
Clearly not the hopeful words that many would have hoped for, and the pity is that it might have been different, according to Harper.
“As with all technologies, the applications take a while to develop,” he says. “If someone had come up with some funding 10 years ago for this specific application then we may have had better tools to deal with it.”
Dexter’s posting about patents and Harper’s comments reminded me of an article by Mason Inman I saw two years ago on the New Scientist website titled, Nanotech ’tissue’ loves oil spills, hates water. From the article,
A material with remarkable oil-absorbing properties has been developed by US researchers. It could help develop high-tech “towels” able to soak up oil spills at sea faster, protecting wildlife and human health.
Almost 200,000 tonnes of oil have been spilled at sea in accidents since the start of the decade, according to the International Tanker Owners Pollution Federation. [This article was posted May 30, 2008]
Clean-up methods have improved in recent years, but separating oil from thousands of gallons of water is still difficult and perhaps the biggest barrier to faster clean ups.
The new water-repellent material is based on manganese oxide nanowires and could provide a blueprint for a new generation of oil-spill cleaners. It is able to absorb up to 20 times its own weight in oil, without sucking up a drop of water.
But [Joerg] Lahann [University of Michigan in Ann Arbor, US] points out that manganese oxide may not be the best material for real-world applications because it could be toxic. He says, though, that the new material “clearly provides a blueprint that can guide the design of future nanomaterials for environmental applications.”
I wonder if they’ve done any research to determine if manganese oxide in the shape and size required to create this nanotech ’tissue’ is toxic. Intriguingly, there was a recent news item on Nanowerk about toxicology research in a marine environment being undertaken.
Led by Dr. Emilien Pelletier, the Institut des Sciences de la Mer de Rimouski at the Université du Québec à Rimouski has obtained an LVEM5 benchtop electron microscope to help them study the short-term and long-term effects of nano-materials on the marine environment.
Dr. Pelletier is the Canada Research Chair in Marine Ecotoxicology. The overall objective of the chair is to understand the impact of natural and anthropogenic stresses on the short-and long-term high-latitude coastal ecosystems to contribute to the conservation, protection and sustainable development of cold coastal marine resources.
Since the news release was written by the company supplying the microscope there is no word as to exactly what Emilien’s team will be researching and how the work might have an impact on other members of the community such as the researchers with the ‘oil-hungry nanotech tissue’ made of nanoscale manganese oxide.
There is as always a political element to all of this discussion about what we could or couldn’t do with nanotechnology-enabled means to clean up oil spills and/or reduce/eliminate our dependence on oil. This discussion is not new as Dr. J. Storrs Hall implies during a presentation being reported in a recent (May 4, 2010) Foresight Institute blog entry by Dave Cronz, PhD. From the posting,
Here I offer my reflections on some of the highlights of the presentation by Dr. J. Storrs Hall of the Foresight Institute, entitled “Feynman’s Pathway to Nanomanufacturing,” and the panel discussion that followed, “How Do We Get There from Here?” Discussions such as these are crucial opportunities to reflect on – and potentially shape – emerging technologies whose destinies are often left to be determined by “market forces.”
Dr. Hall began with an intriguing argument: Feynman’s top-down approach to reaching the nano scale in manufacturing, achieved through a step-down method of replicating and miniaturizing an entire, fully-equipped machine shop in 1:4 scale over and over would yield countless benefits to science, engineering, and manufacturing at each step. These microscopic, tele-manipulated master-slave “Waldos” (named after Heinlein’s 1942 story “Waldo F. Jones”) would get nanotechnology back on track by focusing on machines and manufacturing, since most of our current emphasis is on science at the nano scale. Feynman’s top-down approach to nanoscale manufacturing is missing from the Foresight Institute’s roadmap, according to Hall, “for political reasons.” This raises a fundamental point: science and technology cannot develop independent of the political and social spheres, which pose as many challenges as the technology. Many would argue that social and technological processes are inseparable and treating them otherwise borders on folly. I commend Dr. Hall for offering his argument. It soon became clear that the panelists who joined him after his presentation disagreed. [bolded emphases mine]
As Dr. Hall aptly noted it’s not dispassionate calculations but “serendipity: the way science always works.”
I’m in agreement with Dr. Hall, the political and social spheres are inseparable from the scientific and technological spheres. As for “emerging technologies whose destinies are often left to be determined by market forces”, Dexter’s posting ends with this,
But foresight is not the strong suit of businesses built around short-term profit motives as evidenced by them [BP] not even investing in the remote systems that would have turned the oil well off and possibly avoided the entire problem.
I strongly recommend reading Dexter’s posting to get the nuances and to explore his links.
I’m going to finish on a faint note of hope. There is work being done on site remediation and it seems to be successful, i.e., nonpolluting, less disruptive to the environment, and cheaper. The Project on Emerging Nanotechnologies (PEN) has a webcast of a presentation titled, Contaminated Site Remediation: Are Nanomaterials the Answer?. You can find my comments about the webcast here (scoll down a bit) and PEN’s Nanoremediation Map which lists projects around the world although most are in the US. It’s incomplete since there is no requirement to report a nanoremediation site to PEN but it does give you an idea of what’s going on. Canada has two sites on the map. | <urn:uuid:9bd21225-588a-4438-8ced-d68312a4924c> | CC-MAIN-2019-39 | https://www.frogheart.ca/?p=1033 | s3://commoncrawl/crawl-data/CC-MAIN-2019-39/segments/1568514574039.24/warc/CC-MAIN-20190920134548-20190920160548-00445.warc.gz | en | 0.955456 | 1,982 | 2.53125 | 3 |
We know the word "day" does mean a period of time. In the first book of the Bible called Genesis, day means a 24 hour period of time (evening and morning). this day is the time it takes the earth to revolve on its axis.
The Hebrew word for day is "yom" and can have a variety of meanings : A solar day, daylight, or an indefinite period of time. It was defined a literal day the first time it was used in Genesis 1:3-5. In the Old Testament it occurs 2,291 times and it almost always means a literal day. When used in the plural form "yamin" (845 times) it always refers to a literal day. When modified by numeral or historical narrative (359 times in the Old testament outside Genesis) it always means a literal day. When modified by evening and/or morning (38 times outside Genesis 1), it always means a literal day. The context of Genesis 1 is a tight chronology. It forms the basis for our work week of six literal days (Exodus 20:11). The proper interpretation is a solar day, not an indefinite time period.
"Remember the sabbath day, to keep it holy. Six days shalt thou labour, and do all thy work: But the seventh day is the sabbath of the LORD thy God: in it thou shalt not do any work, thou, nor thy son, nor thy daughter, thy manservant, nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates: For in six days the LORD made heaven and earth, the sea, and all that in them is, and rested the seventh day: wherefore the LORD blessed the sabbath day, and hallowed it" (Exodus 20:8-11)(KJV).
In this passage when kept in context, God instructed the nation of Israel to work six days and rest one day because God worked six days and rested one day in the week during which He created the heavens, the sea, and all things in them. The word "remember" in Hebrew, when used as a command, as it is in Exodus 20:8, always refers back to a real historical event, and that event is the 6 days of creation (Verse 11). Thus, the days of our real work-week are equaled in duration to the literal days of creation. So Exodus 20:11, means a literal 24 hour day. How could God, the Author of Scripture say it any more plainly? He did it all in six solar days. So when people ask, "If God is omnipotent and capable of creating the entire universe instantaneously, why did He take six days?" The answer to this question is : God provided a pattern for our work week. We are to work six days and rest one, just as He did. The seventh day rest is a commemoration of His perfect work of Creation.
To believe the Bible, you first must be saved! Today is the "day of salvation". "(For he saith, I have heard thee in a time accepted, and in the day of salvation have I succoured thee: behold, now is the accepted time, behold, now is the day of salvation)"(2 Corinthians 6:2). When the Philippian jailer brought Paul and Silas out of the jail, he asked them, "Sirs, what must I do to be saved? And they said, Believe on the Lord Jesus Christ, and thou shalt be saved, and thy house" (Acts 16:30-31). | <urn:uuid:15bb5f03-3ba4-4926-8ee1-d1d7d62508f4> | CC-MAIN-2015-14 | http://www.examiner.com/article/the-meaning-of-day?cid=rss | s3://commoncrawl/crawl-data/CC-MAIN-2015-14/segments/1427131304444.86/warc/CC-MAIN-20150323172144-00186-ip-10-168-14-71.ec2.internal.warc.gz | en | 0.945413 | 740 | 3.421875 | 3 |
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When a mental shortcut applies previous learning recalled from the unconscious mind
What does the accuracy of intuition depend on?
- the validity of the origial learning
- the current situation being one where the prior learning is applicable
Are statistical prediction rules more economical than clinical judgment?
What are the 3 possible ways to make a decision (based on SPR)
- Method #1: Relying on experience and training to make an intuitive predition
- Method #2: Relying wholly on the SPR developed to be used in that situation
- Method #3: Taking account of the output of the SPR but possibly modifying it based on professional experience and intuition
What is a fact?
When scientists conducting the same research procedure get the same results
What is a theory?
A convenient way to summarize facts so they can be grasped by our human minds
What is objectivity?
The degree to which qualified people agree on something
What is nomothetic?
That which can be generalized (basic principles
What is idiographic?
That which is unique to an individual
What does science usually come down to?
the personal experience of the scientist
Who were logical positivists?
- Revolted against idealism
- Goal #1: distinguish between science and metaphysics (the problem of demarcation)
- Goal #2: to recontruct all (scientific) knowledge from experiece or sense data (confirmation of theories)
What is demarcation?
the ability of the theory to be falsified or the scientist's ability or willingness to state in advance what would count as falsifying it
What do Popper (Neopositivism) believe?
- science is characterized by the fact that its theories are falsifiable
- the method of science is to propose bold conjectures and try repeatably to find them false
What is confirmation?
Acceptance of a theory that is most falsifiable, but not falsifiable
What is Kuhn's view of neopositivism?
- Neopositivism is not supported by the actual history of science
- Dependence of theory choice in science is on factors other than observation and logic
Why are paradigms chosen?
- It solves the problem that lead its competitor to crisis
- It's more simplistic or has a more accurate empirica fit
Once a paradigm is accepted...
its basic laws and theories are not subjected to testing and used to solved the problems the paradigm encounters
What is data partially determined by?
the paradigm they support
What is the difference between immature and mature sciences?
- Mature science has reached the stage where one paradigm at a time dominates research
- Immature sciences is where a number of paradigms compete and more time is taken in debate than research
Kuhn suggests the history of science is best understood as...?
A succession of paradigms
What is a research program?
A series of complex theories whose hard core remains the same while auxiliary hypotheses are successively modified, replaced, or amplified in order to account for problematic observations
Lakatos suggests that the history of science is best understood in terms of...?
In terms of competing research programs
When is a research program progressive?
- 1.) Each new version of the theory (hard core theory plus auxiliaries) preseves the unrefuted content of its predecessor
- 2.) Each has excess empirical content over its predecessor; it predicts some novel, previously unexpected facts
- 3.) Some of these predicted facts are corroborated
- 1&2 = theory progressive
- 1,2 &3 = theory and empirically progressive
When is a research program degenerating?
When the change from one version to the next accounts at most for the one anomaly for which the change was made, but does not allow for the prediction and discovery of any novel facts
What is a negative heuristic?
the plan to avoid falsification of the hard-core, to direct the tests of the theory against the auxiliary hypotheses and suitable modifications there
What is a positive heuristic?
The development of the auxiliary hypotheses proceeds according to a preconceived plan
What is the difference betweeen immature and mature science (Lakatos)
- Immature only has negative heuristics
- Mature has both negative and positive heuristics
Why is it rational to continue to work on a degenerating program?
- A degenerating program can sometimes be turned around (made progressive again
- Competition in the field generally leads to more overall progress
Explain the idea of "hierarchy of science"
- One level of science can get support from other levels of science
- Interconnection constrains science
How does the interconnection within the hierarchy of science constrain science?
- Laws and theories of higher levels have to conform to lower-level laws
- Lower levels also have to permit the phenomenon described by the levels above them
What is reductionism?
Dividing an entity into its base parts, and explaining its properties or behavior in terms of the base parts' properties or behavior
One has to consider not only the parts of an entity, but also its ______ with its environment in order to understand it.
The demise of reductionism can be attributed to....:
- Top-Down Causation
What is emergence?
The appearance of properties and processes that are only describable by concepts pertaining to a higher level of analysis, which are neither applicable at the lower level nor reducible to (translatable itno) concepts at the lower level.
What is decoupling?
The relative economy of levels in the hierarchy of sciences; each level of the hierarchy of sciences has been stabilized in terms of causation and theory, and the partitions between the sciences are fairly well understood
interactions at the lower levels cannot be predicted by looking at the structure of these levels alone; higher-level variables, which cannot be reduced to lower-level properties or processes, have genuine causal impact. The higher-level system needs to be considered in giving a complete causal account
A naturalistic but non-reductionistic account of entities
Reduction will be possible when....
In the limiting case where B (base) constitutes S (supervenience) under all C's (circumstances) and S (supervenience) is NOT multiply realizable. An example here would be consciousness (S), which is possibly only when there is a certain neural activity
Reduction will NOT be possible when...
- There are multiple C's (circumstances) that make a difference to S (supervenience) and the C's (circumstances) cannot be defined in terms of B (base).
- or when S is multiply realizable by an infinite set of B's
What is the general purpose of science?
To establish knowledge
Scientific research attempts to...
Simplify the complexity of nature and isolate a particular phenomenon for scrutiny
What does methodology teach science?
- Ways to think about the relations between variables
- About causes and effects
- About conclusions drawn from theory, research, and experience
Scientific Hyptheses attempt to:
explain, predict, and explore specific relations
What is parsimony?
- Accept the simplest version or account of the data among the alternatives that are available
- Adopting the simplest of competing views of explaining a phenomenon
What is a plausible rival hyptheses?
- Other explanations, outside of the hypothesis, that may explain findings
- The better the experiment, the fewer the alternatives
What are Findings?
the results that are obtained
What are Conclusions?
The explanation of the findings
What are steps of ruling out rival hypotheses?
- experimental controls
- selection of subjects
- various control groups
What is replication?
Accumuation of multiple investigations
In most research the findings are...
What does methodology have to do with?
What is internal validity?
The extent to which the intervention accounts for the effect
What is history?
Any event occurring in the experiment (unplanned events disrupting administration) or outside the experiment (hisotrical events) that may account for the results
What is maturation?
Processes within the subjects that change over time, such as growing older, strongr, wiser, tired, or bored
What is testing?
When taking a test has an effect on the subsequent performance or learning
What is instrumentation?
Changes in the measuring instrument or measurement procedures over time
What is statistical regression?
The tendency for extreme scores at Time 1 to revert toward the average at Time 2, particularly a problem when subjects are selected because of extreme scores at Time 1
What is selection bias?
the use of different methods for selecting subjects for experimental conditions causing systematic differences in the groups
What is attrition?
Participants dropping out of the study over time
What can affect groups in a study?
combination of history, maturation, and other threats
What is diffusion or imitation of treatment?
When the intervention given to one group is also provided accidentally to all or some subjects of another group
What is the purpose of a control group with random group assignment?
To rule out the threats to internal validity because both groups will share the effects of these influences
What is external validity?
The extent to which the results of an experiment can be generalized or extended outside of the experiment
What are sample characteristics?
- How representative of the population is the sample?
- To what extent can the results be generalized to another sample that varies in age, race, ethnic background, education, or any other characteristic
What are stimulus characteristics and settings?
To what extent is the effect due to the particulars of the setting, experimenters, interviewers, or other factors in experimental arrangement
What is reactivity of experimental arrangements?
- How much did it matter if the subjects knew they were participating in a study
- Would the results be the same if the subjects were not aware that they were being studied?
What is multiple treatment interference?
When one treatment is in the context of other treatments, how do you know which one caused the effect?
What are novelty effects?
When the effect depends on the fact that the intervention is administered under conditions that are particularly salient, infrequent, or otherwise novel
What is an obtrusive measure?
- When subjects are aware that their performance is being assessed
- Concern to external validity b/c awareness that performance is being assessed can alter performance
What is a reactive measure?
When awareness of assessment leads persons to respond differently from how they normally would
What is test sensitization?
The administration of a test may in some way sensitize the subjects so that they are affected differently by the intervention
What is time measurement?
Would the result be the same if the measurement had been taken at another time, especially several months after treatment
Which is more important: internal or external validity?
What is efficacy?
treatment outcomes from controlled studies that are conducted under laboratory-type conditions
What is effectiveness?
treatment outcomes obtained in clinic settings where the usual control procedures are not implemented
What is construct validity?
Did the study test what the researcher meant to test?
What are confounds?
features within the experiment that can interfere with the interpretation
What are attention and contact with clients?
Differential attention across experimental and control groups may be the basis for group differences and threaten constrcut validity
What is the placebo effect?
An apparently effective treatment or intervention that has no active treatment properties that would be expected to produce change for the problem to which it is applied
What are experimenter expectancies?
Unintentional process where the expectancies, beliefs, and desires about the results on the part of the experimenter influence how the subjects perform
What are the cues of the experimental situation?
Seemingly trivial things associated with intervention that may contrubte to the resuls (i.e. info given to subjects prior to their arrival of the experiment
What is statistical conclusion validity?
How well can an investigation detect the effect, and how large is it?
What is a null hypothesis?
There is no statistical difference between the groups; we can reject the NH if we find a statisticaly significant difference, or accept this hypothesis if we do not
What is a Type I Error?
The probability of rejecting the NH when it is true--being too liberal in interpretation
What is a Type II Error?
The probability of accepting the NH when it is false--being too conservative in interpretation
What is power?
The probability of finding a real effect: 1 minus Type II Error
What is low statistical power?
- When power is weak
- Likelihood of concluding that there are no differences between groups
What is subject heterogeneity?
- The greater the heterogeneity of subject characteristics, the less likelihood of detecting a difference between conditions
- Either homogenize or control statistically using multivariate regression and correlation methods
What are unreliable measures?
Reliability puts the ceiling on the effect size
What are multiple comparisons and error rates?
The more statistical tests perfomed, the more likely a chance difference will be found even if there are no true differences between conditions
When can interferences in a study be addressed best?
An increase in sensitivity of a test can result in...?
Limited generality of findings
Enhancement of generality of a test can result in...
Decrease in the sensitivity of the test
What is an artifact/bias?
Extraneous influences that may threaten the validity of experiments
What is the Loose Protocol Effect?
When the investigator does not carefully specify the rationale, the scrip, and activities of the experimenter = introduces variability
What are experimenter expectancy effects?
The experimenter may influence how the subject responds through tone of voice, posture, facial expressions, or other cues
What are demand characteristics?
Cues in the experimental situation that may influence how subjects respond
What are subject roles?
Different ways of responding to the experimental cues of the experiment
The good subject
attempting to support what they think is the experimenter's hypothesis
The negativistic subject
Attempting to refute what they think is the experimenter's hypothesis
The apprehensive subject
being concerned that experimental performance will be used to evaluate their abilities, personal characteristics, or opportunities
The faithful subject
attempting to carefully follow the experimental instructions
What are subject selection biases?
the experimental influences that are attributable to the types of subjects who participated in the experiment
What are samples of convenience?
the selection and use of subjects merely because they're available, and not because they are appropriate for the study
How can the loss of subjects affect virtually all aspects of experimental validity?
- Changing random composition of the groups and group equivalence (internal validity)
- Limiting the generality of findings to a special group who are persistent (external validity)
- Raising the prospect that the treatment X special subject characteristics interaction accounts for the conclusions that the investigator would actually like to attribute to the intervenion (external and construct validity)
- Reducing sample size and power (statistical conclusion validity)
Where do research ideas usually come from?
- previous studies
What is correlation?
An association between variables at a given point in time, no time sequence established
What is a risk factor?
a correlation in which a time sequence is established
What is a cause?
a change in one variable leads to a change at another variable
What are moderators?
Factors that influence the relationship between variables
What are mediators?
the mechanisms or processes through which a relationship works
What is a theory?
a conceptualization of the phenomenon of interest
Why is theory good?
- Brings order to areas where findings are diffuse
- Explains causal relationships
- Gives a manageable focus to research
- Leads to a more effective application of the research to practical probems
- Helps us understand a phenomenon
What are operational definitions?
Defining a construct based on the specific operations used in the experiment
What are the advantages of multiple operations?
Allows an investigator to place more confidence in capturing the construct of interest
Name two experimenter variables
- IV --> DV
one the researcher manipulates
one the researcher observes to see how it responds to the different IVs
Name two observational variables?
- PV --> CV
- analogus to an IV
- Manipulated by elements outside the researcher's control
- Analogus to DV
- Observed changes theoretically interpreted to have been in response to changes in the predictor variabl
Name 2 measurement variables
the construct of interest, typically not directly measureable
the specific measures of the construct
What are true experiments?
- Random group assignment
- control over the IV
- control over internal validity
- Strongest basis for drawing causal inferences
What are true experiments conducted in the context of an intervention?
Randomized Controlled Clinical Trials
What is a quasi experiment?
- Less control than true experiment
- lack of random group assignment
- can still yield valid causal inferences
What is case control design?
- the variable of interest is studied by selecting cases that vary in the characteristic or experience of interest
- can provide important insights
What is a cross-sectional study?
- variable of interest is studied by selecting cases that vary in characteristics or experience of interest
- make comparisons between groups at a given point in time
What are longitudinal studies?
Make comparisons over an extended period
What is random selection?
- There is an equal probability that subjects within the population can be selected
- Enhances the generality of the results
What is random assignment?
The probability of each subject appearing in any of the groups is equal
What are nuisance variables?
- Characteristics in which the researcher is not interest but could influence the results
- random assignment make this less of the problem
What is matching?
grouping subjects together based on their similarity on a particular characteristic
Matching without randomizing leads to...
differential regression to the mean
What is a pretest - posttest design
- Widely used
- controls threats to internal validity
- brings both the advantages and disadvantages of using a pretest
What are the advantages of using a pretest?
- Allows the matching of subj. on one of the variables assessed
- Permits evaluation of matched variable in the results
- Increases statistical power
- Allows the examination of who changed and what proportion of subjects changed in a particular way
- Allows evaluation of attrition
What are the disadvantages of a pretest?
There might be a testing effect
What is a posttest only design?
- No pretest is given
- Less popular in clinical research because of smaller experimental groups
What is a Solomon Four group design?
Gets at whether a pretest influences the results, but takes twice the effort and cost
What are factorial designs?
- Allows the simulataneous investigation of two or more IVs in a single experiment
- Two or more conditions are administered
What are the characteristics of Factorial Design?
- Allows the analysis of interactions (where the effect of one of the IVs or PVs depends on the level of one of the other IVs or PVs)
- Good because you can assess the effects of separate variables in a single experiment,
- Different variables can be studied with fewer subjects and observations
- Can look at interaction effects
- Number of groups multiplies quickly
What is the pretest-posttest control group design?
- depends directly upon the similarity of the experimental and control groups
- threats to validity differ between groups
what are Posttest only design cons?
attributing group differences to the intervention is problematic
Multiple Treatment Design
- Each of the different treatments is presented to each subject
- Usually done with 2 groups in evaluating the effects of medication | <urn:uuid:c226c8d4-16dd-4557-b573-6e2235610895> | CC-MAIN-2017-39 | https://www.freezingblue.com/flashcards/print_preview.cgi?cardsetID=83155 | s3://commoncrawl/crawl-data/CC-MAIN-2017-39/segments/1505818695375.98/warc/CC-MAIN-20170926085159-20170926105159-00431.warc.gz | en | 0.917325 | 4,139 | 3.234375 | 3 |
What we eat doesn't just reflect in how we look but also on how we age, a new study says.
According to the study, seniors' health is closely linked with the kind of diet they have and also on the kind of organisms present in their guts. The study says dietary choices impact what kind of organisms grow in the body that in turn affect peoples' overall health.
"Our findings indicate that any two given older people, independent of [their] starting health status and genetic makeup, could experience very different rates of health loss upon aging due to dietary choices that impact on their gut bacterial ecosystem," Paul O'Toole, senior author of the study and a senior lecturer in genetics at University College Cork, Ireland, told HealthDay.
Researchers analyzed what kinds of organisms were present in the guts of more than 170 people over 78 years of age. They found that the gut microbiota varied according to where the people lived and also according to what they ate.
In general, people living in community were healthier and there was a great diversity in the kind of organisms that grew in their guts. People living long-term in care homes had lower diversity in their gut microbiota and were weaker than other participants.
"The diet of older people changes quickly when they move from community to long-term care (in a couple of weeks), but the microbiota changes more slowly -- up to a year for full change from community type to long-term residential type," One would not expect that the rate of heath decline in this time could be responsible for the change in microbiota composition. It's more plausible to be driven by diet," O'Toole said.
Earlier research said that, in the future, we might be given treatments based on our gut type (meaning what type of microorganisms are present in our guts) so that treatment can be made more effective. Old people have more microbes involved in digestion because as we age our digestive system becomes weak and so microbes have to take up the role of digestion.
"To combat frailty, it makes sense if our microbiota is helping our bodies to be as effective and efficient as possible," said O'Toole, to HealthDay. Gut organisms can also affect mood in old people.
"[Some studies] have shown that gut bacteria can 'talk' to the brain by synthesizing compounds that affect the brain-gut axis. An exciting theory is that altered gut bacteria in older subjects could impact on cognitive function or mood," said O'Toole.
According to previous research, when these microbes grow in the gut, they produce various by-products that are beneficial to the host. A good way to grow beneficial bacteria in the guts is to include fiber in the diet.
The study is published in the journal Nature. | <urn:uuid:5c208a48-56ff-40e6-abf6-8c2d5e158909> | CC-MAIN-2016-30 | http://www.medicaldaily.com/diet-gut-bacteria-influence-how-people-age-241338 | s3://commoncrawl/crawl-data/CC-MAIN-2016-30/segments/1469257824624.99/warc/CC-MAIN-20160723071024-00089-ip-10-185-27-174.ec2.internal.warc.gz | en | 0.975882 | 561 | 3.3125 | 3 |
What medieval witnesses saw was not big lunar impact
UNIVERSITY OF ARIZONA NEWS RELEASE
Posted: April 19, 2001
And this should be welcome news for those worried by Deep Impact movie scenarios.
The idea that 12th century people saw the impact that created a lunar crater more than 10 times as wide as Meteor Crater in northern Arizona has been popular since it was first proposed 25 years ago. But it doesn't hold up under scientific scrutiny, said Paul Withers of the UA Lunar and Planetary Laboratory.
Such an impact would have resulted in a blinding, blizzard-like, week-long meteor storm on Earth - yet there are no such accounts in any known historical record, including the European, Chinese, Arabic, Japanese and Korean astronomical archives, Withers said. He reports the analysis and other tests of the hypothesis in this month's issue of Meteoritics and Planetary Science.
The dramatic passage in question appears in the medieval chronicles of Gervase of Canterbury.
About an hour after sunset June 18, 1178 A.D., a band of five eyewitnesses watched as the upper horn of the bright, new crescent moon "suddenly split in two. From the midpoint of this division a flaming torch sprang up, spewing out . . . fire, hot coals and sparks. . .The body of the moon , which was below writhed. . .throbbed like a wounded snake." The phenomenon recurred another dozen times or more, the witnesses reported.
A geologist suggested in 1976 that this account is consistent with the location and age of Giordano Bruno, the youngest crater of its size or larger on the moon.
A one-to-three kilometer wide (a half-mile to almost 5-mile wide) meteor blasted Giordano Bruno into the northeast limb of the moon. Such an impact on the Earth would be "civilization threatening," causing regional devastation to global climatic catastrophe - so it is important to know if such an event happened on the moon less than a millennium ago, Withers noted.
"I calculate that this would cause a week-long meteor storm potentially comparable to the peak of the 1966 Leonids storm." Ten million tons of rock showering the entire Earth as pieces of ejecta about a centimeter across (inch-sized fragments) for a week is equivalent to 50,000 meteors an hour.
"And they would be very bright, very easy to see, at magnitude 1 or magnitude 2. It would have been a spectacular sight to see! Everyone around the world would have had the opportunity to see the best fireworks show in history, " Withers said.
Yet no vigilant 12th century sky watcher reported such a storm.
So what did the witnessess see that the Canterbury monk recorded?
"I think they happened to be at the right place at the right time to look up in the sky and see a meteor that was directly in front of the moon, coming straight towards them," Withers said. This idea was strongly suggested by others in a 1977 scientific paper.
"And it was a pretty spectacular meteor that burst into flames in the Earth's atmosphere- fizzling, bubbling, and spluttering. If you were in the right one-to-two kilometer patch on Earth's surface, you'd get the perfect geometry," he said. "That would explain why only five people are recorded to have seen it.
"Imagine being in Canterbury on that June evening and seeing the moon convulse and spray hot, molten rock into space, " Withers added. "The memories of it would live with you for the rest of your life." | <urn:uuid:ae3d1e94-be38-4744-b595-94fa307ed077> | CC-MAIN-2020-29 | https://spaceflightnow.com/news/n0104/19bruno/ | s3://commoncrawl/crawl-data/CC-MAIN-2020-29/segments/1593655896905.46/warc/CC-MAIN-20200708062424-20200708092424-00293.warc.gz | en | 0.963678 | 757 | 3.625 | 4 |
With the right policies in place, India can easily become a “Solar Super Power.”
There is a “Green Energy Revolution” underway in India that can increase prosperity for millions of poor families by harnessing the abundant and clean energy of the sun. With the right policies in place India can easily become a world leader in solar energy. This solar endeavor could also help address acute power shortages, and make a real difference in slowing the pace of climate change.
Since being elected in May 2014, Prime Minister Narendra Modi has outlined his vision for increasing India’s renewable energy capacity five-fold from 30 GW to 175 GW, including a boost in solar power generation from 20GW to 100 GW. The plan is to achieve these targets by 2022.
But to do so, India needs a national energy policy, regulatory programs and innovative financing mechanisms that encourage the development of distributed energy, particularly, applications that combine solar generation with energy storage.
India has already taken positive steps by announcing very aggressive goals to meet 40% of its energy needs through renewables by 2030. I firmly believe that, with favorable policies and strategic economic investments, India could meet all of its energy needs through renewables by 2050.
Solar Power Potential in India
India is endowed with abundant free solar energy. Using the country’s deserts and farm land and taking advantage of 300 to 330 sunny days a year, India could easily generate 5,000 trillion kilowatt-hours of solar energy. In other words, India could easily install around 1,000 GW of solar generation — equivalent to four times the current peak power demand (about 250 GW) — using just 0.5% of its land. In addition, India can produce over 200 GW from wind power. As economist and activist Jeremy Rifkin said, while speaking in New Delhi in January 2012: “India is the Saudi Arabia of renewable energy sources and, if properly utilized, India can realize its place in the world as a great power — but political will is required for the eventual shift from fossil fuels to renewable energy.”
India is both densely populated and has high solar insolation, providing ideal conditions for the exponential growth of solar power as a future energy source. With GDP growing at about 8%, solar PV is the only renewable energy resource that can bridge the ‘gap’ between supply and demand. Solar energy can transform India and help to bring about decentralized distribution of energy, thereby empowering people at the grassroots level and eliminating the need for costly expansion of transmission and distribution systems.
How Can India Achieve Its Economic, Environmental and Energy Goals?
Like other developing economies, much of India’s energy currently comes from coal. But, as with other countries, use of fossil fuels has led to crippling pollution, dramatic public health problems, and global debate on climate change. However, these countries (especially India), can turn to the sun for a much cleaner source of energy. After decades of promise, the technology now exists to replace our dangerous addiction to fossil and nuclear power plants with cheap, clean solar energy.
For India, a combination of solar power and energy storage is the answer to true energy independence. For their part, the Indian government has taken several measurable steps toward improving infrastructure and power reliability but, more needs to be done — and fast. Along with expediting the adoption of solar and other renewable energy resources, to secure its energy future India urgently needs to implement innovative policies and financing mechanisms (such as capital and interest subsidies, viability gap funding, concessional finance, etc.) to promote increased use of abundant, sustainable, solar energy.
In addition, microgrids have the potential to change the way communities generate and use energy, can reduce costs, increase reliability, and improve environmental performance. Microgrids can be used to take substantial electrical load off the existing power grid and so reduce the need for building new or expanding existing transmission and distribution systems.
By implementing the following 10 strategies, India can begin to become a “Solar Super Power.”
- Develop National Renewable Energy (RE) Policy – Enact and deploy a comprehensive new energy roadmap or innovative RE policies (e.g., PPAs, Net Metering, FIT, etc.) without delay. In addition, set National Renewable Energy Standards/Policy such as 20% by 2020, 40% by 2030 and 100% by 2050 — to create demand, new industries and innovation, and a new wave of green jobs.
- Invite international developers to meet the revised JSNM targets of 100 GW of Solar and 75 MW of wind by 2022 and beyond.
- Electrifying transportation – Expedite a move to electrify transportation by encouraging expanded use of electric vehicles (EVs) and plug-in hybrids, and deployment of solar-powered EV charging stations around the country. Develop and implement time-of-day pricing to encourage charging of vehicles at night and other times when peak demand is low. In addition, launch the public transportation system of the future with zero-emission battery-powered Electric Buses in all major cities to reduce air pollution and reverse climate change.
- Energy efficiency – Make energy efficiency a high priority by expediting the development and implementation of cost-effective energy efficiency standards. To reduce the long term demand for energy, engage states, industrial companies, utilities and other stakeholders to accelerate energy efficiency investments such as large scale nationwide use of LED lamps.
- Utility-scale projects – Phase out conventional energy subsidies, and develop a long term plan to replace fossil and nuclear plants with utility-scale renewable generation.
- Innovative financing solutions – Provide innovative financing (including tax-free solar bonds or green infrastructure bonds, accelerated depreciation mechanisms, and access to credit at globally competitive rates, etc.) to instill more confidence from potential investors and decrease the cost of financing for renewable energy projects. Create and fund a national smart infrastructure bank for renewable energy.
- Develop large-scale “solar manufacturing hubs” in India to facilitate mass production of PV, CSP and CPV equipment.
- Decentralized energy – Avoid future fossil fuel investments in India and, instead, emphasize nationwide deployment of community scale solar projects (installing 100 million solar roofs, solar co-operatives, and solar cities, etc.) and microgrids with storage. India’s present 40 GW solar target should be extended to include photovoltaic panels on the rooftop of every home in India, generating enough power to reduce the country’s massive dependence on fossil fuels.
- Develop energy storage including thermal, grid battery storage (e.g., Tesla Powerwall home battery backup), compressed air/gas, vehicles-to-grid/home, pumped hydro, fuel cells or hydrogen (H2 – produced from renewable energy only), flywheels, superconducting magnets and super capacitors. Develop a “hydrogen economy” plan. If done successfully, hydrogen and electricity will eventually become society’s primary energy carriers for the twenty-first century.
- Establish R&D facilities within academia, research institutions, industry, government and private entities to guide technology development in India.
India is standing on the threshold of a “Green Energy Revolution” that can light up a new era of energy, economic and environmental security. To achieve this goal, India needs to fundamentally transform the manner in which it produces, distributes and consumes energy. By doing so, India can reduce its dependence on fossil fuels, create millions of new jobs, and enhance its global competitiveness while decreasing carbon emissions and slowing climate change.
Given its abundant solar insolation, India has already outlined clear plans for future energy production from the sun. Barriers to implementing this renewable energy plan seem to be primarily social and political, rather than technological or economic. The technology is well established and available. If properly developed and used, India’s abundantly available renewable resources could meet all of its energy demand by 2030. Meanwhile, existing generation could be converted to renewable energy by 2050, and used for maintaining a reliable power supply in the interim.
Solar energy offers India the theoretical potential to provide all its long-term power needs. Toward that goal, India has revised its target to reach 100 GW of solar capacity by 2022 and recently announced that 40% of its total energy mix would come from alternative sources by 2030. These targets are realistic, desirable and fully achievable. All that is needed now to make this concept a reality is political commitment and appropriate investments and funding for building many more solar power systems, solar farms, hybrid solar-natural gas plants, solar thermal storage and advanced battery-based grid energy storage systems. Excess energy generated from solar could be stored in various forms and then used during times of peak demand.
Investment in these technologies would provide an economic stimulus of at least $1 trillion, and perhaps much more if all indirect effects are included. Given its abundant sunshine, India could even use solar power to produce “solar fuels” (e.g., using electrolysis to extract hydrogen or liquid hydrogen from water), which could be exported at an unimaginable scale to meet the voracious demand for clean energy from the big north Asian economies.
Solar energy provides a golden opportunity for India to move toward a 100 percent clean energy future while reducing poverty, ensuring energy security and combating climate change. Solar energy has the potential to propel India forward as a “Solar Super Power.” However, for India to meet its future energy needs, it can no longer afford to delay deployment of solar energy. | <urn:uuid:8c8d4c2e-f15c-4d24-8751-8fcc30f43147> | CC-MAIN-2017-34 | https://saniconenergysolutions.wordpress.com/2015/11/17/how-india-can-become-a-solar-super-power/ | s3://commoncrawl/crawl-data/CC-MAIN-2017-34/segments/1502886112533.84/warc/CC-MAIN-20170822162608-20170822182608-00123.warc.gz | en | 0.923926 | 1,945 | 2.9375 | 3 |
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