James M. King, Ph.D.
Wilcox Environmental Engineering, Inc.
December 7th, 2021
Hexavalent chromium shot into the public consciousness in 1993 when Erin Brockovich began campaigning against Pacific Gas & Electric, which had used hexavalent chromium compounds as a rust inhibitor at a natural gas compressor station until 1966. Over time, hexavalent chromium contaminated the groundwater supply of the southern California town of Hinkley and plagued the town’s residents with a bevy of chronic health problems. Brockovich was instrumental in building the case against PG&E, which was settled in 1996. The plight of Hinkley was captured in the 2001 film “Erin Brockovich” starring Julia Roberts, which continued to keep hexavalent chromium in the public eye. Since then, hexavalent chromium, also known variously as hex chrome, chromium 6, chromium (VI), Cr6+, or Cr(VI), has stayed in the spotlight as a nasty player when it comes to human health.
Cr(VI), one chemical state of the natural metallic element chromium, is appearing more frequently as a contaminant at Wilcox project sites. Trivalent chromium, or Cr(III), and Cr(VI) are the two most common forms, and they behave quite differently. Cr(III), fortunately the more abundant form in nature, has low toxicity, aqueous solubility, and mobility in the environment. Cr(VI), on the other hand, is toxic, highly soluble, and much more mobile
Cr(VI) compounds are used in a wide range of industrial applications – for example, in electroplating, stainless steel production, protective metal coatings, leather tanning, dye and paint production, and wood preservation. Not surprisingly, most common exposures tend to be occupational, though the case of Hinkley, California, is an alarming example of residential exposure. Exposure to Cr(VI) can occur by inhaling it, ingesting it in food or water, and by direct skin contact. Cr(VI) is listed as a known human carcinogen, and its compounds have been shown to cause lung cancer in humans when inhaled, particularly among workers who were exposed to Cr(VI) in workplace air. Other adverse health effects include nasal and sinus cancers, kidney and liver damage, nasal and skin irritation and ulceration, and eye irritation and damage.
Screening levels published by the Indiana Department of Environmental Management highlight the stark differences in toxicity between Cr(VI) and total chromium, which is typically comprised mostly of Cr(III). The Residential Groundwater Direct Contact screening level for total chromium is 100 µg/L (or parts per billion), whereas the same screening level for Cr(VI) is 0.35 µg/L, 285 times lower. Because of its inhalation risk, residential and commercial indoor-air screening levels for Cr(VI) are among the lowest of any metal, including 2,600 times lower than for residential exposure to vapor from elemental mercury. Total chromium, on the other hand, has no indoor-air screening levels. The residential, commercial, and excavation soil direct contact screening levels exhibit similar contrasts between Cr(VI) and total chromium and Cr(III) as insoluble salts. Differentiating them further, the Cr(VI) screening levels are for carcinogenic (cancer-causing) endpoints, whereas the screening levels for total chromium are for non-carcinogenic endpoints.
Adding to its mischievousness, Cr(VI)’s chemical properties make it tricky to characterize during environmental investigations. Cr(VI) is sensitive to changes in its environment that can transform it to Cr(III) in environmental samples, necessitating a bit more involved groundwater sampling protocols in the field. As noted earlier, Cr(VI) is very soluble and does not significantly interact with soil matrices, traits that give it high mobility in the subsurface. In fact, the distribution (adsorption) coefficient (Kd) of Cr(VI), expressed in L/Kg, is only 1/100,000 that of Cr(III) for the most common pH ranges. These characteristics allow Cr(VI) to readily leach from surface soil into groundwater and then move at essentially the same velocity as the groundwater with little chemical interaction with organic carbon in the aquifer matrix that would slow it down (chemical retardation). Consequently, it’s common to find Cr(VI) at greater down-gradient distances than other contaminants released from the same source.
Fortunately, Cr(VI)’s proclivity for transformation also facilitates its remediation. Cr(VI) in groundwater can be readily reduced to Cr(III) using many of the same methods that rely on electron-donating compounds that create reducing conditions for in-situ chemical reduction (ISCR) and enhanced reductive dechlorination (ERD) at sites contaminated by chlorinated solvents. Under reducing conditions, Cr(VI) reacts with other subsurface minerals to form less toxic, insoluble, and immobile Cr(III) hydroxide precipitates. The precipitates are stable, solid, and integrated with the soil matrix, so they generally stay put – no need to remove them. Under naturally reducing subsurface conditions, Cr(VI) can also be chemically or biologically attenuated.
From all appearances, Cr(VI) will continue to emerge more often as a primary and secondary contaminant at environmental investigation and remediation sites. Our extensive experience with Cr(VI) and with remediation methods that rely on establishing reducing conditions in the subsurface has positioned Wilcox to provide a full range of high-value services to clients affected by Cr(VI) in soil and groundwater.


The National Cancer Institute estimates that more than 43,000 Americans were diagnosed with pancreatic cancer last year and more than 36,000 died from the disease. Despite advances in genetic science showing that the Ras oncogene is mutated in virtually all pancreatic cancers, scientists have been frustrated by the complexity of the signaling pathways in humans, which make it difficult to pinpoint potential therapeutic targets.
"We found an elegant mechanism by which Ras switches partners and showed that the choice leads to very different fates for the cell. Now we can go back to the human pancreatic cancer cell and ask whether similar mechanisms are at work in determining how Ras causes pancreatic cancer," he adds.
Scientists often study simpler organisms to tease out genetic and cellular activity that might be almost impossible to map in humans. "Worms’ cells actually share a great deal of functional overlap with human cells. However, while there may be one mechanism in a simple organism like a worm, there are multiple mechanisms at work in humans. It’s a great thing for us as people, because there is a great deal of redundancy in our biological systems that helps them self-repair and function better, but it makes it a lot harder to study what’s going on at a basic level," Der notes.
"If this signaling works in a similar way in humans, the C. elegans model may be very powerful for helping us find new therapeutic targets for pancreatic cancer," he concludes.
SOURCE Developmental Cell


Theories of the primordial Universe predict the existence of knots in the fabric of space - known as cosmic textures - which could be identified by looking at light from the cosmic microwave background (CMB), the relic radiation left over from the Big Bang.
Using data from NASA's Wilkinson Microwave Anisotropy Probe (WMAP) satellite, researchers from UCL, Imperial College London and the Perimeter Institute have performed the first search for textures on the full sky, finding no evidence for such knots in space.
As the Universe cooled it underwent a series of phase transitions, analogous to water freezing into ice. Many transitions cannot occur consistently throughout space, giving rise in some theories to imperfections in the structure of the cooling material known as cosmic textures.
If produced in the early Universe, textures would interact with light from the CMB to leave a set of characteristic hot and cold spots. If detected, such signatures would yield invaluable insight into the types of phase transitions that occurred when the Universe was a fraction of a second old, with drastic implications for particle physics.
A previous study, published in Science in 2007, provided a tantalising hint that a CMB feature known as the "Cold Spot" could be due to a cosmic texture. However, the CMB Cold Spot only comprises around 3% of the available sky area, and an analysis using the full microwave sky had not been performed.
The new study, published today in Physical Review Letters, places the best limits available on theories that produce textures, ruling out at 95% confidence theories that produce more than six detectable textures on our sky.
Stephen Feeney, from the UCL Department of Physics and Astronomy and lead author, said: "If textures were observed, they would provide invaluable insight into the way nature works at tremendous energies, shedding light on the unification of the physical forces. The tantalizing hints found in a previous small-scale search meant it was extremely important to carry out this full-sky analysis."
Co-author Matt Johnson, from the Perimeter Institute, Canada, said: "Although there is no evidence for these objects in the WMAP data, this is not the last word: in a few months we will have access to much better data from the Planck satellite. Whether we find textures in the Planck data or further constrain the theories that produce them, only time will tell!"
Notes for Editors
1. For more information or to interview the authors, please contact Clare Ryan in the UCL Media Relations Office on tel: +44 (0)20 3108 3846, mobile: +44 07747 565 056, out of hours +44 (0)7917 271 364, e-mail: email@example.com.
2. 'A robust constraint on cosmic textures from the cosmic microwave background' is published in the journal Physical Review Letters on 12 June 2012.
3. Journalists can obtain copies of the paper here: http://arxiv.org/abs/1203.1928
About UCL (University College London)
Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. We are among the world's top universities, as reflected by performance in a range of international rankings and tables. UCL currently has 24,000 students from almost 140 countries, and more than 9,500 employees. Our annual income is over £800 million.
www.ucl.ac.uk | Follow us on Twitter @uclnews
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


How to Protect Yourself Checklist
- Never take antibiotics to treat viral illnesses like colds or the flu. Antibiotics have no effect against viruses.
- When you are prescribed an antibiotic, take every dose, even if your symptoms go away. Taking part of the prescription only treats part of the infection.
- Never share antibiotics. These strong medications can cause dangerous side effects. They should only be used under a doctor’s care.
- Wash your hands well and often. This is the best way to keep from getting sick.
- Ask your doctor about pneumococcal (pneumonia) and influenza (flu) vaccinations.
- If you or your child is suffering from a virus such as cold or flu consult our Upper Respiratory Treatment Guides for symptom relief.


As the month of August nears a close, the nip in the air is back, which signals the start of a brand new school year. Between the hustle and bustle of soccer games and homework, it’s often difficult for students to find spare time for extracurricular reading. Yet, helping your student find that extra hour to read instead of watching television or playing video games may be the key to overall improvement in school performance, according to research done by the University of London. Without a good book though, reading may be more painful than pleasurable. Finding engaging books may be a challenge, which is why we’ve compiled a list of resources that will help your student find a STEM-related book that he or she will actually enjoy reading.
STEM Reading for Teens: A reading list created by the Young Adult Library Services Association of the best STEM Reads.
Suggested Reading: Cinder by Marissa Meyer
Cyborg Cinder, a talented mechanic living in the disease and alien-ridden area of New Beijing, meets Prince Kai when he brings in a robot for repair. As their lives intertwine, Cinder is forced to uncover secrets about her past in order to protect her future.
Women in Science: Goodreads list of STEM-related titles about women.
Suggest Reading: The Immortal Life of Henrietta Lacks by Rebecca Skloot
The creation of the polio vaccine, as well as extensive science research, including information about cancer and viruses, all began from the cells of one Henrietta Lacks, a poor African American tobacco farmer. Henrietta’s cells were harvested and used for research without her knowledge or consent. Her complicated story was the catalyst for the development of bioethics.
STEM Read: Science Behind the Fiction: Program developed by Northern Illinois University to encourage STEM engagement through reading.
Suggested Reading: Ender’s Game by Orson Scott Card
Several years after the initial alien invasion on Earth, Ender Wiggins is recruited to train at a battle school in space to prepare for the next attack. As he trains on the space station, Ender is forced to face increasingly difficult questions about humanity, isolation and the morality of warfare.
RocketSTEM: Online magazine with content focused on fostering a love of STEM within parents, teachers and students.
Other Suggested Readings:
Adaptation by Malinda Lo
Delirium by Lauren Oliver
Fahrenheit 451 by Ray Bradbury
Feed by M.T. Anderson
Flowers for Algernon by Daniel Keyes
Matched by Ally Condie
Miss Peregrine’s Home for Peculiar Children by Ransom Riggs
Physics of the Future by Michio Kaku
Physics of the Impossible by Michio Kaku
Starters by Lissa Price
The Angel Experiment by James Patterson
The Art of Tinkering by Karen Wilkinson
The Boy Who Harnessed the Wind by William Kamkwamba
The Compound by S.A. Bodeen
The Evolution of Calpurnia Tate by Jacqueline Kelly
The Hitchhiker’s Guide to the Galaxy by Douglas Adams
The House of the Scorpion by Nancy Farmer
The Knife of Never Letting Go by Patrick Ness
Uglies by Scott Westerfeld
Unwind by Neal Shusterman
When We Wake by Karen Healey
Wither by Lauren DeStefano
So STEM lovers, which books did we miss? What’s your favorite STEM-related book? Tell us in the comments section!


Tutorials / Guided use cases
Development of an extensive irrigation system downstream the Bagré Dam in Burkina Faso
The story concerns a extensive irrigation system downstream the Bagré Dam, in Burkina Faso. The Bagré dam was inaugurated in 1994 and the irrigation scheme of the dam lies approximately 150 km south east of Burkina Faso's capital, Ouagadougou within the department of Bagré in Boulgou province.
Developing hydropower and large-scale irrigated agriculture were the two main objectives in constructing the Bagré dam. The dam's irrigation objective aims to address food security for the local and national population. Traditional cereal farming on rain-fed land is the main source of livelihood in the region, along with the raising of livestock, including pastoralism. Improving and increasing the production of rice is a key component of the government's national development policies.
Here is the link to the presentation that was made for the hand-in-hand meeting (on Earth Map).
Burkina Faso, West Africa
Surface Water, Irrigation Systems
The vegetation, water and demographic data compiled in Earth Map can show the direct consequences of the construction of a dam and the expansion of irrigation systems, such as the production of improved rice seed in the Bagré area which is helping local rice-producing smallholders in Bagré become self-sufficient in rice production as well as providing new employment opportunities.
i) Looking at the satellite images in December 2019 (Figure 1) we can observe that different land covers such as water, savanna and agricultural plantations can be easily differentiated with the satellite image colours. Big infrastructures such as damns are clearly spotted in the image;
(ii) The agriculture expansion can be identified from images in 1984, 1998, 2002 and 2018 (Figure 2) as a direct consequence of the construction of the dam in 1994. In 2019, the extension of irrigated agriculture is approximately 5 000 ha;
(iii) New permanent (7 782 ha) and new seasonal (13 685 ha) flooded areas (Figure 3) have been identified within the timeframe between 1984 and 2018 due to the building of the dam;
(iv) Population in the area (Figure 4) has more than doubled in 15 years (from 65 711 inhabitants in 2000 to 15 8402 inhabitants in 2015) which most likely is related to local small-hold farmers producing their own rice and their households becoming more resilient.
Figure 1: Screenshot of the Imagery Compare Tool, with zoom into the Bagré Dam. Sentinel 2 cloud free mosaic images are represented in December 2019 . In the image, water (purple colour), savanna (yellow/green colour) and agricultural plantations (orange colour) can be identified based on satellite image colours.


How to Play
To play, first select a puzzle from the dropdown menu below. The objective of the game is to fill in the grid so every row, every column, and every 3x3 box contains each of the vowels you see to right of the puzzle (no repeats!). To place a vowel in a square, click on the vowel to the right of the puzzle and then click the square that you would like to place the vowel in.
See below for tips on how to play.
Select Your Puzzle:Warning: you must enable pop-ups in order to submit your entry.
Prizes for This Week's Lingoku:
Prizes (see below) will be awarded to the 5 people who solve the most puzzles from Friday, March 30 - Thursday, April 5, so start playing today!
- a copy of Agreement by Greville G. Corbett, 2006, Cambridge University Press, donated by Greville G. Corbett
- a one-year subscription to the International Journal of Bilingual Education and Bilingualism, donated by Multilingual Matters
- a copy of Convert Text to Phonetic Spelling (USA accent), donated by Tom Zurinskas
- a copy of Studies on Modern Phonetics and Phonology by Lu, Jilun & Wang Jialing. (eds.) 2004. Tianjin: Tianjin Academy of Social Science, donated by Gang Gu
- a one-year subscription to Linguistics & Science Fiction Newsletter, donated by Suzette Haden Elgins
Tips on How to Play
After you've put a vowel in a square, you can change it by selecting a different vowel and clicking the same square. Also, you can remove a vowel by right-clicking on the space it's in, or by selecting the empty black space at the top of the vowel list on the right and then clicking on the vowel you want to erase.
Not sure which vowels you put in and which are given? The vowels outlined in blue are the ones you've been given by the game - you won't be able to change these. Anything else is your own guess!
You might want to start by, for example, looking at a row that already has several vowels given to you. What vowels are missing? For each blank square in the row, what vowels can you add that are not already in the row, column or 3x3 box that the blank square is in?


Standing in the 150 year old stables of the legendary Pony Express in St. Joseph Missouri, I was impressed by two verifiable facts of history:
- That in this day of 140-character instant global messaging there was a time when it took more than a month to send a message from Washington, DC to Sacramento, California.
- And that both parties the United State Congress could actually agree on something – a solution to the problem of communication with America’s west coast.
The solution was the legendary Pony Express and for 18 months it was the fastest, most innovative and exciting form of communication in North America. The end of the railroad west was in St. Joseph, so mail came that far by train. Then a relay system of hardy young riders on horseback who literally rode night and day for nearly 2,000 miles delivered mail to Sacramento in an unequaled time of 10 days.
In You Bucket Because …
- You love horses, history and heroes.
- You’re intrigued by innovation solutions, no matter when they were implemented.
- Good for those fascinated by the danger and drama of the Old West.
Riding the Pony Express Trail
Johnny Fry was that first rider, bolting out of the stables at 9th and Penn Streets in St. Joseph at 7:15 p.m. on April 3, 1860 carrying 49 letters and five personal telegraphs. Crowds lined the streets, applauding, cheering and slapping the horse on the rump as that first ride began.
“We had orders on that first ride to do our level best,” reported rider George Washington Perkins who was a little farther down the trail. “My run on that record-breaking ride was 57 miles. I had to make it with just one horse and I made the run in mighty good time considering the distance, but I killed the poor horse in doing it.”
About 200 riders, each weighing less than 125 pounds, rode a horse at full gallop about 100 miles night and day, crossing mountains, rivers, desert, through hostile Indian territory and without regard to blizzards, tornadoes or the beating sun. Only one rider died on the trail and only once was a bag of mail lost. For 18 months, at any time of the day or night, as many as five Pony Express riders were on horseback somewhere between St. Joseph Missouri and Sacramento California.
Dispelling the Myth of the Pony Express
Because it operated only 18 months, and because no one really thought what they were doing was a big deal, and because the company was bankrupt when the last rider delivered mail on October 26, 1861, very few records were kept. That, combined with embellished stories over the years and a few extra “facts” for good measure produced by Hollywood, there’s a lot of gray area when it comes to the Pony Express.
However, one myth that historians work to clarify is that the Pony Express was a failed enterprise.
“It was not intended to last forever,” says Jackie Lewin, executive director of the St. Joseph Museums. “This was just a stop-gap until the telegraph and better stage coach routes could be put in place. It was actually incredibly successful.”
Visiting St. Joseph Missouri
When visiting St. Joseph (locals call it St. Jo), a few key Pony Express stops include the Patee House Museum. An elegant hotel with bathrooms and running water when it opened in 1858, the Patee House served as the business office for the Pony Express. Riders were said to have ridden horses right into the hotel to pick up the mail. A railroad mail car at the Patee House allows you to see where the mail was sorted and ready to hand-off to officials in St. Joseph as soon as the train arrived.
Three blocks away are the original stables of the Pony Express, built in 1858, the same time the Patee House was under construction. It’s possible to see several levels of foundation and construction over the years. There’s also a re-created a relay station where horses and riders rested. A real one remains in Gothenberg, Nebraska. Kids have a lot of fun sorting mail under the pressure of a stopwatch. You can choose an appropriate horse for your body style and the landscape particular to that particular leg of the trail you are assigned to ride.
Another good stop for true Pony Express fans is the Mount Mora Cemetery – the final resting place of two Pony Express riders, Charlie Cliff and James Benjamin Hamilton. Their graves are marked with black wrought iron hitching posts shaped in the image of a horse. Also buried at Mount Mora is John Patee, who built the Patee House, and John Landis, the man who designed the “mochilla” or mail pouches that the Pony Express riders carried.
Send Mail Via The Pony Express
Each June the National Pony Express Association re-rides the route. For $5, the public may send mail along, receiving a special stamp that it was carried by the Pony Express. To have a letter carried via Pony Express rider, send all of the appropriate names/addresses and a check for $5 made payable to the Missouri Chapter of the National Pony Express Association.
Send it all to:
Missouri Chapter of the National Pony Express Association
P.O. Box 1022
St. Joseph, Missouri 64152
- St. Joseph is located about 40 minutes north of the Kansas City International Airport. Public transportation is limited. You will need a private automobile.
- Schedule a tour of the Mount Mora Cemetery by calling 816-232-8471.
- While in St. Jo, make plans to visit the Jesse James House Museum.


Make a Paper Chain Calendar
Young kids usually have only a vague sense of time. They probably know that an hour is longer than ten minutes, and a week is shorter than a month, but it’s difficult for them to gauge time’s passing. Making a paper chain calendar can help.
What You Need:
- 3” x 8” strips of colored construction paper
What You Do:
- Pick a date in the future that has some meaning for your child, for example, the first day of school, the date a relative is set to come visit, a birthday, or the start date of a favorite activity, like soccer. Ideally, the date should be about a month away.
- Pull out your calendar, and with your child’s help, count the number of days until the event you’ve chosen.
- Give your child the construction paper strips and explain that each strip stands for one day. Together, count out the correct number of strips (one for each day until your event), then help your child make a paper chain, by gluing the end of each strip together to form a link, then adding the rest of the links to form a “chain”.
- Hang your chain in your child’s room, or in a prominent place. Each day, allow her to remove one link from the chain. As the days pass, this will give her a visual picture to associate with the numbers she sees on the calendar.
Not only does this provide a concrete image for the passing of time, but it gives your child a great excuse to practice counting backwards!


Knee joint is the most used joint after shoulder joint in human body. Knee joint is formed by patella, tibia and femur. Knee joint fracture is either isolated fracture that involves one bone or multiple fractures, which involves patella, tibia and femur. Knee joint fracture includes intra-articular (within knee joint capsule) fracture or extension of extra articular fracture (outside knee joint) into knee joint.
Knee Joint Consists Of Following Two Joints-
- Patella-femoral joint and
- Tibio-femoral joint.
Bones Involved In Forming Of Knee Joint
- Patella (Knee Cap)
- Medial (Inner) Supracondylar Fracture
- Lateral (Outer) Supracondylar Fracture
- Inter-Condylar Fracture
- Medial (Inner) Supracondylar Fracture
- Lateral (Outer) Supracondylar Fracture
- Inter-Condylar Fracture
Classification and Types Of Knee Joint Fracture
1. Hairline Fracture Of Knee Joint
- Hairline Fracture or crack is mostly on the surface of the bone and does not pass through entire thickness of the bone.
- Fracture or crack does not spread through complete circumference of patella, femur or tibia but covers partial circumference of the bone.
- Hairline fracture is treated with conservative treatment.
2. Non-Displaced Fracture Of Knee Joint
- Fracture or cracks passes through entire thickness of the bone.
- Fracture fragment maintains normal anatomical position following injury.
- Fracture fragment maintains normal anatomical position during conservative treatment, which may involve close reduction and application of braces or cast.
- Treated with conservative treatment.
3. Partial Displaced Fracture Of Knee Joint
- Fracture or cracks passes through entire thickness of the bone just like stable partial displaced fracture.
- Fractured fragment is partially displaced away from parent bone.
- Isolated piece of fracture segment is partially displaced from normal anatomical position.
- Fractured fragment maintains normal anatomical position following conservative treatment and close reduction.
- Treated with close reduction.
- Surgical treatment is advised when close reduction and external fixator treatment fails to reduce the fracture.
4. Complete Displaced Fracture Of Knee Joint
- Fracture or cracks passes through entire thickness of the bone just like stable non-displace fracture.
- Fracture fragment is an isolated piece of bone, which is separated from parent bone.
- Fracture fragment does not maintain normal anatomical position.
- Close reduction often fails to bring the displaced segment of fracture bone to normal anatomical position.
- Treated with surgical treatments and medications.
5. Compound (Open) Knee Joint Fracture
- Fracture fragment is completely displaced
- Parent bone or fracture fragment protrudes through skin and subcutaneous tissue and exposed to atmosphere.
- Fracture is associated with loss of covering skin, subcutaneous tissue and muscles.
- Bones are exposed to atmosphere.
- Associated with extensive tissue damage.
- Fracture is associated with nerve damage and ruptured major blood vessels resulting in severe bleeding.
- Treatment is surgery and medications.
Types Of Knee Joint Fracture
Anatomical direction or position of the fracture is described as follows-
- Comminuted (shattered)
Causes Of Knee Joint Fracture
- High-energy direct impact.
- Often associated with dislocation
- Mostly causes multiple bone fracture involving patella, lower end femur and upper end of tibia.
- Work injury such as fall from height results in fracture of upper end of tibia.
- Direct impact of knee joint causes fracture of multiple bones of knee joint.
- Work injury resulting in direct impact of patella causes fracture of patella.
- Domestic injury resulting in fracture of knee joint often seen in elderly patients.
- Tripping over carpet or staircase causes knee joint fracture.
- Osteoporosis causes decrease bone mass and less calcium deposits in bones of knee joint.
- Osteoporotic bones are weak and often fracture.
- Tripping and fall causes fracture of knee joint.
Vitamin And Calcium Deficiency
- Calcium deficiency is caused by dietary deficiency or parathyroid disease
- Patient suffering with calcium deficiency has a tendency to fracture knee joint following fall or direct trauma.
Associated Injuries With Knee Joint Fracture
- Dislocation of Knee joint
- Tendon rupture
- Ligament tear
- Cartilage tear
- Blood vessels tear resulting in intra or extra articular (joint) bleeding and hematoma (blood clot.)
Symptoms Of Knee Joint Fracture
- Fracture causes instant severe pain and patient has to be moved by ambulance to emergency room of nearest hospital
- Pain is located over knee joint and often spreads over thigh and leg
- Pain become extremely severe with touch over fracture site or examination of the joint
- Joint should be immobilized with splint immediately following injury to prevent unbearable severe pain and also to prevent surrounding tissue damage.
Unable to Walk
- Patient is unable to support weight on injured leg.
- Unable to move leg because of severe intractable pain.
- Passive or active movement of the knee joint causes displacement of the fracture bones resulting in severe pain.
- Patient is unable to move knee joint or walk because of hematoma in the knee joint. Hematoma may be associated with hairline fracture.
- Patient is able to ambulate and walk following hairline fracture without hematoma.
- Muscles spasm is observed with muscles of thigh and calf.
- Severe pain is felt over the injured muscles or muscle in spasm.
Tingling, Numbness and Weakness of Leg Below Knee Joint
- Following nerve injury may be associated with knee joint fracture.
- Common peroneal nerve injury
- Saphenous nerve injury
- Symptoms of common peroneal nerve injury
- Tingling and numbness over the skin at the top of the foot and ankle.
- Unable to flex the foot
- Foot drop
- Symptoms of Saphenous nerve injury
- Numbness in front of patella
- Tingling and numbness in front and medial side of leg.
Nausea And Vomiting
- Patient may suffer with symptoms of nausea and vomiting secondary to low blood pressure secondary to blood loss, fear and severe pain.
- Loss of blood causes hypotension and dizziness resulting in nausea and vomiting.
- Nausea and vomiting is also caused by side effects of opioid treatment.
Dizziness is caused by hypotension (low blood pressure). Low blood pressure is secondary to loss of blood resulting in hematoma (blood clot)
Signs Of Knee Joint Fracture
Knee Joint Swelling
- Joint swelling is caused by hematoma (blood clot) within the knee joint or outside knee joint in subcutaneous tissue
- Joint swelling is also exaggerated by tissue edema.
- Joint swelling is felt soft to firm.
- Joint swelling may be fluctuating.
Knee Joint Deformity
- Joint deformity is caused by protrusion of fracture segment.
- Joint deformity is also caused by intra and/or extra articular (joint) bleeding.
- Joint deformity associated with hematoma (blood clot) often looks smooth and even.
- Joint deformity in absence of blood clot is uneven and hard in consistency.
Knee Joint Tenderness
- Knee joint is extremely tender to touch.
- Pain becomes continuous for prolonged period with higher intensity after examination or slight touch.
Inability To Move Joint Or Ambulate (Walk)
- Patient is able to move toes and foot but unable to move the leg at knee.
- Nerve injury may cause leg muscle paralysis resulting in weakness of leg below knee joint.
Initial Treatment At Emergency Room For Knee Joint Fracture
- Treatment of pain
- Treatment of muscle spasm
- Close reduction
- Braces and Cast application
Treatment Of Knee Joint Fracture
Conservative Treatment For Knee Joint Fracture
Rest for Knee Joint Fracture
Rest is advised to immobilize the joint before and after the treatment
Exercises for Knee Joint Fracture
Exercises are advised to prevent muscle weakness and atrophy during treatment and following surgery. Exercises advised are as follows-
- Yoga Therapy
- Stretching Exercises
Cold Therapy for Knee Joint Fracture
Cold treatment is beneficial following surgery. Direct application of ice covered with plastic or cloth left over knee joint for 20 to 30 minutes two or three times a day.
Heat Therapy for Knee Joint Fracture
Moist heat is advised following closed reduction of the fracture and following surgery.
Assistive Devices for Knee Joint Fracture
Following assistive devices are used during and following treatment of knee joint fracture:
- Crutches or
Dietary Supplements for Knee Joint Fracture
Not supported by any research or scientific evidence.
- Chondroitin Sulfate.
Cast and Braces For Knee Joint Fracture
Knee joint is placed in cast and braces to hold the end of bone together in approximate anatomical position. Indications for knee joint cast and braces placement are as follows-
- Hairline fracture of patella, upper end of tibia and lower end of femur.
- Non-displaced fracture of lower end of femur, upper end of tibia and patella.
- Immobilization of knee joint following close reduction of knee joint fracture and surgical treatment.
- Positions of two ends of bones are frequently checked with X-Ray.
- Non-aligned fracture following applications of cast or braces treated with surgeries.
- Cast is placed for 8 to 12 weeks.
Skeletal Traction for Knee Joint Fracture
- Skeletal traction is a continuous pull of the lower leg with weights to maintain the two ends of fracture segment in near normal anatomical position.
- Skeletal traction may involve a placement of pin through shaft of tibia below the fracture. The weights are tied to pin so pin will pull the lower fragment segment and prevent displacement of fractured segment.
Physical Therapy (PT) For Knee Joint Fracture
Physical therapy (PT) is advised after the healing of the knee joint fracture or surgical treatment. Objectives of physical therapy for knee joint fracture are as follows-
- Prevent muscle wasting.
- Prevent muscle atrophy.
- Prevent muscle weakness.
- Improve muscle stretching.
- Improve muscle strengthening.
- Improve range of joint movement and
- Prevent knee joint stiffness.
Medication Treatment For Knee Joint Fracture
NSAIDS For Knee Joint Fracture
- NSAIDs are prescribed only in case of hairline knee joint fracture. NSAIDs are ineffective for severe pain caused by fracture.
- NSAID prescriptions are often restricted because of side effects.
- Side effects often seen are stomach pain, gastric ulcer and bleeding disorder
- Most common NSAIDs prescribed are Motrin, Naproxen, Daypro and Celebrex.
Opioids (Narcotics) For Knee Joint Fracture
Opioids are prescribed for severe pain in almost all cases of knee joint fracture. Patient receives intravenous or intramuscular dose of opioids prior to transportation to emergency room.
- Opioid Side Effects- Nausea, Vomiting, Constipation, Dependence and Addiction.
- Most Common Opioids Prescribed are as follows-
- Short Acting Opioids- Acts for 3 to 4 hours
- Hydrocodone, (Vicodine, Loratab and Norco)
- Oxycodone (OxyIR)
- Morphine (MS IR)
- Long Acting Opioids- Acts for 12 to 24 hours.
- Oxycodone (Oxycontin)
- Morphine (MS Contin), Avinza
- Short Acting Opioids- Acts for 3 to 4 hours
Muscle Relaxants For Knee Joint Fracture
Muscle relaxants are prescribed for muscle pain and muscle spasm. Most common muscle relaxants prescribed are as follows-
- Skelaxin and
Treatment of Neuropathic Pain Following Healing of Knee Joint Fracture
Neuropathic burning pain is a late symptom often seen following healing of fracture. Neuropathic pain may not respond to opioid therapy. Neuropathic pain is treated with following medications-
- Anti-Epileptic Analgesics- Most common antiepileptic prescribed as analgesics is Neurantin and Lyrica.
- Anti-Depressant Analgesics- Most common antidepressant prescribed as analgesics is Cymbalta and Elavil.
Interventional Therapy For Knee Joint Fracture
Knee joint Injection at Fracture Site Using Local Anesthesia
Severe pain following knee joint fracture is often treated with local anesthetics. Local anesthetics injections helps to transport the patient to emergency room from place of injury or from urgent care or emergency room to different hospital.
Cortisone Injection For Knee Joint Fracture Pain
Cortisone injection is performed following complete healing of fracture or surgery. Indications for cortisone injections are as follows-
- Inflammation not responding to NSAIDs.
- Chronic pain not responding to opioids and surgery.
Nerve Block For Knee Joint Fracture Pain
Knee joint pain not responding to opioids and surgery are treated with Nerve block. Following nerve blocks are performed for chronic knee joint pain.
- Femoral Nerve Block
- Lumbar epidural injections
- Field block of knee Joint
Local Anesthetic Medications used for nerve block are lidocaine or bupivacaine.
Indications For Knee Joint Blocks Are As Follows
- Chronic pain not responding to opioids.
- Assist aggressive physical therapy
- Improve joint movements
Spinal Cord Stimulator
Indications for Spinal Cord Stimulator are as Follows
- Continuous chronic pain not responding to opioids.
- Failed surgery
- As an adjuvant therapy to pain medications.
Procedure for Spinal Cord Stimulator are as Follows
- Spinal cord stimulator is a thin linear plastic tube encloses electrode and bundle of wires, which connects electrode to generator.
- Stimulator is placed in epidural space of lumbar segment of spinal cord.
- Stimulator is connected internally to generator.
- Generator sends an electric stimulation of very low voltage to electrode.
- Electrode releases radiofrequency (RF) signals.
- RF signals blocks spinal nerves and pain stimulation going to brain resulting in less or no pain.
Intrathecal Opioid Treatment For Knee Joint Fracture Pain
Indications for Intrathecal Pain Medications are as Follows
- Continuous chronic pain not responding to opioids
- Failed surgery
- Failed treatment with spinal cord stimulator.
Procedure for Intrathecal Pain Medications are as Follows
- Procedure involves placement of intrathecal catheter and electronic medications delivering pump.
- Intrathecal catheter is placed in cerebrospinal fluid. Tip of the catheter is positioned above second lumbar vertebrae.
- Opposite end of catheter is connected to pump.
- Pump has two chambers. Top chamber is reservoir, which stores solution containing pain medication. Bottom chamber contains battery (power supply), motor (delivers pain medication) and computer device.
- Computer is programmed to deliver set amount of volume of medicine and booster extra dose at predetermined time.
- Programming is controlled by physician.
- System is switched on or off by patient using remote control provided to patient following surgery.
Surgical Treatment Options For Knee Joint Fracture
Knee Arthroscopic Surgery
- Knee arthroscopic surgery is performed for diagnosis and treatment. Few hairline fractures are difficult to diagnose with X-Ray and MRI.
- Arthroscopic surgery helps to confirm the questionable non-displaced and hairline fracture.
- Arthroscopic surgery is performed to repair non-displaced fracture, which is not responding to conservative treatment.
- Arthroscopic surgery is also performed to repair rotator, tendon and ligamental tear associated with knee joint fracture.
External Fixation For Knee Joint Fracture
Procedure for External Fixator For Knee Joint Fracture
- Pins are inserted in shaft of femur above the fracture and shaft tibia below the fracture.
- The fracture is reduced with manual pull and traction. The anatomical position of the fracture is checked with X-Ray.
- The normal anatomical position of non-displaced fracture is maintained in normal alignment by creating traction between upper and lower pin using an external retractor.
- External retractor is positioned between the femur and tibial pain.
- External fixator is used for 8 to 12 weeks.
Indications for External Fixator For Knee Joint Fracture
- External fixator is used following close reduction
- External fixator is used when patient is advised against anesthesia or surgery because of heart and lung conditions.
Intramedullary Nailing For Knee Joint Fracture
Procedure For Intramedullary Nailing
- Metal rod is placed inside the shaft of the fragmented bone.
- Femur Rod (nail) passes across the lower fragment segment.
- Tibial rod passes across the upper fragments (segments) of fractured bone.
Indications For Intramedullary Nailing
- Extra-articular supracondylar fracture of tibia and inter-condylar fracture of femur.
- Displaced fracture of tibia and femur
- Comminuted fracture of femur and tibia
- Stabilize fracture segment in anatomical position after reduction of fracture.
Wires or Screw Placement To Treat Knee Joint Fracture
Procedure for Plates and Screw Placement To Treat Knee Joint Fracture
- Open surgery- following skin incision fractured bone fragments are exposed.
- Bone fragments are manually repositioned to normal anatomical position.
- Bone fragments are held together with wires or screws and plates.
Indications for Plates and Screw Placement To Treat Knee Joint Fracture
- Partial or complete articular and condylar fracture of femur and tibia.
- Inter-condylar fracture
- Displace fracture of tibia, femur and patella.
- Comminuted fracture of patella, tibia and femur.
- Compound fracture of patella, tibia and femur.
- Non-displaced unstable fracture of patella, tibia and femur.
Knee Joint Replacement To Treat Knee Joint Fracture
Procedure for Total Knee Replacement To Treat Knee Joint Fracture
- Procedure is performed under epidural, spinal or general anesthesia.
- Skin incision of 8 to 12 inch is made in front of knee joint.
- Damaged lower end of femur and upper end of tibia is shaved and removed.
- Artificial (prosthesis) metallic or plastic head is placed over tibia and femur.
- Prosthesis is cemented within marrow cavity with special synthetic cement.
- Recent equipment and advances in knee replacement surgery requires only small incision of 3 to 5 inches.
Indication for Total Knee Replacement To Treat Knee Joint Fracture
- Unstable displaced knee joint fracture of tibia or femur
- Comminuted fracture of tibia or femur
- Multiple fractures involving femur, tibia and patella.
Complications for Knee Joint Fracture Following Injury And Surgery
- Non-healing of fracture
- Deep vein thrombosis.
Also Read: Rehabilitation Following Knee Joint Surgery.


The British Geological Survey in Edinburgh has been one of the leading geoscience research centers in the world since its founding in 1835. To understand more about the 7.0-magnitude earthquake that devastated Haiti on Tuesday, TIME spoke with one of the survey's seismologists, Roger Musson, about the science behind the seismic event.
What sort of earthquake was this?
An earthquake is the sudden release of energy along a fault line in the earth's crust as rocks break in response to stress. There are three types, and they depend on the sort of movement along the fault. This was what we call a strike-slip, or transform, earthquake, where one side of the fault slides horizontally past the other one.
Which fault produced this earthquake?
It is rather baroquely called the Enriquillo-Plaintain Garden fault. It is a major plate boundary fault and is analogous to the San Andreas fault in California. It starts around the southern border between Haiti and the Dominican Republic and runs west until it reaches Jamaica.
Was it the most destructive type of earthquake?
A thrust earthquake, in which one side of the fault goes up, is the type that produces truly enormous events like the Sumatra earthquake of 2004. But strike-slip faults often run through populated areas, so they can be the most damaging to humans.
People talk about waiting for the Big One in California. Was this a similar earthquake for this fault?
This was the Big One. The fault has been more or less locked for 200 years. Seismologists were unsure as to whether it would produce one Big One or several smaller ones. We seem to have the answer.
Does that mean the fault will be quiet now that the pressure has been
The pressure has probably shifted to the west, so it's likely that there will be another earthquake or perhaps a succession of earthquakes moving westward to Jamaica. That is not in the immediate future but in the next decades or 100 years. My guess would be that we will have another earthquake in Haiti or Jamaica within 20 or 40 years.
What about aftershocks?
Aftershocks, which are a sort of settling down of the earth's crust in the vicinity of the main shock, have been continuing [in Haiti], and the biggest was 5.9 [magnitude] and happened eight minutes after the main shock. But they seem to be slowing down.
Will we learn anything scientifically from this earthquake?
Every earthquake teaches us something, but this is not really a remarkable earthquake a similar one occurred in 1770 and 1751 on the fault.
Was this a fault that seismologists were concerned about, not for geological
reasons but because of the vulnerability of the population there?
Seismologists are human. We are aware of such things. When I saw the data for this earthquake last night, I can tell you that my heart sank.


筆記 SQL Server 如何使用 TSQL 的方式更改 Collate, Collation (定序)。
使用指令的好處是可以先切換成 Single User Mode 完成調整 Collate 所需的獨佔權限，作業完成後再切換恢復。
ALTER DATABASE DatabaseName SET SINGLE_USER WITH ROLLBACK IMMEDIATE;
ALTER DATABASE [DatabaseName] COLLATE Chinese_Taiwan_Stroke_CI_AS
ALTER DATABASE DatabaseName SET MULTI_USER;
Collation in SQL Server is more than just a technical detail; it’s a fundamental aspect that influences data integrity, performance, compatibility, globalization support, and the overall scalability of a database. By understanding and carefully selecting the appropriate collation, you can ensure efficient, accurate, and flexible data management that aligns with your business needs and goals.
Data Integrity and Consistency:
- Explanation: Collation impacts how data is stored and retrieved. It ensures that data is consistently sorted and compared in a way that adheres to specific rules and standards, such as case sensitivity and accent sensitivity.
- Example: If your database stores data in multiple languages, a collation that supports Unicode characters ensures that all characters are stored and retrieved correctly.
- Impact: Using the correct collation preserves data integrity and prevents issues such as data mismatches and incorrect query results.
- Explanation: The right collation can enhance the performance of your database. This is because SQL Server can more efficiently sort and compare data when the collation aligns with the data’s nature and the way it is accessed.
- Example: For a database predominantly dealing with English text, choosing a collation designed for English characters can speed up sorting and querying operations.
- Impact: Optimized performance leads to faster query responses and overall improved user experience.
Application Compatibility and Development Efficiency:
- Explanation: Collation settings in SQL Server must align with the needs of the applications that access the database. Mismatches can lead to errors and inefficient data handling.
- Example: An application designed for a case-insensitive environment might not function correctly if connected to a database with a case-sensitive collation.
- Impact: Proper collation settings ensure compatibility with applications, leading to more efficient development and fewer runtime errors.
Globalization and Localization Support:
- Explanation: SQL Server’s collation settings play a vital role in globalization and localization strategies. They enable the database to handle multiple languages and cultural settings appropriately.
- Example: A database that needs to support both English and Arabic languages will require a collation that respects the linguistic rules of both languages.
- Impact: By supporting various languages and cultural norms, businesses can expand their reach and cater to a global audience more effectively.
Maintenance and Scalability:
- Explanation: Choosing the right collation at the outset simplifies maintenance and scalability of the database. It’s easier to expand or modify a database when its fundamental settings align with long-term needs.
- Example: Changing collation settings on a large, established database can be complex and risky. It’s much simpler when the database is designed with future expansion in mind.
- Impact: Scalability and ease of maintenance are crucial for the long-term success and adaptability of a database system.


Watering your garden doesn’t have to be a chore that you rush through. In fact, it can end up being one of your favorite things to do in the garden, as it helps you to slow down. Here are some tips to enjoy the process:
Watering the garden allows you to stop and be present.
Take time and admire new growth and blooms, dream up ideas to improve new areas of the garden, listen to the birds and the sounds of nature around you. Quiet your mind.
Grab a drink.
Watering the garden should be enjoyed, so bring along your morning coffee or evening beverage, and use the philosophy “Water, Sip, Inspect, Repeat”.
· Water – focus on a section of the garden and give it a really good soak.
· Sip – Enjoy your beverage of choice
· Inspect – check on your plants, what has new growth, what is flowering, what is being eaten by the local wildlife, are there any signs of distress or disease on your plants, what needs dead heading
· Repeat – move on to the next section of the garden
Make sure to give your plants lots of water. If you have pots in the garden, water until the water runs out the bottom, assuming you have drainage holes in your pots. If you don’t have drainage holes, don’t over water, as generally plants don’t like to sit in water. When you water deep, you are encouraging the roots to go down rather than stay near the surface. Deep roots make a plant more sturdy and strong. Plus, you won’t need to water as often.
Give extra water when transferring plants.
If you are moving plants or planting new plants, give them extra water until you see new growth. Plants can go into shock when moved or repotted; the extra water will encourage the roots to grow and get settled quicker.
Top things up.
Don’t forget to top up your birdbath or water fountain for the birds, insects and pets if you have them.


They disagreed. Some took the position that Jesus was “begotten” of God the Father from his own being and therefore had no beginning. Others believed that Jesus was created out of nothing, therefore having a beginning. They couldn’t agree when Easter was to be celebrated. They couldn’t even agree how to run the church. And so in the year 325, the Roman Emperor Constantine I called all 1,800 bishops in the Roman Empire to Nicaea to create a uniform Christian doctrine. We don’t know how many bishops were able to attend the month-long gathering, but the numbers range from 250 to 318. If the orthodox contingent wasn’t the largest, they certainly were the most influential, for all of their proposals were eventually accepted. This gathering came to be known as the First Council of Nicaea, and the summation of beliefs they wrote is known to us as the Nicene Creed.
Reginald Heber (1783-1826) was an English hymn writer, vicar, bishop and missionary. Believing that the sermon, hymns and liturgy of a service should all have a common theme, he wrote hymns connected with the Epistles and Gospels, to be sung after the speaking of Nicene Creed in the worship service. The hymn Holy, Holy, Holy! was written for use on Trinity Sunday.
In 1861, John Bacchus Dykes (1823-1876) wrote the hymn tune specifically to go with Heber’s text. Dykes named the tune NICAEA as a tribute to the First Council of Nicaea which formalized the doctrine of the Trinity.


Experimental database with renewable fuels
Within the framework of ENERXICO, advanced modelling tools for high-fidelity combustion simulations have been developed to study the use of renewable fuels in future sustainable transportation systems. This includes both biofuels and power-to-liquid fuels, the so-called ‘e-fuels’, for which combustion characteristics need to be further understood before they can be applied in combustion systems with optimal efficiency and with minimum pollutant emissions.
The reliable use of these computational models demand for extensive validation from highly controlled experiments, such as the ones performed within ENERXICO. These experiments replicate the operating conditions that such advanced fuels will find in the combustion chamber of an engine in an optically accessible vessel. This means filling up a test volume with air of controlled composition at high pressure (up to 150 bar) and temperature (up to 730ºC), and injecting the fuel through a single-hole injector at realistic injection pressure (1500 bar). Compared to a real engine, where multi-hole injectors are used, and wall interaction as well as piston movement can occur, this is a much more simplified environment. However, conditions of the experiments are highly controlled, and highly advanced optical diagnostic tools can be used to quantify parameters that cannot be obtained from a normal operation of the engine.
Figure 1. Overall view of the experimental facility used to measure characterize renewable fuel combustion. The cylinder in the center is the spray vessel, with different optical accesses and cameras around that make possible to quantify the flame relevant parameters.
In terms of optical diagnostics, advanced tools for combustion analysis have been used. Those include high speed cameras recoding 25000 images per second to resolve all the information occurring within an injection process, which lasts just 4 milliseconds. The radiation of the flame has been recorded both in the visible and ultraviolet wavelength ranges, from which information on when ignition occurs and what the flame length is has been acquired. Adequate imaging devices allow to determine the time-resolved spread of the fuel in the combustion chamber, as well as the amount of soot particulates formed within the flame. Finally, high-power laser light sources are used to quantify information on the presence of relevant combustion species within the flame.
Some of these data are available at CMT website.
Figure 2. Comparison of schlieren visualization recordings of fuel under investigation in the Enerxico project. Images correspond to experiments under the same operating conditions and timing after start of injection with the fuel denoted in the corresponding figure caption.


Vitamin D deficiency has been implicated in numerous health conditions in recent years, including depressed mood and major depressive disorder.
Recent observational studies provide some support for an association of vitamin D levels with depression, but the data do not indicate whether vitamin D deficiency causes depression or vice versa. These studies also do not examine whether vitamin D supplementation improves depression.
A systematic review of clinical trials that have examined the effect of vitamin D supplementation on depression found that few well-conducted trials of vitamin D supplementation for depression have been published and that the majority of these show little to no effect of vitamin D on depression.
The review, by Jonathan A. Shaffer, PhD, assistant professor of medical sciences at Columbia University Medical Center (CUMC), and colleagues at CUMC's Center for Cardiovascular Behavioral Health, was published recently in the online edition of Psychosomatic Medicine.
The review found that only seven trials with a total of approximately 3200 participants compared the effect of vitamin D supplementation on depression with no vitamin D supplementation. Nearly all of these trials were characterized by methodological limitations, and all but two involved participants without clinically significant depression at the start of the study. The overall improvement in depression across all trials was small and not clinically meaningful.
However, additional analyses of the clinical data by Dr. Schaffer hinted that vitamin D supplements may help patients with clinically significant depression, particularly when combined with traditional antidepressant medication. New well-designed trials that test the effect of vitamin D supplements in these patients are needed to determine if there is any clinical benefit.
The authors note that supplementation with vitamin D also may be effective only for those with vitamin D deficiency. They also recommend that future studies consider how vitamin D dosing and mode of delivery contribute to its effects on depression.
"Although tempting, adding vitamin D supplements to the armamentarium of remedies for depression appears premature based on the evidence available at this time," said Dr. Shaffer. He hopes that the current review will guide researchers to design new trials that can answer the question more definitively.
The title of the paper is "Vitamin D Supplementation for Depressive Symptoms: A Systematic Review and Meta-analysis of Randomized Controlled Trials." The other contributors are Donald Edmondson, Lauren Taggart Wasson, Louise Falzon, and Kirsten Homma (CUMC); Nchedcochukwu Ezeokoli (Stanford University); Peter Li (New York University); and Karina W. Davidson (CUMC).
This study was supported by grants from the National Institutes of Health (K23-HL112850, R01 HL117832, and P01 HL088117) and the American Heart Association (12CRP8870004).
The authors declare no financial or other conflicts of interests.
Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.
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Simpson's paradox occurs when a trend appears in several different groups of data but disappears or reverses when the data from these groups are combined.
In this video, Guillaume Riesen, currently a Ph.D. student in neuroscience at Stanford University, gives examples of how combining data from two disparate groups can lead to a different and misleading conclusion due to a third, lurking variable.
As Guillaume points out, before making conclusions from any data, you must be aware of any lurking variables between the groups you are comparing and “have a firm grasp about causal relationships among the variables in play.”
Graphing your data appropriately can go a long way in helping.
In this example diagram, the A data has a downward trend as does the B data. However, when combined, the A+B data has an upward trend.
As Guillaume mentions, there are several real examples found in Wikipedia.
- UC Berkeley Gender Bias
- Kidney Stone Treatment
- MLB Batting Averages
There in the section labeled Implications for Decision Making, the point is aptly made that depending on the “story” behind the data, sometimes the aggregated data dictates the correct decision.
“As to why and how a story, not data, should dictate choices, the answer is that it is the story which encodes the causal relationships among the variables.”
You can see Guillaume’s instructive video here.


Vries, Adriaen de (c. 1545-1626) | Sculptor
De Vries was Giambologna's most brilliant student and a gifted bronze sculptor. In keeping with the mannerist "figura serpentinata" (serpentine moving figure), the slender-limbed faun turns gracefully on its own axis. Originally he was looking at a statuette of a nymph (delivered in 1924), to whom the insinuating gesture of his right hand was directed. The model may have been the antique torso of a satyr on the right, which was still in Italy in the 16th century.
A faun – or perhaps Faunus, as the Italic peoples, the ancestors of the ancient Romans, called the god of nature and the forests. Faunus was equivalent to the Greek god Pan. The goddess Fauna was regarded either as Faunus’s wife, sister or daughter. Faunus was a fertility god, and his main task was to ensure the fields, animals and people flourished and were fertile.
In the stories in Roman mythology, fauns increasingly appeared as mythical creatures – half human, half animal, with horns, hooves and a tail, rather like the Greek satyrs. But fauns continued to be associated with fertility. Always sexually active, they liked nothing more than chasing nymphs – a subject taken up by innumerable painters, sculptures, poets and musicians, only further consolidating the reputation of fauns as salacious forest deities.
- Material & Technique
- before 1588
- Inventory number
- ZV 3205


Created to Preserve, Promote and Protect Open Class Kart Racing
Ingenuity / Camaraderie / Sportsmanship
4412 W 6th Ave.
Beaver Falls, PA 15101
Fax (724) 847-1566
|Calculating Engine Displacement|
How to Determine the Displacement of a Kart Engine
Here’s what you will need.
Step 1 Remove the cylinder head from the engine.
The engine should not need to be removed from the kart to do this although the
Step 2 Position piston at bottom dead center (BDC)
To accomplish this use insert the 5/16 hex key in the starter nut or place a socket on the clutch nut. Turn the hex key or socket wrench until the piston is all of the way down to the bottom of the cylinder. Another way to get the piston to bdc is to simply push the piston down with your finger.
Step 3 Measure and record the cylinder bore.
Use the digital or dial caliper to carefully measure the cylinder bore. Be very
A. Make sure that the piston is pushed all of the way down to the very bottom of the cylinder.
C. Insert the dial indicator into the hole in the bridge just enough for it
D. Turn the face of the dial indicator so that the needle is pointing to zero.
E. Slowly turn the crankshaft with one of the wrenches while watching the dial.
F. Count how many full times the needle revolves plus how many additional
G. Record the reading. This measurement is the stroke of the engine.
Step 5 Calculate the Displacement of the Engine
A. Plug your measurements into the following formula.
____________ X ___________ X _____________ X .7854 = Displacement
B. If the measurements were made using the metric system, in other words, in millimeters, the result will be the cubic centimeters of the engine. You now know what you need to know to calculate the entrant’s minimum weight.
C. If the measurements were made using the customary system, in other words, in inches, the result will be in cubic inches. This willneed to be converted to cubic centimeters.
D. To convert cubic inches to cubic centimeters;
__________ X 16.39 = _________ CC
Questions or comments about these instructions should be directed to;


Linux is an Operating System which build up on Linux Kernel with other Linux apps. So Kernel is the core of an OS. Linux Kernel is a Unix like OS Kernel. Linux Kernel was developed and created by Linus Torvalds in 1991 and that’s why the OS named as Linux. First prototype of Linux were released in 1991 and Version 1.0 was released on March 1994.
Now the latest stable version of Linux Kernel available is 4.7.5. Lot of Linux based distributions are available. Fedora (Red Hat), openSUSE (SUSE) and Ubuntu (Canonical Ltd.), Debian, Slackware, Gentoo, Arch Linux etc are some examples. But most important achievement and one of the best gift given by Linux to the world is “Embedded Linux”. Now in world almost all the electronic devices are controlled by Linux OS.
There is a big community who contributes for the development of Linux kernel. Linux is an open source. It comes under GNU General Public License (GPL) which is a free Software license.
Great Thanks to Linus Torvalds for presenting this wonderful OS. Also great thanks to the Linux contributors.


The course is comprised of twenty-eight (28) modules. Each module is comprised of topics.
- Modules emphasize critical thinking, problem-solving, collaboration, and the practical application of skills.
- Each module contains some way to practice and assess understanding, such as a lab or a Packet Tracer.
These module-level activities provide feedback and are designed to indicate learner’s mastery of the skills needed for the course. Learners can ensure their level of understanding well before taking a graded quiz or exam.
- Some topics may contain a Check Your Understanding interactive quiz, or some other way to assess understanding, such as a lab or a Packet Tracer. These topic-level assessments are designed to tell learners if they have a good grasp of the topic content, or if they need to review before continuing. Learners can ensure their level of understanding well before taking a graded quiz or exam. Check Your Understanding quizzes do not affect the learner’s overall grade.
- Rich multimedia content, including interactive activities, videos, and quizzes, addresses a variety of learning styles and helps stimulate learning and increase knowledge retention.
- Virtual environments simulate real-world cyber security threat scenarios and create opportunities for security monitoring, analysis and resolution.
- Hands-on labs help students develop critical thinking and complex problem-solving skills.
- Innovative assessments provide immediate feedback to support the evaluation of knowledge and acquired skills.
- Technical concepts are explained using language that works well for learners at all levels and embedded interactive activities break up reading of the content and help reinforce understanding.
- The curriculum encourages students to consider additional IT education but also emphasizes applied skills and hands-on experience
- Cisco Packet Tracer activities are designed for use with Packet Tracer 7.3 or later.
Cyber Ops Associate v1.0covers the knowledge and skills needed to successfully handle the tasks, duties, and responsibilities of an associate-level Cyber security Analyst working in a Security Operations Center (SOC). Upon completion of the Cyber Ops Associate v1.0 course, students will be able to perform the following tasks:
- Install virtual machines to create a safe environment for implementing and analyzing cyber security threat events
- Explain the role of the Cyber security Operations Analyst in the enterprise
- Explain the Windows Operating System features and characteristics needed to support cyber security analyses.
- Explain the features and characteristics of the Linux Operating System
- Analyze the operation of network protocols and services.
- Explain the operation of the network infrastructure.
- Classify the various types of network attacks
- Use network monitoring tools to identify attacks against network protocols and services
- Explain how to prevent malicious access to computer networks, hosts, and data.
- Explain the impacts of cryptography on network security monitoring
- Explain how to investigate endpoint vulnerabilities and attacks
- Evaluate network security alerts
- Analyze network intrusion data to identify compromised hosts and vulnerabilities.
- Apply incident response models to manage network security incidents.
Virtual Machine Lab Requirements
This course uses two virtual machines (VM).All labs require a single VM. The lab or student PCs should
meet the following requirements:


The Last Judgment is a triptych attributed to Flemish painter Hans Memling and painted between 1467 and 1471. It is now in the National Museum in Gdańsk in Poland. It was commissioned by Angelo Tani, an agent of the Medici at Bruges, but was captured at sea by Paul Beneke, a privateer from Danzig. (A lengthy lawsuit against the Hanseatic League demanded its return to Italy.) It was placed in the Basilica of the Assumption but in the 20th century it was moved to its present location.
The triptych depicts the Last Judgement during the second coming of Jesus Christ, the central panel showing Jesus sitting in judgment on the world, while St Michael the Archangel is weighing souls and driving the damned towards Hell (the sinner in St. Michael’s right-hand scale pan is a donor portrait of Tommaso Portinari); the left hand panel showing the saved being guided into heaven by St Peter and the angels; and the right-hand panel showing the damned being dragged to Hell.


Report on Erebus (Antarctica) — February 1981
Scientific Event Alert Network Bulletin, vol. 6, no. 2 (February 1981)
Managing Editor: Lindsay McClelland.
Erebus (Antarctica) Lava lake revisited; seismic and acoustic monitoring begin
Please cite this report as:
Global Volcanism Program, 1981. Report on Erebus (Antarctica) (McClelland, L., ed.). Scientific Event Alert Network Bulletin, 6:2. Smithsonian Institution. https://doi.org/10.5479/si.GVP.SEAN198102-390020.
77.53°S, 167.17°E; summit elev. 3794 m
All times are local (unless otherwise noted)
"The summit crater was visited by Japanese, New Zealand and U.S. scientists during late December and early January. A 1-day visit was also made in November. The anorthoclase phonolite lava lake was still present, although its level may have been slightly lower than that observed over the last 2 years. The 120-m-long oval-shaped lava lake still showed a simple convection pattern with lava apparently welling up from two centers about 1/3 of the way from each end.
"Small Strombolian eruptions continued at a frequency of 2-6/day. The noise associated with the eruptions consisted of a long drawn-out roar, contrasted with the strong explosive eruptions heard in previous years. Although no eruptions were witnessed they are believed to occur from the small Active Vent, adjacent to the lava lake. Very few bombs were found on the main crater rim during December, but in January there were a few sharper explosive eruptions and these ejected material onto the rim.
"The three nations commenced a new project and installed three permanent seismometers on the mountain. The seismometers have radio-telemetry links with Scott Base (the New Zealand research station on Ross Island). Two seismometer are on the W flank of the volcano at altitudes between 1,500 and 1,900 m about 5 km from the crater rim. It is anticipated that these stations will run until April, when darkness sets in. The stations should be reactivated in October, when new batteries will be installed and the solar panels will function. The third station is at the summit, and has its batteries buried in warm ground. It is hoped that it will operate all year round. The summit station is also transmitting the output from an acoustic sensor (a microphone which monitors the sounds of volcanic eruptions) and a large wire loop around the crater, which monitors induced currents. A fourth permanent seismic station will be installed in December 1981.
"Preliminary observations from the seismic network, which can detect events with magnitudes less than 1, indicate a surprisingly high level of microearthquake activity, with up to 10 events/day. Some of these are apparently tectonic earthquakes occurring some distance from Mt. Erebus. Antarctica has been considered aseismic, but this is apparently not the case, at least not for microearthquakes with magnitudes less than 3."
Geologic Background. Mount Erebus, the world's southernmost historically active volcano, overlooks the McMurdo research station on Ross Island. It is the largest of three major volcanoes forming the crudely triangular Ross Island. The summit of the dominantly phonolitic volcano has been modified by one or two generations of caldera formation. A summit plateau at about 3,200 m elevation marks the rim of the youngest caldera, which formed during the late-Pleistocene and within which the modern cone was constructed. An elliptical 500 x 600 m wide, 110-m-deep crater truncates the summit and contains an active lava lake within a 250-m-wide, 100-m-deep inner crater; other lava lakes are sometimes present. The glacier-covered volcano was erupting when first sighted by Captain James Ross in 1841. Continuous lava-lake activity with minor explosions, punctuated by occasional larger Strombolian explosions that eject bombs onto the crater rim, has been documented since 1972, but has probably been occurring for much of the volcano's recent history.
Information Contacts: P. Kyle, Ohio State Univ.


Education Video Series: Traffic Laws
While bike laws can vary widely from state to state, there are some foundational rules that all bicyclists should follow when they are on the road.
Here are some of the basics:
- First Come, First Served: Everyone on the road is entitled to the lane width they need. This includes the space behind, to each side and the space in front. If you want to use someone else’s space you must yield to whoever is using it.
- Ride on the Right: In the United States, everyone must drive on the right-hand side of the roadway.
- Yielding to Crossing Traffic: When you come to an intersection, if you don’t have the right of way, you must yield.
- Yielding when Changing Lanes: If you want to change lanes, you must yield to traffic that is in your new lane of travel.
- Speed Positioning: The slowest vehicles on the road should be the furthest to the right. Where you position yourself on the road depends on the location of any parked cars, your speed, and your destination. Always pass on the left.
- Lane Positioning: Bikes can share the same lane with other drivers. If a lane is wide enough to share with another vehicle (about 14 feet), ride three feet to the right of traffic. If the lane is not wide enough to share, “take the lane” by riding in the middle.
- Intersection positioning: When there is a lane that is used for more than one direction, use the rightmost lane going in the direction you are traveling.


3 Ways to Classify Hierarchy of Building in Architecture
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Hierarchy is created when an element appears more important in comparison to other elements in the design. Hierarchy in architecture is generally used in building design and construction to emphasise the particular thing or part in a building. It influences the order in which the human eye perceives what it sees! This order is created by the visual contrast between forms in a field of perception.
Must Read: Importance of Hierarchy in Architecture
The hierarchy in architecture is most often established through the use of its unique shape, size, colour, or placement. By following the design element or form it will be easily noticeable from the overall design which is aesthetically emphasised by an architect for the overall building design and construction.
There are three ways to classify hierarchy in architecture:
01. Create Hierarchy by Size
02. Create Hierarchy by Shape
03. Create Hierarchy by Placement
01. Create Hierarchy by Size:
A form or shape may dominate an architectural composition by being significantly different in size from all the other elements in the composition.
If one element is larger than another element in the design, it will appear more hierarchical. It is human’s natural tendency that we look at the largest element first in design. For example, if there are five arches in front façade of the building and one is twice the size of others; our attention will focus on the largest arch first for the particular building design and construction.
Normally, this dominance is made visible by the sheer (steep/vertical/transparent) size of an element
In some cases, an element can dominate by being significantly smaller than the other elements in the organisation, but placed in a well-defined setting.
02. Create Hierarchy by Shape:
A form or shape can be made visually dominant and thus important by clearly differentiating its shape from that of the other elements in the composition.
Generally, the differentiation in the hierarchy in architecture is based on a change in geometry or regularity. At the same time, it is also important that the shape selected for the hierarchically significant element be compatible with its functional use.
The element which has a different shape than other elements can also appear more hierarchical. We naturally look first at the irregular shape in building design and construction. The best example is the legislative assembly in Chandigarh which is designed by architect Le Corbusier. It is square in a plan where we can identify the hierarchy of space by the use of different structural forms as shown in figure i.e. entrance curvilinear roof, hyperbolic structure, pyramid roof.
03. Create Hierarchy by Placement:
A form or space may be strategically placed to call attention to itself as being the most important element in a composition.
Hierarchically important locations for a form or space for building design and construction include:
- The termination of a linear sequence or axial organisation.
- The centrepiece of the symmetrical organisation.
- The focus of a centralised or radial organisation.
- Being offset above, below, or in the foreground of a composition.


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Wikipedia PolicyLast Updated on 2013-07-25 15:19:16
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Thanks to mathematics, the quality of underwater photographs is about to get dramatically better. The first-of-its-kind method for radically improving underwater shots combines a mathematical formula or algorithm with a filter normally used for land photography.
"This is a brand new solution to solving the problem of underwater image degradation," notes lead researcher Professor Yoav Schechner of the Faculty of Electrical Engineering at the Technion - Israel Institute of Technology.
"Underwater photos tend to be degraded and lacking in clear details because of the 'veiling' effect of ambient light," explains Schechner. "From above the water's surface, ambient light scatters into the line of sight -- an effect commonly known as 'backscatter.' This causes poor visibility in even the clearest water." He adds that the veiling effect increases with distance, making many details undetectable.
Schechner and graduate student Nir Karpel realized that photographic images could be greatly improved by eliminating the backscatter effect. The two then developed an algorithm that -- combined with a polarizing filter readily available for $20 to $100 -- compensates for backscatter.
Once the photographs are taken using the filter, they are transferred to a computer program, which then applies the algorithm, compensating for the underwater image degradation caused by backscatter. Unlike standard photo imaging programs that treat a photographic image as a whole, the new method corrects different elements -- such as objects that are closer or distant -- individually, according to need.
According to the researchers, this process also provides estimates of underwater distances, resulting in improved picture quality and photographs with three-dimensional depth.
Schechner says the program could be placed on a chip embedded within the camera or be integrated with existing video systems to vastly improve underwater video quality. In the future, it could be utilized for a myriad of applications including engineering, marine biology and archeology, underwater mapping, recreational photography and underwater rescue. The researchers are negotiating commercialization of the program.
The findings by researchers at the Technion-Israel Institute of Technology were presented at the Institute of Electrical & Electronics Engineers (IEEE) Conference on Computer Vision and Pattern Recognition in Washington, DC in June.
Published by Globes [online] - www.globes.co.il - on Thursday, September 02, 2004


What does Claudia destruction of white baby dolls say about her relationship to the ideal of whiteness? In Toni Morning’s The Bluest Eye, we are presented with ideals of what it is to be black and how it is to be white and how society’s constructions of the ‘ideal’ human affects characters within this novel. Claudia Macerate is a young African-American girl who struggles with these ideas and societies notion of perfection. Claudia battles with her own identity and demonstrates her frustrations and self- hatred in outward behaviors.
Utilizing these themes around identity and idealism we will explore Claudia explosion of emotions in the form of her destroying of the dolls she received as a gift. The event in which Claudia sees this doll looking back at her with “round moronic eyes, the pancake face, and orangeroots hair’ (Morrison 18) strikes as a poignant note from her point of view. This doll that she had received was blonde haired, blue eyed with rosy pink cheeks, but more importantly she was white (Morrison 18).
The doll represented everything that Claudia wished she was but knew she could never be and this bred self-hate within herself. This was channeled into her sister, Fried and directly towards a young white girl they knew, Rosemary Villainous. Claudia direct hate for Rosemary was primarily due to the fact that Rosemary was everything Claudia wanted to be, white. Claudia feelings towards this doll and its representations is captured in this paragraph, “l had only one desire: to dismember it.
To see what it was made, to discover the dearness, to find the beauty, the desirability that had escaped me, but apparently only me. Adults, older girls, shops, magazines, newspapers, window signs- all the world ad agreed that a blue-eyed, yellow-haired, pink-skinned doll was what every girl child treasured”. (Morrison 18) Her aggressive behavior can also be seen as a positive personality trait for Claudia. As a young black girl, she recognizes the difficulties she faces beyond the realms of her own family and home.
She recognizes that she is judged because of her color and her opportunities are limited in contrast to the white population. The image of her dismembering the doll can be seen as her frustrations being channeled into an inanimate object that satisfies her resentment towards the white race. It also shows a form of inner strength. It highlights her ability to be able to stand as an individual rather than embracing her oppressed future as a sentence. Claudia has had love in her life in the form of her family and this has allowed her to learn by example.
Her mother is a strong woman and has taught her daughters that regardless of their situation, which often found them very poor and without material possessions, that love, protection, compassion and nationality are all the possessions she will need on her journey to becoming a strong woman. (Morrison 16) Claudia is growing up in a time where civil rights and women movements were on the rise after the initial movements took full flight in the sass’s at the conclusion Of a war time period.
The post- war baby boom meant that by the 1 ass’s the ‘generation of revolution’ (Gillis 1999) were young adults. This prompted an era of change. Claudia referred to dollied icons of the time such as Shirley Temple, to whom she dislikes for her ascetically acceptable perfections and instead found comfort and understanding to Jewish women of the Holocaust and less popular icons such as Jane Withers. This formed the notion that she admired women who rose above adversity to become successfully influential devoid of their imperfections and socially constructed shortcomings.
Claudia feels empathetic towards Pectoral and rather than join the groups of children, and adults alike, making fun of her and calling her ‘ugly’, she feels sad for her. Pectoral represents the oppression and the negative connotations that came tit being African American at that time. Claudia finds that she is surrounded by girls and women who idols celebrities that socially fit the idyllic ‘white’ mould and she finds it her responsibility to reject these socially constructed characters.
In Pectoral she sees abuse and neglect on both a personal and social level. Their community has been taught to embrace what is socially ‘beautiful’, which in essence is white. Whilst the African-American women cannot change their skin color they are influenced to take on traits that are socially desirable which include confidence, elegance and manner as well as dolling the beauty of popular culture icons such as Shirley Temple.
Pectoral is in essence why Claudia is against ‘whiteness<, Pecola longs to have blue eyes and blonde hair and to just 'fit in' to a world she historically will find it difficult to do so. Claudia's rejections of all white associations is a powerful message within the novel. The young girl is socially aware and finds that she does not agree with what she is being expected to idolise and embrace as a black woman. Pecola's longing for those blue eyes contrasts Claudia's societal rejections.
Claudia finds that Pectoral beholds everything she is against and what society has done to Pectoral byway of rejecting her as an individual and labeling her as being ‘ugly’ for rejecting ‘whiteness’. Claudia does not want to conform and therefore builds as an individual that does not long to be “blonde haired, blue eyed with rosy pink cheeks” (18), but a girl of resistance to what has socially been constructed to be expected of her. Claudia outward behavior allows the reader to see that she holds pride, strength, elf-belief, self-worth and intellect at a higher level than material possessions.


Paracetamol, also called Acetaminophen, is one of the most popular analgesic medicines for pain relief, especially during pregnancy. It is so widespread that any associated side effect could affect millions of patients around the world.
Indeed, a new study states that using paracetamol during pregnancy could restrain masculinity and lead to a flaccid sex drive during adult life.
The paper , published by a team of scientists from the university of Copenhagen in Denmark, adds further concerns to those raised in another paper from 2016. This latter had linked the use of paracetamol during pregnancy to the earlier female infertility during adulthood.
In 2015, another paper had found that, in addition to relieving pain, paracetamol may dull emotions. The CBS video below discusses this not so surprising side effect.
These discoveries revive the controversies that accompanied the famous pain killer since its first clinical trials in 1887. In that time, the German pharmacologist Joseph von Mering discarded it for its tendency to produce methemoglobinemia, a type of blood disorder. Paracetamol, and its derivatives, has then been overshadowed by aspirin for half a century, to be later rediscovered and marketed again in the United States in 1955.
 Prenatal exposure to paracetamol/acetaminophen and precursor aniline impairs masculinisation of male brain and behaviour