22 results
Geometry of stratified turbulent mixing: local alignment of the density gradient with rotation, shear and viscous dissipation
- Xianyang Jiang, Amir Atoufi, Lu Zhu, Adrien Lefauve, John R. Taylor, Stuart B. Dalziel, P.F. Linden
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- Journal:
- Journal of Fluid Mechanics / Volume 977 / 25 December 2023
- Published online by Cambridge University Press:
- 21 December 2023, R5
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We introduce a geometric analysis of turbulent mixing in density-stratified flows based on the alignment of the density gradient in two orthogonal bases that are locally constructed from the velocity gradient tensor. The first basis connects diapycnal mixing to rotation and shearing motions, building on the recent ‘rortex–shear decomposition’ in stratified shear layers (Jiang et al., J. Fluid Mech., vol. 947, 2022, A30), while the second basis connects mixing to the principal axes of the viscous dissipation tensor. Applying this framework to datasets taken in the stratified inclined duct laboratory experiment reveals that density gradients in locations of high shear tend to align preferentially (i) along the direction of minimum dissipation and (ii) normal to the plane spanned by the rortex and shear vectors. The analysis of the local alignment across increasingly turbulent flows offers new insights into the intricate relationship between the density gradient and dissipation, and thus diapycnal mixing.
Stratified inclined duct: two-layer hydraulics and instabilities
- Amir Atoufi, Lu Zhu, Adrien Lefauve, John R. Taylor, Rich R. Kerswell, Stuart B. Dalziel, Gregory A. Lawrence, P.F. Linden
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- Journal of Fluid Mechanics / Volume 977 / 25 December 2023
- Published online by Cambridge University Press:
- 19 December 2023, A25
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The stratified inclined duct (SID) sustains an exchange flow in a long, gently sloping duct as a model for continuously forced density-stratified flows such as those found in estuaries. Experiments have shown that the emergence of interfacial waves and their transition to turbulence as the tilt angle is increased appears to be linked to a threshold in the exchange flow rate given by inviscid two-layer hydraulics. We uncover these hydraulic mechanisms by (i) using recent direct numerical simulations (DNS) providing full flow data in the key flow regimes (Zhu et al., J. Fluid Mech., vol. 969, 2023, A20), (ii) averaging these DNS into two layers, and (iii) using an inviscid two-layer shallow-water and instability theory to diagnose interfacial wave behaviour and provide physical insight. The laminar flow is subcritical and stable throughout the duct and hydraulically controlled at the ends of the duct. As the tilt is increased, the flow becomes supercritical everywhere and unstable to long waves. An internal jump featuring stationary waves first appears near the centre of the duct, then leads to larger-amplitude travelling waves, and to stronger jumps, wave breaking and intermittent turbulence at the largest tilt angle. Long waves described by the (nonlinear) shallow-water equation are interpreted locally as linear waves on a two-layer parallel base flow described by the Taylor–Goldstein equation. This link helps us to interpret long-wave instability and contrast it with short-wave (e.g. Kelvin–Helmholtz) instability. Our results suggest a transition to turbulence in SID through long-wave instability relying on vertical confinement by the top and bottom walls.
Determinants of incomplete childhood hepatitis B vaccination in Sierra Leone, Liberia, and Guinea: Analysis of national surveys (2018–2020)
- George A. Yendewa, Peter B. James, Amir Mohareb, Umaru Barrie, Samuel P. E. Massaquoi, Sahr A. Yendewa, Manal Ghazzawi, Tahir Bockarie, Peterlyn E. Cummings, Ibrahima S. Diallo, Ambulai Johnson, Benjamin Vohnm, Lawrence S. Babawo, Gibrilla F. Deen, Mustapha Kabba, Foday Sahr, Sulaiman Lakoh, Robert A. Salata
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- Journal:
- Epidemiology & Infection / Volume 151 / 2023
- Published online by Cambridge University Press:
- 03 November 2023, e193
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Vaccination against hepatitis B virus (HBV) is effective at preventing vertical transmission. Sierra Leone, Liberia, and Guinea are hyperendemic West African countries; yet, childhood vaccination coverage is suboptimal, and the determinants of incomplete vaccination are poorly understood. We analyzed national survey data (2018–2020) of children aged 4–35 months to assess complete HBV vaccination (receiving 3 doses of the pentavalent vaccine) and incomplete vaccination (receiving <3 doses). Statistical analysis was conducted using the complex sample command in SPSS (version 28). Multivariate logistic regression was used to identify determinants of incomplete immunization. Overall, 11,181 mothers were analyzed (4,846 from Sierra Leone, 2,788 from Liberia, and 3,547 from Guinea). Sierra Leone had the highest HBV childhood vaccination coverage (70.3%), followed by Liberia (64.6%) and Guinea (39.3%). Within countries, HBV vaccination coverage varied by socioeconomic characteristics and healthcare access. In multivariate regression analysis, factors that were significantly associated with incomplete vaccination in at least one country included sex of the child, Muslim mothers, lower household wealth index, <4 antenatal visits, home delivery, and distance to health facility vaccination (all p < 0.05). Understanding and addressing modifiable determinants of incomplete vaccination will be essential to help achieve the 2030 viral hepatitis elimination goals.
Stratified inclined duct: direct numerical simulations
- Lu Zhu, Amir Atoufi, Adrien Lefauve, John R. Taylor, Rich R. Kerswell, Stuart B. Dalziel, Gregory A. Lawrence, P.F. Linden
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- Journal:
- Journal of Fluid Mechanics / Volume 969 / 25 August 2023
- Published online by Cambridge University Press:
- 15 August 2023, A20
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The stratified inclined duct (SID) experiment consists of a zero-net-volume exchange flow in a long tilted rectangular duct, which allows the study of realistic stratified shear flows with sustained internal forcing. We present the first three-dimensional direct numerical simulations (DNS) of SID to explore the transitions between increasingly turbulent flow regimes first described by Meyer & Linden (J. Fluid Mech., vol. 753, 2014, pp. 242–253). We develop a numerical set-up that faithfully reproduces the experiments and sustains the flow for arbitrarily long times at minimal computational cost. We recover the four qualitative flow regimes found experimentally in the same regions of parameter space: laminar flow, waves, intermittent turbulence and fully developed turbulence. We find good qualitative and quantitative agreement between DNS and experiments and highlight the added value of DNS to complement experimental diagnostics and increase our understanding of the transition to turbulence, both temporally (laminar/turbulent cycles) and parametrically (as the tilt angle of the duct and the Reynolds number are increased). These results demonstrate that numerical studies of SID – and deeper integration between simulations and experiments – have the potential to lead to a better understanding of stratified turbulence.
First confirmed records of white-coat pups of the Endangered Caspian seal Pusa caspica on the coast of Iran
- Amir S. Shirazi, Ali T. Qashqaei, Samaneh Faezi, Seyedreza Khaleghi, Nikta Moghaddamipour, Tara Ebrahimi, Shadi Karbalaei Hassan, B. Louise Chilvers
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The endemic Caspian seal Pusa caspica breeds on land-fast ice or stable drift ice in the northern Caspian Sea. Breeding has rarely been reported in the ice-free south-eastern Caspian Sea. Five carcases of white-coat Caspian seal pups were recovered from the southern Caspian Sea, Iran, during 2019–2022. From survey interviews, two white-coat Caspian seal pups were also observed in Amirabad and between Ghorogh and Rudsar. These records represent very late pupping dates compared to normal pupping periods. Coastal Iran should be surveyed annually for Caspian seal pups to determine frequency of breeding and areas of importance identified in the Iran Caspian Seal Action Plan.
Chapter 8 - Fertility Counseling beyond 40
- from Section 5 - Optimal Deployment of ART beyond 40
- Edited by Dimitrios S. Nikolaou, David B. Seifer
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- Book:
- Optimizing the Management of Fertility in Women over 40
- Published online:
- 15 September 2022
- Print publication:
- 06 October 2022, pp 98-105
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Summary
Two main fertility challenges women over 40 face are decreased oocyte quality and quantity. Age is the most significant predictor of oocyte quality. There is no reliable test aimed at evaluating a single oocyte quality in vivo or in vitro following oocyte retrieval or just prior to fertilization. On the other hand, there are good ovarian reserve tests aimed at estimating the residual follicular pool in aging women: AMH, AFC, and cycle day 2-4 FSH. Each have acceptable specificity for detecting diminished ovarian reserve. The majority of clinicians prefer AMH over AFC and FSH due to its technical simplicity, lower intra- and intercycle variability and increased prognostic value in the context of older women 43,44. Once stating a desire to conceive, women who are 40 or older should have an immediate comprehensive infertility evaluation that must include prompt ovarian reserve testing. Lifestyle changes including nutrition, vitamins, exercise, stress reduction and adequate sleep can only assist in the goal. Lastly, preparation, engagement and support of a team of professionals are essential to approach conceiving over the age of 40.
Risk of bacterial bloodstream infection does not vary by central-line type during neutropenic periods in pediatric acute myeloid leukemia
- Caitlin W. Elgarten, William R. Otto, Luke Shenton, Madison T. Stein, Joseph Horowitz, Catherine Aftandilian, Staci D. Arnold, Kira O. Bona, Emi Caywood, Anderson B. Collier, M. Monica Gramatges, Meret Henry, Craig Lotterman, Kelly Maloney, Arunkumar J. Modi, Amir Mian, Rajen Mody, Elaine Morgan, Elizabeth A. Raetz, Anupam Verma, Naomi Winick, Jennifer J. Wilkes, Jennifer C. Yu, Richard Aplenc, Brian T. Fisher, Kelly D. Getz
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 2 / February 2023
- Published online by Cambridge University Press:
- 25 April 2022, pp. 222-229
- Print publication:
- February 2023
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Background:
Bloodstream infections (BSIs) are a frequent cause of morbidity in patients with acute myeloid leukemia (AML), due in part to the presence of central venous access devices (CVADs) required to deliver therapy.
Objective:To determine the differential risk of bacterial BSI during neutropenia by CVAD type in pediatric patients with AML.
Methods:We performed a secondary analysis in a cohort of 560 pediatric patients (1,828 chemotherapy courses) receiving frontline AML chemotherapy at 17 US centers. The exposure was CVAD type at course start: tunneled externalized catheter (TEC), peripherally inserted central catheter (PICC), or totally implanted catheter (TIC). The primary outcome was course-specific incident bacterial BSI; secondary outcomes included mucosal barrier injury (MBI)-BSI and non-MBI BSI. Poisson regression was used to compute adjusted rate ratios comparing BSI occurrence during neutropenia by line type, controlling for demographic, clinical, and hospital-level characteristics.
Results:The rate of BSI did not differ by CVAD type: 11 BSIs per 1,000 neutropenic days for TECs, 13.7 for PICCs, and 10.7 for TICs. After adjustment, there was no statistically significant association between CVAD type and BSI: PICC incident rate ratio [IRR] = 1.00 (95% confidence interval [CI], 0.75–1.32) and TIC IRR = 0.83 (95% CI, 0.49–1.41) compared to TEC. When MBI and non-MBI were examined separately, results were similar.
Conclusions:In this large, multicenter cohort of pediatric AML patients, we found no difference in the rate of BSI during neutropenia by CVAD type. This may be due to a risk-profile for BSI that is unique to AML patients.
Does the Prosperity of a Country Play a Role in COVID-19 Outcomes?
- Amir Khorram-Manesh, Eric Carlström, Attila J. Hertelendy, Krzysztof Goniewicz, Carter B. Casady, Frederick M. Burkle, Jr.
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 16 / Issue 1 / February 2022
- Published online by Cambridge University Press:
- 12 August 2020, pp. 177-186
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Objective:
This study aims to clarify the association between prosperity and the coronavirus disease (COVID-19) outcomes and its impact on the future management of pandemics.
Methods:This is an observational study using information from 2 online registries. The numbers of infected individuals and deaths and the prosperity rank of each country were obtained from worldometer.info and the Legatum Institute’s Prosperity Index, respectively.
Results:There is a combination of countries with high and low prosperity on the list of COVID-19-infected countries. The risk of the virus pandemic seems to be more extensive in countries with high prosperity. A Spearman’s rho test confirmed a significant correlation between prosperity, the number of COVID-19 cases, and the number of deaths at the 99% level.
Conclusion:New emerging pandemics affect all nations. In order to increase the likelihood of successfully managing future events, it is important to consider preexisting health security, valid population-based management approaches, medical decision-making, communication, continuous assessment, triage, treatment, early and complete physical distancing strategies, and logistics. These elements cannot be taught on-site and on occasion. There is a need for innovative and regular educational activities for all stakeholders committed to safeguarding our future defense systems concerning diagnostic, protection, treatment, and rehabilitation in pandemics, as well as other emergencies.
Group interpersonal psychotherapy for maternal depression an exploratory randomized control trial
- H. Nusrat, N. Zehra, B. Amir, C. Nasim, K. tayyeba, Z. Shehla, F. Batool, H. Meher, N. Farooq
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- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S413-S414
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Introduction
The global burden of depression is high for women in both high income and low-and-middle income countries WHO. Depression is particularly common during pregnancy and in the postnatal period and phenomenology said to be the same as in non-child bearing age. Despite high prevalence of prenatal and postnatal depression in Pakistan, research on the effectiveness of psychological interventions is limited.
AimsThis study aimed to assess the feasibility of group interpersonal psychotherapy (IPT) intervention for maternal depression in Karachi, Pakistan.
MethodsA total of 50 mothers aged 18 years and above with children below 3 years of age, and experiencing mild to moderate depression were recruited. Assessments were done using Edinburgh Postnatal Depression Scale (EPDS) Rosenberg's Self-Esteem Scale and EuroQol-5D at baseline, 3 months, and 6 months. Rosenberg's Self-Esteem Scale and EQ-5D were also used to measure self-esteem and health related quality of life. Participants were randomly assigned into IPT plus treatment as usual (TAU) and TAU groups. Ten sessions of group IPT were delivered to intervention group.
ResultsResults indicated significant difference between intervention and control group on EPDS. The mean score at baseline for the IPT group (mean = 14.76) reduced to (mean = 6.40) (P < 0.000) at 3-month and to (mean = 6.64) (P < 0.001) at 6-month intervals as compared to TAU (mean = 11.44) (P < 0.000) at 3-month and to (mean = 11.08) at 6-month (P < 0.001) after randomisation.
ConclusionIPT is a successful fit for women with maternal depression in low-income areas and IPT can be the appropriate treatment option as it is time limited, specific, and evidence based.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
An unusual presentation of a large cardiac mass
- Mitchell I. Cohen, Lucas R. Collazo, Alexandru Firan, Amir Dangol, Melany B. Atkins
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- Cardiology in the Young / Volume 29 / Issue 12 / December 2019
- Published online by Cambridge University Press:
- 05 November 2019, pp. 1549-1551
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We present a case of a large left ventricular capillary haemangioma incidentally discovered in a pre-adolescent patient.
Forced motion of a cylinder within a liquid-filled elastic tube – a model of minimally invasive medical procedures
- Amit Vurgaft, Shai B. Elbaz, Amir D. Gat
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- Journal:
- Journal of Fluid Mechanics / Volume 881 / 25 December 2019
- Published online by Cambridge University Press:
- 29 October 2019, pp. 1048-1072
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This work analyses the viscous flow and elastic deformation created by the forced axial motion of a rigid cylinder within an elastic liquid-filled tube. The examined configuration is relevant to various minimally invasive medical procedures in which slender devices are inserted into fluid-filled biological vessels, such as vascular interventions, interventional radiology, endoscopies and laparoscopies. By applying the lubrication approximation, thin shell elastic model, as well as scaling analysis and regular and singular asymptotic schemes, the problem is examined for small and large deformation limits (relative to the gap between the cylinder and the tube). At the limit of large deformations, forced insertion of the cylinder is shown to involve three distinct regimes and time scales: (i) initial shear dominant regime, (ii) intermediate regime of dominant fluidic pressure and a propagating viscous-peeling front, (iii) late-time quasi-steady flow regime of the fully peeled tube. A uniform solution for all regimes is presented for a suddenly applied constant force, showing initial deceleration and then acceleration of the inserted cylinder. For the case of forced extraction of the cylinder from the tube, the negative gauge pressure reduces the gap between the cylinder and the tube, increasing viscous resistance or creating friction due to contact of the tube and cylinder. Matched asymptotic schemes are used to calculate the dynamics of the near-contact and contact limits. We find that the cylinder exits the tube in a finite time for sufficiently small or large forces. However, for an intermediate range of forces, the radial contact creates a steady locking of the cylinder inside the tube.
Biological and Behavioral Patterns of Post-Stroke Depression in Rats
- Gal Ifergane, Matthew Boyko, Dmitri Frank, Honore N. Shiyntum, Julia Grinshpun, Ruslan Kuts, Amir B. Geva, Zeev Kaplan, Vladimir Zeldetz, Hagit Cohen
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 45 / Issue 4 / July 2018
- Published online by Cambridge University Press:
- 08 June 2018, pp. 451-461
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Background: Post-stroke depression (PSD) is the most frequent psychiatric complication following ischemic stroke. It affects up to 60% of all patients and is associated with increased morbidity and mortality following ischemic stroke. The pathophysiology of PSD remains elusive and appears to be multifactorial, rather than “purely” biological or psychosocial in origin. Thus, valid animal models of PSD would contribute to the study of the etiology (and treatment) of this disorder. Methods: The present study depicts a rat model for PSD, using middle cerebral artery occlusion (MCAO). The two-way shuttle avoidance task, Porsolt forced-swim test, and sucrose preference test were employed to assess any depression-like behavior. Localized brain expressions of brain-derived neurotrophic factor (BDNF) protein levels were evaluated to examine the possible involvement of the brain neuronal plasticity in the observed behavioral syndrome. The raw data were subjected to unsupervised fuzzy clustering (UFC) algorithms to assess the sensitivity of bio-behavioral measures indicative of depressive symptoms post MCAO. Results: About 56% of the rats developed significant depressive-like behavioral disruptions as a result of MCAO compared with 4% in the sham-operated control rats. A pattern of a depressive-like behavioral response was common to all affected MCAO animals, characterized by significantly more escape failures and reduced number of total avoidance shuttles, a significant elevation in immobility duration, and reduced sucrose preference. Significant downregulations of BDNF protein levels in the hippocampal sub-regions, frontal cortex, and hypothalamus were observed in all affected MCAO animals. Conclusion: The UFC analysis supports the behavioral analysis and thus, lends validity to our results.
Transient gas flow in elastic microchannels
- Shai B. Elbaz, Hila Jacob, Amir D. Gat
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- Journal:
- Journal of Fluid Mechanics / Volume 846 / 10 July 2018
- Published online by Cambridge University Press:
- 08 May 2018, pp. 460-481
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We study pressure-driven propagation of gas into a two-dimensional microchannel bounded by linearly elastic substrates. Relevant fields of application include lab-on-a-chip devices, soft robotics and respiratory flows. Applying the lubrication approximation, the flow field is governed by the interaction between elasticity and viscosity, as well as weak rarefaction and low-Mach-number compressibility effects, characteristic of gaseous microflows. A governing equation describing the evolution of channel height is derived for the problem. Several physical limits allow simplification of the governing equation and solution by self-similarity. These limits, representing different physical regimes and their corresponding time scales, include compressibility–elasticity–viscosity, compressibility–viscosity and elasticity–viscosity dominant balances. Transition of the flow field between these regimes and corresponding exact solutions is illustrated for the case of an impulsive mass insertion in which the order of magnitude of the deflection evolves in time. For an initial channel thickness which is similar to the elastic deformation generated by the background pressure, a symmetry between compressibility and elasticity allows us to obtain a self-similar solution which includes weak rarefaction effects. The presented results are validated by numerical solutions of the evolution equation.
Attentional Bias Modification for Social Anxiety Disorder: What do Patients Think and Why does it Matter?
- Jennie M. Kuckertz, Casey A. Schofield, Elise M. Clerkin, Jennifer Primack, Hannah Boettcher, Risa B. Weisberg, Nader Amir, Courtney Beard
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- Journal:
- Behavioural and Cognitive Psychotherapy / Volume 47 / Issue 1 / January 2019
- Published online by Cambridge University Press:
- 06 May 2018, pp. 16-38
- Print publication:
- January 2019
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Background: In the past decade, a great deal of research has examined the efficacy and mechanisms of attentional bias modification (ABM), a computerized cognitive training intervention for anxiety and other disorders. However, little research has examined how anxious patients perceive ABM, and it is unclear to what extent perceptions of ABM influence outcome. Aims: To examine patient perceptions of ABM across two studies, using a mixed methods approach. Method: In the first study, participants completed a traditional ABM program and received a hand-out with minimal information about the purpose of the task. In the second study, participants completed an adaptive ABM program and were provided with more extensive rationale and instructions for changing attentional biases. Results: A number of themes emerged from qualitative data related to perceived symptom changes and mechanisms of action, acceptability, early perceptions of the program, barriers/facilitators to engagement, and responses to adaptive features. Moreover, quantitative data suggested that patients’ perceptions of the program predicted symptom reduction as well as change in attentional bias. Conclusions: Our quantitative data suggest that it may be possible to quickly and inexpensively identify some patients who may benefit from current ABM programs, although our qualitative data suggest that ABM needs major modifications before it will be an acceptable and credible treatment more broadly. Although the current study was limited by sample size and design features of the parent trials from which these data originated, our findings may be useful for guiding hypotheses in future studies examining patient perceptions towards ABM.
RELATIVE HILBERT CO-EFFICIENTS
- Part of
- AMIR MAFI, TONY J. PUTHENPURAKAL, RAKESH B. T. REDDY, HERO SAREMI
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- Journal:
- Glasgow Mathematical Journal / Volume 59 / Issue 3 / September 2017
- Published online by Cambridge University Press:
- 01 March 2017, pp. 729-741
- Print publication:
- September 2017
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Let (A, ${\mathfrak{m}$) be a Cohen–Macaulay local ring of dimension d and let I ⊆ J be two ${\mathfrak{m}$-primary ideals with I a reduction of J. For i = 0,. . .,d, let eiJ(A) (eiI(A)) be the ith Hilbert coefficient of J (I), respectively. We call the number ci(I, J) = eiJ(A) − eiI(A) the ith relative Hilbert coefficient of J with respect to I. If GI(A) is Cohen–Macaulay, then ci(I, J) satisfy various constraints. We also show that vanishing of some ci(I, J) has strong implications on depth GJn(A) for n ≫ 0.
Conservation challenges regarding species status assessments in biogeographically complex regions: examples from overexploited reptiles of Indonesia
- Kyle J. Shaney, Elijah Wostl, Amir Hamidy, Nia Kurniawan, Michael B. Harvey, Eric N. Smith
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IUCN Red List assessments are important for conservation and management initiatives. However, status assessments are often challenging because of poor sampling between biogeographical regions. Researchers sometimes assess poorly known species, which can have unforeseen ramifications, including the trade of rare and cryptic species under common species names. Here, we address this issue in relation to economically important reptile species in Indonesia. We reviewed examples of single species categorized as Least Concern for which the assessments probably encompassed multiple closely related species. We also examined Red List assessments that utilized species distribution modelling techniques, and identified biogeography as a major barrier to using such methods. To test how biogeography may affect status assessments we used our own model lizard system from Indonesia, taking an integrative phylogeographical approach to quantify status assessments under contrasting scenarios. We show that failure to account for biogeographical breaks leads to significant variation in Red List status. Our model system fluctuates from Least Concern to Endangered, depending upon whether biogeographical boundaries are considered in taxonomic evaluations. We identify Sauria (lizards) and Serpentes (snakes) as major lineages requiring taxonomic and conservation attention in Indonesia. We also make the following recommendations: (1) Indonesia's trade quotas should further subdivide management zones to account for gaps in taxonomic evaluations; (2) genetic sampling should be considered a high priority during wildlife exportation processes from poorly studied geographical areas; and (3) continuation of thorough biological inventory is critical for conservation initiatives across heterogeneous mountain and island landscapes.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. 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Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. 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Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Management of Traumatic Liver Injuries without a Valid Trauma System
- Amir Khorram-Manesh, B. Pourseidi
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- Journal:
- Prehospital and Disaster Medicine / Volume 24 / Issue 4 / August 2009
- Published online by Cambridge University Press:
- 28 June 2012, pp. 349-355
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- August 2009
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Introduction:
Despite a global increase in conservative treatment of blunt liver injuries, the number of surgically treated traumas in one major trauma center in Iran has increased. The aim of this study was to unveil the reasons behind this increase in operative management by studying 228 consecutive patients at this regional center.
Hypothesis:The increased number of liver injuries operated upon is due to the lack of a solid, well-defined trauma system.
Methods:A retrospective review of all patients admitted for liver trauma at Bahonar Hospital, Kerman, Iran, from March 2001 until March 2006 was conducted. Patient data were collected, studied and statistically processed with regard to demographics, clinical and laboratory findings, surgical procedures, complications, and mortality.
Results:All patients who were admitted between 30–360 minutes after injury were included. Twelve hemodynamically stable patients were treated conservatively in an ordinary surgical ward.The remaining 216 patients, 153 of whom had blunt injuries, were hemodynamically unstable. A total of 70 patients were in hemorrhagic shock at the time of arrival. Hemodynamically unstable patients with either the suspicion of associated injuries and/or who displayed clinical deterioration and could not be observed in an ordinary surgical ward were treated surgically. The majority of patients who were operated upon in this series had a grade-II liver injury. The total mortality rate in surgically treated patients was 18.1%. None of the patients treated conservatively died.
Conclusions:Despite the low grade of their liver injuries, the high number of surgically treated patients in this series was due to the absence of a valid trauma system. This result should encourage the authorities to review current trauma systems and trauma surgical guidelines.
(K118) Development of a Simulation Model for Evaluation and Comparison of Different Triage Methods
- Kristina B. Lennquist Montan, Amir Khorram-Manesh, Per Örtenwall
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- Journal:
- Prehospital and Disaster Medicine / Volume 24 / Issue S1 / February 2009
- Published online by Cambridge University Press:
- 17 February 2017, p. s144
- Print publication:
- February 2009
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List of Contributors
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- By Harold P. Adams, Colum F. Amory, Anne Angelillo-Scherrer, Irena Anselm, Marcel Arnold, Robert W. Baloh, Ralf W. Baumgartner, José Biller, Valérie Biousse, Matthias Bischof, Julien Bogousslavsky, Natan M. Bornstein, Marie Germaine Bousser, Robin L. Brey, John C. M. Brust, Alan Bryer, Olivier Calvetti, Louis R. Caplan, José Castillo, Hugues Chabriat, Chin-Sang Chung, Charlotte Cordonnier, Steven C. Cramer, Luís Cunha, Rima M. Dafer, John F. Dashe, Cyrus K. Dastur, Antonio Dávalos, Larry E. Davis, Patricia Davis, Stephen M. Davis, Jan L. De Bleecker, Michael A. De Georgia, Amir R. Dehdashti, Oscar H. Del Brutto, Jacques L. De Reuck, Hans-Christoph Diener, Kathleen B. Digre, Vivian U. Fritz, Nancy Futrell, Bhuwan P. Garg, Philip B. Gorelick, Glenn D. Graham, Alexander Y. Gur, John J. Halperin, Michael Hennerici, Isabel Lestro Henriques, Roberto C. Heros, Daniel B. Hier, Lorenz Hirt, Joanna C. Jen, Taro Kaibara, Sumit Kapoor, Sarosh M. Katrak, Siddharth Kharkar, Walter J. Koroshetz, Monisha Kumar, Sandeep Kumar, Emre Kumral, Tobias Kurth, Rogelio Leira, Steven R. Levine, Didier Leys, Doris Lin, Jonathan Lipton, Alfredo M. Lopez-Yunez, Betsy B. Love, Ayrton Roberto Massaro, Heinrich P. Mattle, Manu Mehdiratta, John H. Menkes, Philippe Metellus, Reto Meuli, Patrik Michel, Panayiotis Mitsias, Jorge Moncayo-Gaete, Julien Morier, Krassen Nedeltchev, Bernhard Neundörfer, Olukemi A. Olugemo, Nikolaos I. H. Papamitsakis, Stephen D. Reck, Luca Regli, Marc D. Reichhart, Daniele Rigamonti, Michael J. Rivkin, E. Steve Roach, Jose F. Roldan, David Z. Rose, Daniel M. Rosenbaum, N. Paul Rosman, Elayna O. Rubens, Sean I. Savitz, Marc Schapira, Robert J. Schwartzman, Magdy Selim, Yukito Shinohara, Aneesh B. Singhal, Michael A. Sloan, Barney J. Stern, Mathias Sturzenegger, Oriana Thompson, A. Wesley Thevathasan, Jonathan D. Trobe, Michael Varner, Dana Védy, Jorge Vidaurre, Engin Y. Yilmaz, Khaled Zamel, Mathieu Zuber
- Edited by Louis R. Caplan, Julien Bogousslavsky
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- Book:
- Uncommon Causes of Stroke
- Published online:
- 06 January 2010
- Print publication:
- 09 October 2008, pp ix-xiv
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