An epidemic of roller-blade injuries in children

Roller blading is a new and increasingly popular leisure activity in many countries. We reviewed 110 consecutive patients with roller-blade injuries between 1 January and 30 June 1996. The patients ranged from 4 to 14 years in age (mean 6.5 years). Eighty-three (75.4%) sustained injuries to the upper limb and 27 (24.5%) injured the lower limb. Fifty-six patients, were girls and 54 were boys. Of the 110 patients, 79 (72.7%) sustained fractures, 28 (25.4%) soft tissue injuries and 3 (2.7%) dislocations. Eighty-three (75.4%) of the patients wore no protective equipment on the limbs. Four months following injury 103 (93.6%) patients were fully recovered. The mean duration of school absence was 3 days. Subsequently 101 children returned to using roller-blades following injury. Seventy-three (66.3%) of these now use protective equipment. We found that injuries were unrelated to age or duration of roller-blading experience or to the brand-name of roller blades used, and that most of our patients wore no protective equipment at the time of injury.     

Prevalence of multiple cardiovascular disease risk factors among women in the United States, 1992 and 1995: the Behavioral Risk Factor Surveillance System

We sought to examine the prevalence of self-reported multiple cardiovascular disease (CVD) risk factors (hypertension, high blood cholesterol, diabetes, overweight, and current smoking) among women in 1992 and 1995 in the United States using data from the Behavioral Risk Factor Surveillance System. In 1992, 37.5%, 34.4%, and 28.1% of women had zero, one, and two or more of the five risk factors, respectively. In 1995, the respective estimates were 35.5%, 34.3%, and 30%. In both years, the prevalence of two or more risk factors increased with age, decreased with educational level, was higher among black women (lowest among Hispanic women and women of other ethnic groups), and higher among women reporting cost as a barrier to healthcare. The percentage of women with two or more risk factors was higher in 1995 than in 1992 for 35 of 48 states, being statistically significant for 7 states. The percentage of women with at least two risk factors was not significantly lower in 1995 than in 1992 for any state. A higher percentage of women reported having multiple CVD risk factors in 1995 compared with 1992. A multifactorial approach to primary prevention and risk factor reduction should be encouraged to help reduce the prevalence and burden of CVD among women.     

Lung reduction surgery in chronic obstructive lung disease

In the 1960s the promise of the Brantigan lung reduction surgery was shattered when it was shown that the improvement in airway conductance drifted back towards the preoperative value over a period of 12 to 18 months. Since then there has been a marked improvement in our understanding of emphysema, its pathology, and techniques for obtaining images of the lung. In addition, reliable automated cardiopulmonary and physiologic testing, advances in critical care medicine, and new pharmacologic agents have improved patient care. Surgical techniques now allow better control of air leaks and access to anatomic regions not previously accessible. The combination of all of the above makes lung reduction surgery worth re-examining as a palliative procedure for severely symptomatic patients. Clearly, it is not a panacea but can in some cases produce dramatic improvements in symptomatology and quality of life. This article presents the available data describing potential mechanisms of improvement and clinical outcomes following lung reduction surgery. It also outlines areas that need further work, such as patient selection and surgical techniques.     

Prevention of neonatal group B streptococcal infection

Neonatal group B streptococcal infection is the primary cause of neonatal morbidity related to infection. It can often be prevented by identifying and treating pregnant women who carry group B streptococci or who are at highest risk of transmitting the bacteria to newborns. Increasing evidence and expert opinion support intrapartum treatment of women at relatively high risk of delivering an infant with group B streptococcal infection. Such women can be identified through the use of an anogenital culture for group B streptococci obtained at 35 to 37 weeks of gestation and by the presence of at least one of many risk factors associated with neonatal infection. These risk factors include preterm labor or rupture of the membranes at less than 37 weeks of gestation, previous delivery of an infant with invasive group B streptococcal disease, group B streptococcal bacteriuria during the present pregnancy, maternal intrapartum fever of 38 degrees C (100.4 degrees F) or higher and rupture of the fetal membranes for 18 hours or more. The recommended agent for intrapartum chemoprophylaxis is intravenous penicillin G; clindamycin is used in penicillin-allergic women. The use of risk markers alone to guide the administration of intrapartum antibiotics is much more cost-effective than other preventive strategies, but it exposes more women and infants to antibiotic-associated risks. Management of the infants of treated mothers is empiric and is currently guided by expert opinion.     

Interfacial Connections between Organic Perovskite/n+ Silicon/Catalyst that Allow Integration of Solar Cell and Catalyst for Hydrogen Evolution from Water

The rapidly increasing solar conversion efficiency (PCE) of hybrid organic–inorganic perovskite (HOIP) thin-film semiconductors has triggered interest in their use for direct solar-driven water splitting to produce hydrogen. However, application of these low-cost, electronic-structure-tunable HOIP tandem photoabsorbers has been hindered by the instability of the photovoltaic-catalyst-electrolyte (PV+E) interfaces. Here, photolytic water splitting is demonstrated using an integrated configuration consisting of an HOIP/n⁺silicon single junction photoabsorber and a platinum (Pt) thin film catalyst. An extended electrochemical (EC) lifetime in alkaline media is achieved using titanium nitride on both sides of the Si support to eliminate formation of insulating silicon oxide, and as an effective diffusion barrier to allow high-temperature annealing of the catalyst/TiO₂-protected-n⁺silicon interface necessary to retard electrolytic corrosion. Halide composition is examined in the (FA_1-xCs_x)PbI₃ system with a bandgap suitable for tandem operation. A fill factor of 72.5% is achieved using a Spiro-OMeTAD-hole-transport-layer (HTL)-based HOIP/n⁺Si solar cell, and a high photocurrent density of −15.9 mA cm⁻² (at 0 V vs reversible hydrogen electrode) is attained for the HOIP/n⁺Si/Pt photocathode in 1 m NaOH under simulated 1-sun illumination. While this thin-film design creates stable interfaces, the intrinsic photo- and electro-degradation of the HOIP photoabsorber remains the main obstacle for future HOIP/Si tandem PEC devices.     

High repetition rate collisional soft X-ray lasers based on grazing incidence pumping

We discuss the demonstration of gain-saturated high repetition rate table-top soft X-ray lasers producing microwatt average powers at wavelengths ranging from 13.9 to 33 nm. The results were obtained heating a precreated plasma with a picosecond optical laser pulse impinging at grazing incidence onto a precreated plasma. This pumping geometry increases the energy deposition efficiency of the pump beam into the gain region, making it possible to saturate soft X-ray lasers in this wavelength range with a short pulse pump energy of only 1 J at 800-nm wavelength. Results corresponding to 5-Hz repetition rate operation of gain-saturated 14.7-nm Ni-like Pd and 32.6-nm line Ne-like Ti lasers pumped by a table-top Ti:sapphire laser are reported. We also discuss results obtained using a 1 /spl omega/1054-nm prepulse and 2 /spl omega/527-nm short pulse from a Nd:glass pump laser. This work demonstrates the feasibility of producing compact high average power soft X-ray lasers for applications.     

Summative evaluation of the SINCGARS Tutor

In an earlier set of studies with a different Intelligently Coached Simulation (Orey, M.A., Fan, H., Park, J., Tzeng, S., & Gustafson, K. (1995). Evaluation of Device operator in a context of a coached simulation environment), we found a retention and a transfer problem. We tried to solve these problems while building a new Intelligently Coached Simulation (the SINCGARS Tutor). The solutions to the two problems were to use an interactive conceptual model for the retention problem and we used photographs of the equipment as the visuals of the simulation. We then tested this new tutor with a group of 22 officers who were not only required to know how to operate the SINCGARS radio, but would be responsible for teaching others in their unit when their training was complete. We had one group of officers train on the real equipment, in pairs, with one instructor available for guidance. The other group of 11 learned via the SINCGARS Tutor. The post test was to put an actual radio into operation while being observed by a trained observer. Results indicate that not only did the transfer problem go away, but officers trained on the computer performed the task more accurately both initially on the immediate post test and again on a surprise four-week delayed post test. The SINCGARS Tutor was found to be a very good training solution.     

Defining resilience for the US building industry

ABSTRACT

Initiatives to operationalize the concept of resilience in the building industry are rapidly emerging. The concept of resilience has introduced a way to explore solutions to some important problems in the building industry. However, much of the work that has taken place to date represents activities generally assigned to risk management, which is discussed as being inherently insufficient for sustaining the functions of the built environment under stresses. This commentary considers the opportunities and limitations for mainstreaming resilience into building industry processes and actors. Barriers include indeterminate analytical meaning, event and performance uncertainty, immature regulatory standards setting, and untested enterprise economics. Further, the multiple outcomes of recovery and the relationship between building recovery and adaptation are discussed and, along with economics of resilience investments, a research need highlighted. A simple heuristic is presented to illustrate the complement of resilience to risk management and advance the integration of resilience into existing industry workflows.     

The belief-based emotion of suprise: The case for a lag in understanding relative to false belief.

Three experiments were carried out to determine whether there is a lag in predicting surprise relative to false belief. All 3 experiments used "backwards reasoning" tasks. The findings were that ( a ) there is a lag in predicting surprise relative to false belief, ( b ) by 5 or 6 years of age children claim that one will be surprised when they gain knowledge of that which they were previously ignorant or when they discover that they had previously held a false belief, ( c ) by 7 to 9 years of age they understand that surprise will more likely result from false beliefs rather than mere ignorance, and ( d ) children's difficulty understanding surprise as specifically belief-based does not likely stem from information processing limitations. It is argued that the lag likely results because children must build a new concept of surprise ( e.g., from desire- to belief-based ) . (PsycINFO Database Record (c) 2010 APA, all rights reserved)