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A wavelet decomposition based technique is applied to air pressure data obtained from laboratory-scale powder snow avalanches. This technique is shown to be a powerful tool for identifying both repeatable and chaotic features at any frequency within the signal. Additionally, this technique is demonstrated to be a robust method for the removal of noise from the signal as well as being capable of removing other contaminants from the signal. Whilst powder snow avalanches are the focus of the experiments analysed here, the features identified can provide insight to other particle-laden gravity currents and the technique described is applicable to a wide variety of experimental signals. [ABSTRACT FROM AUTHOR]

This Letter describes an investigation of interfacial melting in ice-bearing granular flows. It is proposed that energy associated with granular collisions causes melting at an ice particle's surface, which can thus occur at temperatures well below freezing. A laboratory experiment has been designed that allows quantification of this process and its effect on the dynamics of a granular shear flow of ice spheres. This experiment employs a rotating drum, half filled with ice particles, situated in a temperature controlled laboratory. Capillary forces between the wetted melted particle surfaces lead to the clumping of particles and enhanced flow speeds, in turn leading to further melting. Dimensional analysis defines a parameter space for further experimentation. [ABSTRACT FROM AUTHOR]

Deep vein thrombosis (DVT) is a major health problem, which affects 1 in 1000 people in the general population each year. It may be asymptomatic or cause swelling and pain, and can lead to potentially fatal complications. Immobilisation following bone surgery significantly increases the risk of DVT, and prevention is a salient goal for nursing. This article reviews the pathogenesis of DVT, and therapeutic venous thromboembolic prophylaxis in the prevention of DVT following orthopaedic surgery. Best nursing practice is outlined for management of the Arteriovenous (A-V) Impulse System, the advent of which has had a positive impact on the incidence of DVT following orthopaedic surgery but requires further research to substantiate its effectiveness and determine patient acceptability. [ABSTRACT FROM AUTHOR]

Paratuberculosis (Johne's disease) is a significant animal health problem. Evaluation of diagnostic tests for Johne's disease has been difficult due to lack of a gold standard test. In recent years, there has been interest in receiver operating characteristic (ROC) curve estimation without any gold standard test. Typically, either Bayesian or maximum likelihood methods are proposed. Although these methods overcome the lack of a gold standard test in ROC curve estimation, little work has been done to incorporate covariates in the analysis. In this paper, we propose a method for estimation of ROC curves based on statistical models to adjust for covariate effects when the true disease states of test animals are unknown. The covariates may be correlated with the disease process or with the diagnostic testing procedure, or both. We propose a 2-part Bayesian model: first, a logistic regression model for disease prevalence is used to fit the covariates; second, a linear model is used to fit the covariates to the distribution of test scores. We used Markov chain Monte Carlo methods to compute the posterior estimates of the sensitivities and specificities that provide the groundwork for inference concerning the diagnostic procedure's accuracy. We applied the methodology to milk ELISA scores from several dairy-cow herds for the diagnostic testing of paratuberculosis. We found that both milk yield and its interaction with age had significant effects on the disease process whereas only milk yield was significant on the testing procedure. [ABSTRACT FROM AUTHOR]

This article aims to address the potential shortfall in care provision offered by general practitioners (GPs) resulting from pending retirement and the retention and recruitment crisis. An educational module was developed that offered both theory and practise to unqualified general practice assistants. The module content was determined following discussion with local GPs. A small qualitative study of six students was carried out to review efficacy of participants in their new role. Using a grounded theory approach, participant and supervisor views of course content and delivery, role preparation diversity were analysed and compared. Tape recorded interviews were conducted and analysis carried out employing the constant comparative method. Data were coded and emergent themes categorized. Overall, participants agreed that the module had strengthened their knowledge, added new skills, heightened their job satisfaction, added significant diversity to their role and enhanced their employability potential. Five participants communicated that they were more confident in performing clinical skills and advising health improvement techniques. Supervisors also reported that participants displayed a more competent and professional approach to health care, which was complementary to the role of the GP and practice nurse. Ultimately this allowed both GP and practice nurse to focus on dealing with chronic illness targets, as required in the new directive (Scottish Executive, 2004). [ABSTRACT FROM AUTHOR]

A large powder snow avalanche was artificially triggered at the Swiss Vallée de la Sionne test site on February 7th, 2003. Two synchronised digital video cameras were used to track manually identified features on the surface of the powder cloud. By identifying the same features on different cameras, their three-dimensional location was determined using stereoscopic projection. The surface of the avalanche was inferred from these measurements and used to calculate such quantities as flow height, flow volume and flow velocity. [Copyright &y& Elsevier]

We study the role of suspension density in eruption currents, a regime of gravity-driven flow that is sustained by massive, localized blow-out of particles acting as a steady source of heavier fluid injected into a uniform flow at high Reynolds number. Inspired by the potential flow solution of Saffman and Yuen ['Finite-amplitude interfacial waves in the presence of a current,' J. Fluid Mech. 123, 459-476 (1982)], we show that the relative density difference between the two fluids swells the size of the current's head without changing its shape, while inducing a velocity jump at the interface. We test this inviscid theory against inviscid and large-eddy-simulations. We also conduct experiments in a water flume, where a line source of fluorescent brines of various densities is injected in a cross-stream and visualized with a narrow sheet of light. Simulations and experiments reveal that, with isotropic velocity distribution on a finite source, eruption currents expand further and develop interface oscillations, but the inviscid theory still captures relative swelling induced by density. We compare predictions to the static pressure data of McElwaine and Turnbull ['Air pressure data from the Vallee de la Sionne avalanches of 2004,' J. Geophys. Res. 110, F03010, doi:10.1029/2004JF000237 (2005)] in powder snow avalanches. [ABSTRACT FROM AUTHOR]

The nutritional functions of selenium (Se) are recognized as being due to a number of Se-containing proteins. It is not clear, however, whether any of these function in the anti-tumorigenic effects of Se most of which have been demonstrated for Se exposures greater than those required for selenoprotein expression. Indeed, other anti-tumorigenic mechanisms have been demonstrated for certain Se-metabolites. The Nutritional Prevention of Cancer Trial found supplemental Se (200 μg/day, as Se-enriched yeast) to be associated with significant reductions in cancer risks in subjects with pre-treatment plasma Se concentrate ions below ca. 120 ng/ml (1.5 nmoles/ml), which level would appear to require food-Se intakes of ca. 1.5 μg/kg body weight/day. However, the putative anti-carcinogenic Se-metabolite(s) should be more relevant than total plasma Se as a supplementation target for cancer prevention. These may be components of the non-protein-bound fraction of Se in plasma, which constitutes 2-4% of total plasma Se. [ABSTRACT FROM AUTHOR]

Background: Anti-angiogenic therapies are effective in metastatic renal cell carcinoma (mRCC), but resistance is inevitable. A dual-inhibition strategy focused on hypoxia-inducible factor (HIF) is hypothesized to be active in this refractory setting. CRLX101 is an investigational camptothecin-containing nanoparticle-drug conjugate (NDC), which durably inhibits HIF1α and HIF2α in preclinical models and in gastric cancer patients. Synergy was observed in the preclinical setting when combining this NDC and anti-angiogenic agents, including bevacizumab. Patients and methods: Patients with refractory mRCC were treated every 2 weeks with bevacizumab (10 mg/kg) and escalating doses of CRLX101 (12, 15 mg/m²) in a 3 + 3 phase I design. An expansion cohort of 10 patients was treated at the recommended phase II dose (RP2D). Patients were treated until progressive disease or prohibitive toxicity. Adverse events (AEs) were assessed using CTCAE v4.0 and clinical outcome using RECIST v1.1. Results: Twenty-two patients were response-evaluable in an investigator-initiated trial at two academic medical centers. RCC histologies included clear cell (n = 12), papillary (n = 5), chromophobe (n = 2), and unclassified (n = 3). Patients received a median of two prior therapies, with at least one prior vascular endothelial tyrosine kinase inhibitor therapy (VEGF-TKI). No dose-limiting toxicities were observed. Grade =3 AEs related to CRLX101 included non-infectious cystitis (5 events), fatigue (3 events), anemia (2 events), diarrhea (2 events), dizziness (2 events), and 7 other individual events. Five of 22 patients (23%) achieved partial responses, including 3 of 12 patients with clear cell histology and 2 of 10 patients (20%) with non-clear cell histology. Twelve of 22 patients (55%) achieved progression-free survival (PFS) of >4 months. Conclusions: CRLX101 combined with bevacizumab is safe in mRCC. This combination fulfilled the protocol's predefined threshold for further examination with responses and prolonged PFS in a heavily pretreated population. A randomized phase II clinical trial in mRCC of this combination is ongoing. [ABSTRACT FROM AUTHOR]

Objective: To determine whether a nutritional supplement of selenium will decrease the incidence of cancer.Design: A multicenter, double-blind, randomized, placebo-controlled cancer prevention trial.Setting: Seven dermatology clinics in the eastern United States.Patients: A total of 1312 patients (mean age, 63 years; range, 18-80 years) with a history of basal cell or squamous cell carcinomas of the skin were randomized from 1983 through 1991. Patients were treated for a mean (SD) of 4.5 (2.8) years and had a total follow-up of 6.4 (2.0) years.Interventions: Oral administration of 200 microg of selenium per day or placebo.Main Outcome Measures: The primary end points for the trial were the incidences of basal and squamous cell carcinomas of the skin. The secondary end points, established in 1990, were all-cause mortality and total cancer mortality, total cancer incidence, and the incidences of lung, prostate, and colorectal cancers.Results: After a total follow-up of 8271 person-years, selenium treatment did not significantly affect the incidence of basal cell or squamous cell skin cancer. There were 377 new cases of basal cell skin cancer among patients in the selenium group and 350 cases among the control group (relative risk [RR], 1.10; 95% confidence interval [CI], 0.95-1.28), and 218 new squamous cell skin cancers in the selenium group and 190 cases among the controls (RR, 1.14; 95% CI, 0.93-1.39). Analysis of secondary end points revealed that, compared with controls, patients treated with selenium had a nonsignificant reduction in all-cause mortality (108 deaths in the selenium group and 129 deaths in the control group [RR; 0.83; 95% CI, 0.63-1.08]) and significant reductions in total cancer mortality (29 deaths in the selenium treatment group and 57 deaths in controls [RR, 0.50; 95% CI, 0.31-0.80]), total cancer incidence (77 cancers in the selenium group and 119 in controls [RR, 0.63; 95% CI, 0.47-0.85]), and incidences of lung, colorectal, and prostate cancers. Primarily because of the apparent reductions in total cancer mortality and total cancer incidence in the selenium group, the blinded phase of the trial was stopped early. No cases of selenium toxicity occurred.Conclusions: Selenium treatment did not protect against development of basal or squamous cell carcinomas of the skin. However, results from secondary end-point analyses support the hypothesis that supplemental selenium may reduce the incidence of, and mortality from, carcinomas of several sites. These effects of selenium require confirmation in an independent trial of appropriate design before new public health recommendations regarding selenium supplementation can be made [ABSTRACT FROM AUTHOR]