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This paper identifies a set of processes which characterized the organized disaster response to Hurricane Hugo in Puerto Rico. It uses insights generated from the technology transfer literature to compare the relative effectiveness of three disaster mitigation programs in Puerto Rico, and to generalize to the likely difficulties inherent in international disaster mitigation programs emanating from core societies. In Puerto Rico the services of the Weather Service Forecasting Office and the computer model used to evacuate and shelter populations worked well. However, the coastal management program has had mixed success at best. This paper attempts to identify the causes of the differential effectiveness of these three programs by showing the similarities between the WSFO program and the SLOSH computer model and their differences from the coastal management program. It also considers other elements in the disaster response system that did not work as well: sheltering, long term emergency housing, and lifeline protection.

BackgroundEstablishing stable and adequate flow of blood to the lungs using a systemic-to-pulmonary arterial shunt in infants with low birth weight may involve significant morbidity and mortality. We reviewed our experience with this procedure in patients weighing less than 3 kilograms.MethodsBetween June, 2002, and June, 2007, we placed systemic-to-pulmonary arterial shunts in 32 infants weighing less than 3 kilograms, the range being 1.8 to 2.86 kg, with a median of 2.5 kg. The median age at placement of the shunt was 8 days, with a range from 2 to 70 days. In 17 patients (53%), the anatomic defects had produced a functionally univentricular heart, while 15 (47%) had defects which permitted staging to biventricular repair. Patients staged to univentricular palliation were much more likely to have a circulation dependent on the arterial duct as compared with those staged to biventricular palliation (p < 0.001). The latter patients tended to have smaller pulmonary arteries, significantly the left pulmonary artery, which has a median diameter of 3.6 versus 2.0 mm, p = 0.01. In all patients a saphenous venous homograft was used as the conduit, its size ranging in diameter from 2.5 to 4 mm, with a median of 3.0 mm.ResultsThe overall hospital mortality rate for the entire cohort was 6.25%, with 2 patients dying. There was no significant difference between the two groups with regard to length of stay in intensive care or hospital. Follow-up has ranged from 3 months to 4.7 years, with a mean of 2.1 years). Of those with functionally univentricular hearts, 3 have subsequently died, along with 1 patient having a biventricular circulation (p = 0.3). All deaths occurred before takedown of the shunt. A trend toward longer survival was noted in those with biventricular as compared to functionally univentricular circulations (p = 0.06).ConclusionSystemic-to-pulmonary arterial shunts can be constructed safely in infants with biventricular physiology born with low weight. Those having functionally univentricular circulations carry an increased rate of mortality for the period of shunting. Using the saphenous venous homograft permits use of smaller grafts, which does not significantly increase the risk for thrombosis or survival when compared to previous studies using polytetrafluoroethylene grafts.

Understanding the reproductive biology of plant species is essential for successful domestication and genetic improvement programs. Casuarina equisetifolia L. is an important plantation species in China and India but information on reproductive biology is limited. To address this issue, grafted ramets of C. equisetifolia were used to study floral biology, breeding system and progeny performance. The female floral longevity of C. equisetifolia reached 28.4 days under non-pollination conditions, which was significantly longer than that of supplementary pollination (5.5 days) and open pollination (12.2 days), implying successful pollination would accelerate senescence of female flowers. Higher fruit set (88.8%) and seed set (35.7%) under supplementary pollination were obtained, compared with 75.9% and 21.7%, respectively, under open pollination, although there were no fruit set and seed set under non-pollination conditions. Pollen limitation was evident based on pollen limitation index (0.39) in seedling plantations of C. equisetifolia. Selfed seedlings had low height and diameter growth in both nursery and field trials and markedly lower survival in field trial, indicating inbreeding depression. Microsatellite-based estimates of selfing rate of open pollinated, monoecious individuals was 42%, suggesting that monoecious C. equisetifolia individuals are self-compatible, and that the breeding system should be classified as facultative xenogamy.

The Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study concluded that rate control with anticoagulation was equivalent overall to rhythm control with cardioversion for long-term survival and that anticoagulation reduced the risk of stroke. We compared baseline and follow-up data for three ethnic groups: Caucasians (n=3,599), African Americans (n=265) and Hispanics (n=132). Caucasians were older and more likely male, African Americans were more likely female and hypertensive, and Hispanics had higher prevalence of cardiomyopathy. Survival was better for rate control than rhythm control in Caucasians, equivalent in African Americans and better for rhythm control in Hispanics. Outcomes may be influenced by differential baseline characteristics, but low numbers of African Americans and Hispanics warrant caution in data interpretation. BACKGROUND: The AFFIRM study compared a rate-control strategy to a rhythm-control strategy for the treatment of atrial fibrillation (AF) in patients at high risk for stroke or death. It concluded that the rhythm-control strategy offered no survival advantage, and it also confirmed the value of anticoagulation to prevent complications of AF. Data have not previously been available for specific racial ethnic populations. METHODS: We compared baseline and follow-up data for the patients randomized to rate-control versus rhythm-control in three population groups-Caucasian, African-American and Hispanic. RESULTS: Among 4,060 total patients, 3,599 were Caucasian, 265 were African-American and 132 were Hispanic. At baseline, Caucasians were older and had a higher percentage of males, normal ejection fractions, AF as their only cardiac diagnosis, a prior antiarrhythmic drug failure and less congestive heart failure. African Americans were more likely to be female, had more hypertension and qualified for the study with a first episode of AF, compared to Caucasians. Hispanics had more cardiomyopathy at baseline than Caucasians. Overall survival in Caucasians at five years for the rate-control and rhythm-control groups was 78.9% vs. 76.4%, respectively (p=0.04); for African Americans, 79.0% vs. 69.4% (p=0.22); and for Hispanics, 66.5% vs. 83.9% (p=0.01). Overall, survival was not different between the three populations. However, lower rates of event-free survival were recorded for Hispanics and for African Americans (p=0.0182). CONCLUSIONS: Different survival rates were found for rate-control versus rhythm-control in African-American and Hispanic patients, compared to Caucasian. These findings may be influenced by differences in baseline characteristics, but must be interpreted with caution because of the small sample sizes for African-American and Hispanic participants.

We describe a case of Phaeoacremonium olecranon osteomyelitis. The patient, initially felt to have traumatic olecranon bursitis, was found to have an indolent filamentous fungus cultured from the olecranon bursa. In retrospect, x-rays revealed bony erosion, which heightened the index of suspicion for infection in this particular case. Surgical bursal excision was performed and antifungal therapy was administered with clinical resolution. This case emphasizes that aspiration, synovial fluid analysis, and culture of bursal fluid is essential in excluding typical and atypical causes of chronic bursitis.

In one of the longest-running experiments in biology, researchers at the University of Illinois have selected for altered composition of the maize kernel since 1896. Here we use an association study to infer the genetic basis of dramatic changes that occurred in response to selection for changes in oil concentration. The study population was produced by a cross between the high- and low-selection lines at generation 70, followed by 10 generations of random mating and the derivation of 500 lines by selfing. These lines were genotyped for 488 genetic markers and the oil concentration was evaluated in replicated field trials. Three methods of analysis were tested in simulations for ability to detect quantitative trait loci (QTL). The most effective method was model selection in multiple regression. This method detected ∼50 QTL accounting for ∼50% of the genetic variance, suggesting that >50 QTL are involved. The QTL effect estimates are small and largely additive. About 20% of the QTL have negative effects (i.e., not predicted by the parental difference), which is consistent with hitchhiking and small population size during selection. The large number of QTL detected accounts for the smooth and sustained response to selection throughout the twentieth century.

We present a new approach to assessing requirements stability as a contribution to the building of more stable long lifetime systems. A goal-based model is used to analyze the requirements in a number of possible future worlds described by scenarios of the possible future environment of the system. The result is an assessment of possible instability of the requirements and the assumptions, which can be presented to system developers to inform alternative requirements definition and architectural choices supporting 'targeted design for change'. A process for carrying out the analysis is described and practical tool support outlined. Results from an industrial scale, live case study validating the approach, process and tool support is reported, and possible developments of the concept, process and tool are discussed.

The mutual solubility of carbon dioxide and alcohols over a wide range of temperature and pressure provides a useful and tunable medium for reactions and separations. For many years, researchers have used alcohols as cosolvents in supercritical CO2, and recently CO2-swollen alcohols have been used for antisolvent crystallization and as mobile phases for chromatography. However, little consideration has been given to chemical interaction between the alcohols and CO2. We have confirmed that such an interaction does exist and can create an acidic environment. By isolating reaction products we have demonstrated that alcohol−CO2 complexes react similarly to carboxylic acids with diazodiphenylmethane, a compound typically used to evaluate acid strengths. Our evidence indicates that the behavior of CO2−alcohol systems is comparable to that of CO2−water systems, where carbonic acid is formed.

High-pressure phase behavior has been measured for CO2/methanol/tetramethylammonium bicarbonate (TMAB) and CO2/methanol/TMAB/water systems at (25 and 70) °C and pressures up to 30 MPa. An increase in methanol concentration results in a decrease in the phase-transition pressure due to the higher miscibility of methanol and salt in CO2. At higher methanol concentrations, single phase mixtures could be achieved at moderate pressures with up to 70 mol % CO2. As expected, the addition of water sharply increases the phase transition pressure. The experimental results for the above systems were modeled using the Peng−Robinson equation of state; model predictions were found to be sensitive to adjustable parameters.

Eleven cases of high-energy industrial roller injuries treated between 1980 and 1984 were retrospectively reviewed. The dominant extremity was affected in nine. Six patients sustained fractures and/or dislocations, and three of these patients required fasciotomies for clinical signs of impending compartment syndromes. All fracture/dislocations, with the exception of a scapula fracture, anterior dislocation of a thumb interphalangeal joint, and a fractured coronoid process of the ulna, required open reduction with internal fixation. Three patients required split-thickness skin grafting for extensive skin degloving. Two patients required immediate amputation. Late sequelae included prolonged edema, nutritional depletion, neuroma formation of the superficial branch of the radial nerve, late carpal tunnel syndrome, and partial brachial plexus palsy. Industrial roller injuries continue to be an occupational hazard associated with more severe crushing trauma than the low-energy wringer washer injuries first described by MacCollum (11). Attention must be paid to the treatment of crushed skin, muscle, and nerves, fracture stabilization, nutritional support, and occupational therapy. Concurrent monitoring for signs of a developing compartment syndrome and complications of rhabdomyolysis is essential.