Search

Objectives The aim of this in vitro study was to identify and quantify up to 38 microbial species from human saliva penetrating through the implant-abutment interface in two different implant connections, external hexagon and tri-channel internal connection, both with conventional flat-head or experimental conical-head abutment screws. Material and methods Forty-eight two-part implants with external hexagon ( EH; n = 24) or tri-channel internal ( TI; n = 24) connections were investigated. Abutments were attached to implants with conventional flat-head or experimental conical-head screws. After saliva incubation, Checkerboard DNA- DNA hybridization was used to identify and quantify up to 38 bacterial colonizing the internal parts of the implants. Kruskal-Wallis test followed by Bonferroni's post-tests for multiple comparisons was used for statistical analysis. Results Twenty-four of thirty-eight species, including putative periodontal pathogens, were found colonizing the inner surfaces of both EH and TI implants. Peptostreptococcus anaerobios ( P = 0.003), Prevotella melaninogenica ( P < 0.0001), and Candida dubliniensis ( P < 0.0001) presented significant differences between different groups. Means of total microbial count (×104, ± SD) for each group were recorded as follows: G1 (0.27 ± 2.04), G2 (0 ± 0), G3 (1.81 ± 7.50), and G4 (0.35 ± 1.81). Conclusions Differences in the geometry of implant connections and abutment screws have impacted the microbial leakage through the implant-abutment interface. Implants attached with experimental conical-head abutment screws showed lower counts of microorganisms when compared with conventional flat-head screws. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the real consumption of CHO during a 10km competitive run, to compare data with the recommended quantities according to current guidelines, and to analyse the clinical events associated with these different amounts. Protocol 1: observational study including 31 athletes with T1D and 127 athletes without diabetes, comparing data taken from dietary records of CHO intake on the competition day. Protocol 2: single-blind randomized trial in 18 athletes with T1 D, testing a pre-exercise CHO supplement of 0.7g CHO·kg-1 (n = 10) or 0.35g CHO·kg-1 (n = 8). The results showed that T1 D athletes consumed a lower quantity of CHO than athletes without diabetes at their usual breakfast and during the meal taken < 1 h after the competition, but no differences were found in the supplement taken before the competition. In the randomized study, athletes consuming the higher dose of CHO (0.7g CHO·kg-1) showed increased glycemic levels, comparing with the lower dose (0.35g CHO·kg-1). In conclusion, athletes with T1 D seem to increase CHO intake prior to the competition consuming similar amounts to those athletes without diabetes, but consuming smaller quantities of CHO than the recommended amounts. This appears to induce a more stable glycemic response, in comparison with supplements with high-CHO content. [ABSTRACT FROM AUTHOR]

his article presents a review about the impact that the smart devices in the framework of the IoT have in the diagnosis and rehabilitation of patients with cognitive impairment. The work is based on a review of papers obtained by means of the principal data bases as IEEEXplore, SCOPUS, Springer Link y NCBI. According to the information obtained, a reflection about adult population all araund the world was made, and for this reason, it is necessary to implement tools in order to help the patients in his ordinary life. It is also is necessary to consider the interest to carry out early diagnosis of diseases such as Alzheimer and Dementia in order to apply prevenient therapies to avoid the long term cognitive impairment. There are many possibilities, in terms of research and development of software and smart devices based on IoT, to contribute with the detection and treatment of these patients. [ABSTRACT FROM AUTHOR]

In a way similar to the automotive industry, outboard emissions limits are being constantly revised, which strongly effects the development of the new engines and their compliance. During the last ten years, conventional two-stroke outboard engines, which are used for fishing and recreational boats, have thus been replaced by four-stroke engines or direct-injection two-stroke engines. The objective of this article is to compare various outboard engines and the technical solutions developed for the reduction of exhaust emissions, with special emphasis being placed on the low-power gasoline and diesel outboard engine range. A gasoline outboard engine was also transformed to allow the use of liquefied petroleum gas (LPG) and showed that this technique could be an alternative solution for the future emission limit compliance. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this study is to compare the engine performance and emission results of biodiesel derived from used cooking oil when applied in different proportions in outboard engines. Results revealed that the use of biodiesel resulted in lower emissions of CO (up to 12%) with an increase in emissions of NO x (up to 20%, except in one case which presented a slight reduction). Biodiesel also presented a slight increase in specific fuel consumption (lower than 11.4%) which may be acceptable considering the reduction in exhaust emissions. The experimental results proved that biodiesel alone or blended biodiesel can be used in compression ignition outboard engines, thereby providing a viable alternative to diesel. Special attention should be paid to the use of biodiesel in boats operating on lakes and rivers and in sheltered bays, which are more vulnerable to pollution. [Copyright &y& Elsevier]

The energy dispatch process in Colombia is carried out in four different stages. Electrical and reliability constraints are added at each stage. One of the most important characteristics of the dispatch process is the inclusion of a balanced risk policy. The dispatch must be calculated so that the expected relative load sheddings in the different sub-areas of the system are minimized and equalized. This paper presents a lineal optimization model that solves the dispatch problem in one single stage and incorporates the balanced risk policy mentioned above. [ABSTRACT FROM AUTHOR]

Patients with early breast cancer (EBC) achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) have a favorable prognosis. Breast surgery and more chemotherapy treatment might be avoided in patients in whom the presence of residual tumor can be ruled out with high confidence. We investigated the diagnostic accuracy of contrast enhanced MRI (CE-MRI) in predicting pCR and long-term outcome after NACT. Patients with EBC, who had undergone CE-MRI before and after NACT, were retrospectively analyzed (n = 421), and regarding to the absence (radiologic complete remission; rCR) or presence (no-rCR) of residual contrast enhancement. Overall rCR and pCR rates were 35% (147/421) and 36% (154/421), respectively. We found a total of 70% (101/144) of rCR corresponded to a pCR (meaning the positive predictive value - PPV). In contrast, in 80% (219/272) of patients, residual tumor observed on MRI was pathologically confirmed (meaning the negative predictive value - NPV). Sensitivity to detect a pCR was 65% (101/154), while specificity to detect residual tumor and accuracy were 83% (219/262); and 76% (320/421), respectively. The PPV was significantly lower in luminal compared to HER2 positive and triple negative tumors (10/34 = 29 % vs. 50/62 = 81% and 41/48 = 85% respectively). The concordance between rCR and pCR was moderate (Cohen's kappa − 0.5) but with low level in luminal tumors (Coheńs Kappa – 0.3). In multivariate analysis both assessments were significantly associated with disease free survival (rCR : HR:0,344 P = 0.001; pCR : HR : 0,154 P = 0.000), but not in luminal tumors (rCR : HR:0,813 P = 0.692; pCR : HR : 0,326 P = 0.275). The accuracy of preoperative CE-MRI to predict pCR after NACT for EBC is moderate but in luminal tumors did not accurately predict pCR. However, rCR was strongly associated with favorable RFS, especially in HER2 positive and triple negative breast cancer tumors. The authors. Has not received any funding. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Nodal involvement is a common prognostic factor in early breast cancer (EBC) but their response and assessment after neoadjuvant chemotherapy (NAC) is controversial, hence its impact in survival is not clear. We analyze a cohort of 308 EBC patients with initial nodal involvement and their response to neoadjuvant chemotherapy and their impact in disease free survival (DFS). Median age was 52 (range 29-87), median tumor size was 38mm (10-100) and 178 patients (57,8%) had initial palpable node involvement. According to the immunohistochemical expression of hormonal receptors, Ki 67 and HER2; 110 patients (35,7%) was HER2 positive, 119 (38,6%) luminal and 79 (25,6%) triple negative breast cancer. After NAC we found a total of pathological complete response in breast (pCRb) of 30% and pathological complete response in axilla (pCRa) of 45%. Response by different subtypes was: in HER2 a pCRb 41,8% and pCRa 56,3%; luminal a pCRb 13% pCRa 30,3% and triple negative a pCRb 41,8% pCRa 50,6%. Luminal patients achieved the worst axillary response (p:0,004) and without other variables with significant association like tumor initial size or palpable axillary nodes. The global coincidence between pCRb and pCRa was 83% and very similar in the different subtypes. Axillary pCR was associated with a better DFS in the global series (HR: 0,377 p:0,000) but not in the luminal patients (HR:0,455 p:0,072) and the median survival in patients with pCRa was 157 months in contrast to 121 in patients that not achieve a pCRa (153 vs 99 in HER2, 160 vs 141 in luminal and 167 vs 93 in triple negative). The complete pathological response in axila after neoadjuvant chemotherapy is 45% in our serie but lower in luminal patients with only a 30%. There was a high level of concordance between pCR in breast and axilla in all subtypes with an 83%. Achieving pCR in axilla is associated with better disease free survival but this benefit is lower in luminal phenotype. The authors. Has not received any funding. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background: Mobilization of critically ill patients is safe and may improve functional outcomes. However, the prevalence of mobilization activities of ICU patients in Brazil is unknown. Methods: A one-day point prevalence prospective study with a 24-hour follow-up period was conducted in Brazil. Demographic data, ICU characteristics, prevalence of mobilization activities, level of patients' mobilization, and main reasons for not mobilizing patients were collected for all adult patients with more than 24hs of ICU stay in the 26 participating ICUs. Mobilization activity was defined as any exercise performed during ICU stay. Results: In total, 358 patients were included in this study. Mobilization activities were performed in 87.4% of patients. Patients received mobilization activities while under invasive mechanical ventilation (44.1%), noninvasive ventilation (11.7%), or without any ventilatory support (44.2%). Passive exercises were more frequently performed [46.5% in all patients; 82.3% in mechanically ventilated patients]. Mobilization activities included in-bed exercise regimen (72.2%). Out-of-bed mobility was reported in 39.9% of mobilized patients, and in 16.3% of patients under invasive mechanical ventilation. The presence of an institutional early mobility protocol was associated with early mobilization (OR, 3.19; 95% CI, 1.23 to 8.22; p = 0.016), and with out-of-bed exercise (OR, 5.80; 95% CI, 1.33 to 25.30; p = 0.02). Conclusion: Mobilization activities in critically ill patients in Brazil was highly prevalent, although there was almost no active mobilization in the mechanically ventilated patients. Moreover, the presence of an institutional early mobility protocol was associated with a threefold higher chance of ICU mobilization during that day. [ABSTRACT FROM AUTHOR]

BACKGROUND AKT pathway activation is implicated in endocrine-therapy resistance. Data on the efficacy and safety of the AKT inhibitor capivasertib, as an addition to fulvestrant therapy, in patients with hormone receptor-positive advanced breast cancer are limited. METHODS In a phase 3, randomized, double-blind trial, we enrolled eligible pre-, peri-, and postmenopausal women and men with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer who had had a relapse or disease progression during or after treatment with an aromatase inhibitor, with or without previous cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor therapy. Patients were randomly assigned in a 1:1 ratio to receive capivasertib plus tor-assessed progression-free survival assessed both in the overall population and among patients with AKT pathway-altered (PIK3CA, AKT1, or PTEN) tumors. Safety was assessed. RESULTS Overall, 708 patients underwent randomization; 289 patients 040.8°6) had AKT pathway alterations, and 489 (69.1%) had received a CDK4/6 inhibitor previously for advanced breast cancer. In the overall population, the median progression-free survival was 7.2 months in the capivasertib-fulvestrant group, as compared with 3.6 months in the placebo-fulvestrant group (hazard ratio for progression or death, 0.60; 95% confidence interval ICI], 0.51 to 0.71; P<0.001). In the AKT pathway-altered population, the median progression-free survival was 7.3 months in the capivasertib-fulvestrant group, as compared with 3.1 months in the placebofulvestrant group (hazard ratio, 0.50; 95% CI, 0.38 to 0.65; P<0.001). The most frequent adverse events of grade 3 or higher in patients receiving capivasertibfulvestrant were rash (in 12.1% of patients, vs. in 0.3% of those receiving placebofulvestrant) and diarrhea (in 9.396 vs. 0.396). Adverse events leading to discontinuation were reported in 13.0% of the patients receiving capivasertib and in 2.3°6 of those receiving placebo. CONCLUSIONS Capivasertib-fulvestrant therapy resulted in significantly longer progression-free survival than treatment with fulvestrant alone among patients with hormone receptor-positive advanced breast cancer whose disease had progressed during or after previous aromatase inhibitor therapy with or without a CDK4/6 inhibitor. (Funded by AstraZeneca and the National Cancer Institute. [ABSTRACT FROM AUTHOR]

In this article, the right to health is discussed as a social right and an essential requisite in the construction and guarantee of human rights, more precisely human dignity, considering this right as a complex but effective process in the transformation of the social reality. In the first place, the activities of the public power and its difficulties to guarantee universal access to health are highlighted. This scenario ends up inhibiting the practice of the right to health and prevents users from enjoying and using it. In that sense, this article challenges and explores some alternatives to solidify and put in practice the right to health in Brazil. Departing from the analysis of the Unified Health System (SUS) and social participation in Brazil, this article discusses the judicialization of health in the country, highlighting the difficulties the State faces to equitably offer universal healthcare to society. This context offers an opportunity for reflection and a paradigm change, from the “judicialization of health” to the “judicialization of health policies.” Finally, the public health policies adopted by other countries are emphasized, in the attempt to construct the empowerment of human beings in the practice of their rights, particularly social participation and the discussion about the States’ responsibility to put their citizens’ right to health in practice. In conclusion, the political and collective construction of the right to health needs to be encouraged, distinguishing the legitimate interests of the different interlocutors involved. [ABSTRACT FROM AUTHOR]

Importance: Intravenous fluids are used for almost all intensive care unit (ICU) patients. Clinical and laboratory studies have questioned whether specific fluid types result in improved outcomes, including mortality and acute kidney injury.Objective: To determine the effect of a balanced solution vs saline solution (0.9% sodium chloride) on 90-day survival in critically ill patients.Design, Setting, and Participants: Double-blind, factorial, randomized clinical trial conducted at 75 ICUs in Brazil. Patients who were admitted to the ICU with at least 1 risk factor for worse outcomes, who required at least 1 fluid expansion, and who were expected to remain in the ICU for more than 24 hours were randomized between May 29, 2017, and March 2, 2020; follow-up concluded on October 29, 2020. Patients were randomized to 2 different fluid types (a balanced solution vs saline solution reported in this article) and 2 different infusion rates (reported separately).Interventions: Patients were randomly assigned 1:1 to receive either a balanced solution (n = 5522) or 0.9% saline solution (n = 5530) for all intravenous fluids.Main Outcomes and Measures: The primary outcome was 90-day survival.Results: Among 11 052 patients who were randomized, 10 520 (95.2%) were available for the analysis (mean age, 61.1 [SD, 17] years; 44.2% were women). There was no significant interaction between the 2 interventions (fluid type and infusion speed; P = .98). Planned surgical admissions represented 48.4% of all patients. Of all the patients, 60.6% had hypotension or vasopressor use and 44.3% required mechanical ventilation at enrollment. Patients in both groups received a median of 1.5 L of fluid during the first day after enrollment. By day 90, 1381 of 5230 patients (26.4%) assigned to a balanced solution died vs 1439 of 5290 patients (27.2%) assigned to saline solution (adjusted hazard ratio, 0.97 [95% CI, 0.90-1.05]; P = .47). There were no unexpected treatment-related severe adverse events in either group.Conclusion and Relevance: Among critically ill patients requiring fluid challenges, use of a balanced solution compared with 0.9% saline solution did not significantly reduce 90-day mortality. The findings do not support the use of this balanced solution.Trial Registration: ClinicalTrials.gov Identifier: NCT02875873. [ABSTRACT FROM AUTHOR]

Importance: Slower intravenous fluid infusion rates could reduce the formation of tissue edema and organ dysfunction in critically ill patients; however, there are no data to support different infusion rates during fluid challenges for important outcomes such as mortality.Objective: To determine the effect of a slower infusion rate vs control infusion rate on 90-day survival in patients in the intensive care unit (ICU).Design, Setting, and Participants: Unblinded randomized factorial clinical trial in 75 ICUs in Brazil, involving 11 052 patients requiring at least 1 fluid challenge and with 1 risk factor for worse outcomes were randomized from May 29, 2017, to March 2, 2020. Follow-up was concluded on October 29, 2020. Patients were randomized to 2 different infusion rates (reported in this article) and 2 different fluid types (balanced fluids or saline, reported separately).Interventions: Patients were randomized to receive fluid challenges at 2 different infusion rates; 5538 to the slower rate (333 mL/h) and 5514 to the control group (999 mL/h). Patients were also randomized to receive balanced solution or 0.9% saline using a factorial design.Main Outcomes and Measures: The primary end point was 90-day survival.Results: Of all randomized patients, 10 520 (95.2%) were analyzed (mean age, 61.1 years [SD, 17.0 years]; 44.2% were women) after excluding duplicates and consent withdrawals. Patients assigned to the slower rate received a mean of 1162 mL on the first day vs 1252 mL for the control group. By day 90, 1406 of 5276 patients (26.6%) in the slower rate group had died vs 1414 of 5244 (27.0%) in the control group (adjusted hazard ratio, 1.03; 95% CI, 0.96-1.11; P = .46). There was no significant interaction between fluid type and infusion rate (P = .98).Conclusions and Relevance: Among patients in the intensive care unit requiring fluid challenges, infusing at a slower rate compared with a faster rate did not reduce 90-day mortality. These findings do not support the use of a slower infusion rate.Trial Registration: ClinicalTrials.gov Identifier: NCT02875873. [ABSTRACT FROM AUTHOR]

Objective: To determine the prescription of physical exercise in a program carried out through Virtual Reality (VR) for elderly people. Materials and method: Literature review was conducted by searching keywords such as "virtual reality", "physical therapy", "Exergames", "Healthy", "Older people", and "Exercise" in the following search engines: Pubmed, Sciencedirect, Google Scholar and Databases from the Escuela de Ingeniería de Antioquia (EIA). The inclusion criteria of the articles comprised intensity, frequency, session duration, types of games and results of the physical activity. Results: A selection of 40 articles allowed us to identify the prescription of physical activity using VR for elderly people. Conclusion: The prescription of physical activity in VR may encompass sessions with a length of time between 30 to 50 minutes and three to five sessions per week. The proposal consists of 3 to 5 sets of 8 to 20 repetitions of an initial intensity at 30% to 75% of the maximum heart rate. [ABSTRACT FROM AUTHOR]

Patients with mNSCLC benefit in terms PFS and OS of treatment with immunotherapy (IO) in first (1L) and second line (2L); However, the majority of patients do not respond to IO, which, due to the high cost of these new treatments, makes identifying predictive factors of response imperative in order to select the patients who will really respond to this therapy. Bearing in mind that most hospitals do not have the technology to perform high sensitivity techniques such as NGS, it seems prudent to be able to identify these patients using more common, cheap and affordable methods in any hospital. In all mNSCLC treated with IO in monotherapy in two university hospitals in Spain, from February 2012 to January 2018, a RWD study of predictive factors of response was performed. 198 patients from the University Hospital Arnau de Vilanova of Lleida and the University Hospital Dr. Josep Trueta (ICO Girona) were analyzed. Statistical analysis of the data was performed using IBM SPSS Statistics 23.0 software. With a median follow-up from the start of treatment with IO of 217 days, it was found that in all treated patients, the overall response rate (ORR = CR + PR) was 26.6%. In 1L the ORR was 56%, in 2L 22.8%, in 3L 15% and in 4L 0%. In 1L, the factor that is associated with a better response is the absence of liver mets: ORR 66.7% vs 16.7% (p: 0.03). The factor associated with a better OS is Hb ≥ 12.5 gr/dl (p 0.001): 495 vs 241 days. Analyzing by treatment lines, we objectify that in 1L, the factors that influence better OS are the absence of liver mets (p 0.003): 421 (CI: 345-497) vs 138 days (CI: 65-212)) and Hb ≥ 12.5gr dl (p 0.027) 440 (CI: 368-512) vs 215 days (CI: 111-319). In 2L the factors that influence a better OS are younger age with a cutoff point of 70 years (p 0.008): 328 vs 239 days; Hb ≥ 12.5 gr/dl (p 0.001): 512 vs 325 days and lymphocytes > 1450 (p 0.013): 353 vs 241 days. Methods that are easily available in any hospital can help select the patients that benefit most from immunotherapy in monotherapy. In our series, patients older than 70 years, with Hb ≤ 12.5 gr/dl and lymphocytes ≤1.450, have worse overall survival independently of PDL1. The authors. Has not received any funding. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the results of a quality improvement initiative in sepsis in an emerging setting and to analyze it according to the institutions' main source of income (public or private).Design: Retrospective analysis of the Latin American Sepsis Institute database from 2005 to 2014.Settings: Brazilian public and private institutions.Patients: Patients with sepsis admitted in the participant institutions.Interventions: The quality improvement initiative was based on a multifaceted intervention. The institutions were instructed to collect data on 6-hour bundle compliance and outcomes in patients with sepsis in all hospital settings. Outcomes and compliance was measured for eight periods of 6 months each, starting at the time of the enrollment in the intervention. The primary outcomes were hospital mortality and compliance with 6-hour bundle.Measurements and Main Results: We included 21,103 patients; 9,032 from public institutions and 12,071 from private institutions. Comparing the first period with the eigth period, compliance with the 6-hour bundle increased from 13.5% to 58.2% in the private institutions (p < 0.0001) and from 7.4% to 15.7% in the public institutions (p < 0.0001). Mortality rates significantly decreased throughout the program in private institutions, from 47.6% to 27.2% in the eighth period (adjusted odds ratio, 0.45; 95% CI, 0.32-0.64). However, in the public hospitals, mortality diminished significantly only in the first two periods.Conclusion: This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved compliance with quality indicators. However, this reduction was sustained only in private institutions. [ABSTRACT FROM AUTHOR]

If briquettes are to be used efficiently and rationally as fuel, they must be characterized to determine such technological parameters as their reactivity, moisture content, density, ashes, volatile matter, and heat value, along with their major component elements. Traditionally, research has centered on small particles of coal that do not reflect the combustion behavior of briquettes as heterogeneous solids. The objective of this work is to compare experimental data on the reactivity of biomass briquettes and to analyze the results. From the reactivity and the rest of the data available, it will be possible to asses what kind of briquette is suitable for a particular application by matching its behavior to specific requirements, including pollutant emissions. [ABSTRACT FROM AUTHOR]

Abstract: Reducing emissions of CO2 and other GHGs is one of the biggest environmental challenges facing the European Union as it strives for sustainable development. If that challenge is to be met, domestic energy consumption must be controlled: it currently accounts for 40% of the total, making it one of the biggest sources of emissions. EU Directives 93/76 and 2002/91 make it compulsory for energy rating systems to be set up to report on consumption in buildings. This paper looks at the various rating systems now up and running, with varying levels of success, in EU countries. However, Denmark''s is the only system that can be considered as providing a full energy rating in the sense of awarding a graded score to buildings rather than a simple pass/fail rating, and proposing ways of improving the score obtained. Indeed, many regulations on energy saving in the residential sector are extremely recent, and it is too soon to assess their results. In some States they may also be modified by reforms currently being studied or processed. [Copyright &y& Elsevier]

The NASA Scanning Radar Altimeter (SRA) flew aboard one of the NOAA WP-3D hurricane research aircraft to document the sea surface directional wave spectrum in the region between Charleston, South Carolina, and Cape Hatteras, North Carolina, as Hurricane Bonnie was making landfall near Wilmington, North Carolina, on 26 August 1998. Two days earlier, the SRA had documented the hurricane wave field spatial variation in open water when Bonnie was 400 km east of Abaco Island, Bahamas. Bonnie was similar in size during the two flights. The maximum wind speed was lower during the landfall flight (39 m s[sup -1]) than it had been during the first flight (46 m s[sup -1]). Also, Bonnie was moving faster prior to landfall (9.5 m s[sup -1]) than when it was encountered in the open ocean (5 m s[sup -1]). The open ocean wave height spatial variation indicated that Hurricane Bonnie would have produced waves of 10 m height on the shore northeast of Wilmington had it not been for the continental shelf. The gradual shoaling distributed the wave energy dissipation process across the shelf so that the wavelength and wave height were reduced gradually as the shore was approached. The wave height 5 km from shore was about 4 m. Despite the dramatic differences in wave height caused by shoaling and the differences in the wind field and forward speed of the hurricane, there was a remarkable agreement in the wave propagation directions for the various wave components on the two days. This suggests that, in spite of its complexity, the directional wave field in the vicinity of a hurricane may be well behaved and lend itself to be modeled by a few parameters, such as the maximum wind speed, the radii of the maximum and gale force winds, and the recent movement of the storm. [ABSTRACT FROM AUTHOR]