Background:Incidence and risk factors of parachute injuries has been studied in developed countries,but not in trainees of the airborne forces in the Royal Thailand Army.Methods:A prospective cohort study was conducte...Background:Incidence and risk factors of parachute injuries has been studied in developed countries,but not in trainees of the airborne forces in the Royal Thailand Army.Methods:A prospective cohort study was conducted among 992 military personnel who attended the basic airborne training program from February to July 2018.Information sheets were used to collect data about(a)personal demographics;(b)environmental conditions surrounding the parachute practice;and(c)parachute-related injuries.The incidence rate of injury was then calculated.Risk factors were examined using multilevel Poisson regression analysis and presented as incidence rate ratio(IRR)and 95%confidence interval(95%CI).Results:A total of 166 parachute-related injuries occurred in 4677 jumps.The incidence rate of injury was 35.50 per 1000 jumps(95%CI 30.04–41.21).Factors significantly related to parachute injury included:jumping with equipment versus without equipment[adjusted IRR(95%CI):1.28(0.88–1.87)],higher wind speed[1.54(1.27–1.87)per knot],airplane versus helicopter exit[1.75(0.68–4.55)],side versus rear exit[2.13(1.43–3.23)],night versus day jumping[2.19(0.81–5.90)],and presence of motion sickness[3.43(1.93–6.92)].Conclusions:To prevent military static line parachute injuries,the following factors should be taken into consideration:type of aircraft,aircraft exit,time of the day,equipment,motion sickness and wind speed.Trial registration:The project was certified by the Research Ethics Committee,Faculty of Medicine,Chulalongkorn University(IRB No.697/60).展开更多
Botanic gardens around the world maintain collections of living plants for science, conservation, education, beauty and more. These collections change over time-in scope and content-but the predicted impacts of climat...Botanic gardens around the world maintain collections of living plants for science, conservation, education, beauty and more. These collections change over time-in scope and content-but the predicted impacts of climate change will require a more strategic approach to the succession of plant species and their landscapes. Royal Botanic Gardens Victoria has recently published a 'Landscape Succession Strategy'for its Melbourne Gardens, a spectacular botanical landscape established in 1846. The strategy recognizes that with 1.6 million visitors each year, responsibility for a heritage-listed landscape and the need to care for a collection of 8500 plant species of conservation and scientific importance, planting and planning must take into account anticipated changes to rainfall and temperature. The trees we plant today must be suitable for the climate of the twenty-second century. Specifically, the Strategy sets out the steps needed over the next twenty years to transition the botanic garden to one resilient to the climate modelled for2090. The document includes a range of practical measures and achievable(and at times somewhat aspirational) targets. Climate analogues will be used to identify places in Australia and elsewhere with conditions today similar to those predicted for Melbourne in 2090, to help select new species for the collection. Modelling of the natural and cultivated distribution of species will be used to help select suitable growth forms to replace existing species of high value or interest. Improved understanding of temperature gradients within the botanic garden, water holding capacity of soils and plant water use behaviour is already resulting in better targeted planting and irrigation. The goal is to retain a similar diversity of species but transition the collection so that by 2036 at least 75% of the species are suitable for the climate in 2090. Over the next few years we hope to provide 100% of irrigation water from sustainable water sources, and infrastructure will be improved to adapt to predicted higher temperatures and more climatic extremes. At all times there will be a strong focus on assisting the broader community in their response to climate change.展开更多
Significant loss of life and damage to properties, ecosystems and marine facilities occur due to various natural hazards such as cyclones and tsunamis. Royal HaskoningDHV has developed regional hydrodynamic and wave m...Significant loss of life and damage to properties, ecosystems and marine facilities occur due to various natural hazards such as cyclones and tsunamis. Royal HaskoningDHV has developed regional hydrodynamic and wave models covering the Northern Arabian Sea to address these issues. Cyclone modelling was carried out on 11 major cyclones since 1945 and the tsunami modelling on an earthquake along the Makran Fault Line in 1945. Sample results from these modelling studies are presented in this paper. The methodology described in this article for modelling cyclones and tsunamis in the Arabian Sea could be applied to simulate these natural hazards at other sites around the world.展开更多
Objectives: To describe thoracic endovascular aortic repair (TEVAR) outcomes at the Royal Brisbane and Women’s Hospital between 2001-2010. Design: Prospective cohort study. Results: We successfully treated 95 of 97 p...Objectives: To describe thoracic endovascular aortic repair (TEVAR) outcomes at the Royal Brisbane and Women’s Hospital between 2001-2010. Design: Prospective cohort study. Results: We successfully treated 95 of 97 patients for a 98% procedural success rate. Of the treated patients, 68 (72%) were males and mean age was 61 ± 17 years. Average follow up was 3.6 ± 2.0 years. Pathologies treated were: dissection (n = 35), aneurysmal disease (n = 32), traumatic disease (n = 19), coarctation (n = 5) and miscellaneous (n = 4). There was one peri-procedural myocardial infarction. Renal complications occurred in 7 patients (3 with doubling creatinine and 4 requiring temporary renal replacement therapy). Stroke occurred in 2 patients and paresis in 2 patients (permanent in one). Six patients died during index hospitalization and 17 deaths occurred during follow-up, 2 of which were confirmed secondary to aortic pathology. Age (HR 1.08 per year, p < 0.01) and ASA class (HR 2.2 per class, p = 0.02) were independently associated with mortality. There were 25 re-interventions in 22 patients. Eighteen of these re-interventions in 16 patients were related to the management of complications of TEVAR of which 13 were for endoleaks;eight type I, four type II, one type III. Conclusion: TEVAR can be used to treat thoracic aortic pathology but questions remain regarding long-term durability.展开更多
Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole ...Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this context.In the absence of established heart disease,cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney disease.It is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological abnormalities.Despite the clinical description of these potential cardiac-related complications of the liver,the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in HRS.Yet from a physiological sense,temporality(prior onset)of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic patients.In this review,we discuss current concepts surrounding how the heart may influence the development and progression of HRS,and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this setting.The temporality of heart and kidney dysfunction in HRS will be discussed.For a subgroup of patients who receive portosystemic shunting,the dynamics of cardiorenal interactions following treatment is reviewed.Continued research to determine the unknowns in this topic is anticipated,hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.展开更多
Pericardial hematoma is a rare but potentially lifethreatening consequence following cardiac surgery that requires prompt recognition and intervention.Patients can present with symptoms such as chest pain,dyspnea,tach...Pericardial hematoma is a rare but potentially lifethreatening consequence following cardiac surgery that requires prompt recognition and intervention.Patients can present with symptoms such as chest pain,dyspnea,tachycardia,and hypotension,which may mimic other post-operative issues.Loculated pericardial hematoma compressing the atria might be difficult to diagnose.Bleeding and hematoma are more common in patients receiving early anticoagulant therapy.A focused cardiac ultrasound (Fo CUS) plays a pivotal role in the diagnosis,revealing the presence of pericardial effusion and signs of cardiac compression.The aim of this report was to provide a prompt diagnosis of loculated pericardial hematoma via Fo CUS in the emergency department (ED).展开更多
We derived the properties of the terrestrial magnetopause(MP)from two modeling approaches,one global–fluid,the other local–kinetic,and compared the results with data collected in situ by the Magnetospheric Multiscal...We derived the properties of the terrestrial magnetopause(MP)from two modeling approaches,one global–fluid,the other local–kinetic,and compared the results with data collected in situ by the Magnetospheric Multiscale 2(MMS2)spacecraft.We used global magnetohydrodynamic(MHD)simulations of the Earth’s magnetosphere(publicly available from the NASA-CCMC[National Aeronautics and Space Administration–Community Coordinated Modeling Center])and local Vlasov equilibrium models(based on kinetic models for tangential discontinuities)to extract spatial profiles of the plasma and field variables at the Earth’s MP.The global MHD simulations used initial solar wind conditions extracted from the OMNI database at the time epoch when the MMS2 observes the MP.The kinetic Vlasov model used asymptotic boundary conditions derived from the same in situ MMS measurements upstream or downstream of the MP.The global MHD simulations provide a three-dimensional image of the magnetosphere at the time when the MMS2 crosses the MP.The Vlasov model provides a one-dimensional local view of the MP derived from first principles of kinetic theory.The MMS2 experimental data also serve as a reference for comparing and validating the numerical simulations and modeling.We found that the MP transition layer formed in global MHD simulations was generally localized closer to the Earth(roughly by one Earth radius)from the position of the real MP observed by the MMS.We also found that the global MHD simulations overestimated the thickness of the MP transition by one order of magnitude for three analyzed variables:magnetic field,density,and tangential speed.The MP thickness derived from the local Vlasov equilibrium was consistent with observations for all three of these variables.The overestimation of density in the Vlasov equilibrium was reduced compared with the global MHD solutions.We discuss our results in the context of future SMILE(Solar wind Magnetosphere Ionosphere Link Explorer)campaigns for observing the Earth’s MP.展开更多
When assessing the sliding stability of a concrete dam,the influence of large-scale asperities in the sliding plane is often ignored due to limitations of the analytical rigid body assessment methods provided by curre...When assessing the sliding stability of a concrete dam,the influence of large-scale asperities in the sliding plane is often ignored due to limitations of the analytical rigid body assessment methods provided by current dam assessment guidelines.However,these asperities can potentially improve the load capacity of a concrete dam in terms of sliding stability.Although their influence in a sliding plane has been thoroughly studied for direct shear,their influence under eccentric loading,as in the case of dams,is unknown.This paper presents the results of a parametric study that used finite element analysis(FEA)to investigate the influence of large-scale asperities on the load capacity of small buttress dams.By varying the inclination and location of an asperity located in the concrete-rock interface along with the strength of the rock foundation material,transitions between different failure modes and correlations between the load capacity and the varied parameters were observed.The results indicated that the inclination of the asperity had a significant impact on the failure mode.When the inclinationwas 30and greater,interlocking occurred between the dam and foundation and the governing failure modes were either rupture of the dam body or asperity.When the asperity inclination was significant enough to provide interlocking,the load capacity of the dam was impacted by the strength of the rock in the foundation through influencing the load capacity of the asperity.The location of the asperity along the concrete-rock interface did not affect the failure mode,except for when the asperity was located at the toe of the dam,but had an influence on the load capacity when the failure occurred by rupture of the buttress or by sliding.By accounting for a single large-scale asperity in the concrete-rock interface of the analysed dam,a horizontal load capacity increase of 30%e160%was obtained,depending on the inclination and location of the asperity and the strength of the foundation material.展开更多
文摘Background:Incidence and risk factors of parachute injuries has been studied in developed countries,but not in trainees of the airborne forces in the Royal Thailand Army.Methods:A prospective cohort study was conducted among 992 military personnel who attended the basic airborne training program from February to July 2018.Information sheets were used to collect data about(a)personal demographics;(b)environmental conditions surrounding the parachute practice;and(c)parachute-related injuries.The incidence rate of injury was then calculated.Risk factors were examined using multilevel Poisson regression analysis and presented as incidence rate ratio(IRR)and 95%confidence interval(95%CI).Results:A total of 166 parachute-related injuries occurred in 4677 jumps.The incidence rate of injury was 35.50 per 1000 jumps(95%CI 30.04–41.21).Factors significantly related to parachute injury included:jumping with equipment versus without equipment[adjusted IRR(95%CI):1.28(0.88–1.87)],higher wind speed[1.54(1.27–1.87)per knot],airplane versus helicopter exit[1.75(0.68–4.55)],side versus rear exit[2.13(1.43–3.23)],night versus day jumping[2.19(0.81–5.90)],and presence of motion sickness[3.43(1.93–6.92)].Conclusions:To prevent military static line parachute injuries,the following factors should be taken into consideration:type of aircraft,aircraft exit,time of the day,equipment,motion sickness and wind speed.Trial registration:The project was certified by the Research Ethics Committee,Faculty of Medicine,Chulalongkorn University(IRB No.697/60).
文摘Botanic gardens around the world maintain collections of living plants for science, conservation, education, beauty and more. These collections change over time-in scope and content-but the predicted impacts of climate change will require a more strategic approach to the succession of plant species and their landscapes. Royal Botanic Gardens Victoria has recently published a 'Landscape Succession Strategy'for its Melbourne Gardens, a spectacular botanical landscape established in 1846. The strategy recognizes that with 1.6 million visitors each year, responsibility for a heritage-listed landscape and the need to care for a collection of 8500 plant species of conservation and scientific importance, planting and planning must take into account anticipated changes to rainfall and temperature. The trees we plant today must be suitable for the climate of the twenty-second century. Specifically, the Strategy sets out the steps needed over the next twenty years to transition the botanic garden to one resilient to the climate modelled for2090. The document includes a range of practical measures and achievable(and at times somewhat aspirational) targets. Climate analogues will be used to identify places in Australia and elsewhere with conditions today similar to those predicted for Melbourne in 2090, to help select new species for the collection. Modelling of the natural and cultivated distribution of species will be used to help select suitable growth forms to replace existing species of high value or interest. Improved understanding of temperature gradients within the botanic garden, water holding capacity of soils and plant water use behaviour is already resulting in better targeted planting and irrigation. The goal is to retain a similar diversity of species but transition the collection so that by 2036 at least 75% of the species are suitable for the climate in 2090. Over the next few years we hope to provide 100% of irrigation water from sustainable water sources, and infrastructure will be improved to adapt to predicted higher temperatures and more climatic extremes. At all times there will be a strong focus on assisting the broader community in their response to climate change.
文摘Significant loss of life and damage to properties, ecosystems and marine facilities occur due to various natural hazards such as cyclones and tsunamis. Royal HaskoningDHV has developed regional hydrodynamic and wave models covering the Northern Arabian Sea to address these issues. Cyclone modelling was carried out on 11 major cyclones since 1945 and the tsunami modelling on an earthquake along the Makran Fault Line in 1945. Sample results from these modelling studies are presented in this paper. The methodology described in this article for modelling cyclones and tsunamis in the Arabian Sea could be applied to simulate these natural hazards at other sites around the world.
文摘Objectives: To describe thoracic endovascular aortic repair (TEVAR) outcomes at the Royal Brisbane and Women’s Hospital between 2001-2010. Design: Prospective cohort study. Results: We successfully treated 95 of 97 patients for a 98% procedural success rate. Of the treated patients, 68 (72%) were males and mean age was 61 ± 17 years. Average follow up was 3.6 ± 2.0 years. Pathologies treated were: dissection (n = 35), aneurysmal disease (n = 32), traumatic disease (n = 19), coarctation (n = 5) and miscellaneous (n = 4). There was one peri-procedural myocardial infarction. Renal complications occurred in 7 patients (3 with doubling creatinine and 4 requiring temporary renal replacement therapy). Stroke occurred in 2 patients and paresis in 2 patients (permanent in one). Six patients died during index hospitalization and 17 deaths occurred during follow-up, 2 of which were confirmed secondary to aortic pathology. Age (HR 1.08 per year, p < 0.01) and ASA class (HR 2.2 per class, p = 0.02) were independently associated with mortality. There were 25 re-interventions in 22 patients. Eighteen of these re-interventions in 16 patients were related to the management of complications of TEVAR of which 13 were for endoleaks;eight type I, four type II, one type III. Conclusion: TEVAR can be used to treat thoracic aortic pathology but questions remain regarding long-term durability.
文摘Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this context.In the absence of established heart disease,cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney disease.It is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological abnormalities.Despite the clinical description of these potential cardiac-related complications of the liver,the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in HRS.Yet from a physiological sense,temporality(prior onset)of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic patients.In this review,we discuss current concepts surrounding how the heart may influence the development and progression of HRS,and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this setting.The temporality of heart and kidney dysfunction in HRS will be discussed.For a subgroup of patients who receive portosystemic shunting,the dynamics of cardiorenal interactions following treatment is reviewed.Continued research to determine the unknowns in this topic is anticipated,hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.
文摘Pericardial hematoma is a rare but potentially lifethreatening consequence following cardiac surgery that requires prompt recognition and intervention.Patients can present with symptoms such as chest pain,dyspnea,tachycardia,and hypotension,which may mimic other post-operative issues.Loculated pericardial hematoma compressing the atria might be difficult to diagnose.Bleeding and hematoma are more common in patients receiving early anticoagulant therapy.A focused cardiac ultrasound (Fo CUS) plays a pivotal role in the diagnosis,revealing the presence of pericardial effusion and signs of cardiac compression.The aim of this report was to provide a prompt diagnosis of loculated pericardial hematoma via Fo CUS in the emergency department (ED).
基金support from the European Space Agency(ESA)PRODEX(PROgramme de Développement d’Expériences scientifiques)Project mission(No.PEA4000134960)Partial funding was provided by the Romanian Ministry of Research,Innovation and Digitalization under Romanian National Core Program LAPLAS VII(Contract No.30N/2023)+2 种基金the Belgian Solar-Terrestrial Centre of Excellencesupported by the project Belgian Research Action through Interdisciplinary Networks(BRAIN-BE)2.0(Grant No.B2/223/P1/PLATINUM)funded by the Belgian Office for Research(BELSPO)partially supported by a grant from the Romanian Ministry of Education and Research(CNCS-UEFISCDI,Project No.PN-III-P1-1.1TE-2021-0102)。
文摘We derived the properties of the terrestrial magnetopause(MP)from two modeling approaches,one global–fluid,the other local–kinetic,and compared the results with data collected in situ by the Magnetospheric Multiscale 2(MMS2)spacecraft.We used global magnetohydrodynamic(MHD)simulations of the Earth’s magnetosphere(publicly available from the NASA-CCMC[National Aeronautics and Space Administration–Community Coordinated Modeling Center])and local Vlasov equilibrium models(based on kinetic models for tangential discontinuities)to extract spatial profiles of the plasma and field variables at the Earth’s MP.The global MHD simulations used initial solar wind conditions extracted from the OMNI database at the time epoch when the MMS2 observes the MP.The kinetic Vlasov model used asymptotic boundary conditions derived from the same in situ MMS measurements upstream or downstream of the MP.The global MHD simulations provide a three-dimensional image of the magnetosphere at the time when the MMS2 crosses the MP.The Vlasov model provides a one-dimensional local view of the MP derived from first principles of kinetic theory.The MMS2 experimental data also serve as a reference for comparing and validating the numerical simulations and modeling.We found that the MP transition layer formed in global MHD simulations was generally localized closer to the Earth(roughly by one Earth radius)from the position of the real MP observed by the MMS.We also found that the global MHD simulations overestimated the thickness of the MP transition by one order of magnitude for three analyzed variables:magnetic field,density,and tangential speed.The MP thickness derived from the local Vlasov equilibrium was consistent with observations for all three of these variables.The overestimation of density in the Vlasov equilibrium was reduced compared with the global MHD solutions.We discuss our results in the context of future SMILE(Solar wind Magnetosphere Ionosphere Link Explorer)campaigns for observing the Earth’s MP.
基金the Research Council of Norway(Grant No.244029)the project‘Stable dams’,FORMAS(Grant No.2019e01236)+1 种基金the project‘Improved safety assessment of concrete dams’,and SVC(Grant No.VKU32019)the project‘Safe dams’,that supported the development of the research presented in this article.
文摘When assessing the sliding stability of a concrete dam,the influence of large-scale asperities in the sliding plane is often ignored due to limitations of the analytical rigid body assessment methods provided by current dam assessment guidelines.However,these asperities can potentially improve the load capacity of a concrete dam in terms of sliding stability.Although their influence in a sliding plane has been thoroughly studied for direct shear,their influence under eccentric loading,as in the case of dams,is unknown.This paper presents the results of a parametric study that used finite element analysis(FEA)to investigate the influence of large-scale asperities on the load capacity of small buttress dams.By varying the inclination and location of an asperity located in the concrete-rock interface along with the strength of the rock foundation material,transitions between different failure modes and correlations between the load capacity and the varied parameters were observed.The results indicated that the inclination of the asperity had a significant impact on the failure mode.When the inclinationwas 30and greater,interlocking occurred between the dam and foundation and the governing failure modes were either rupture of the dam body or asperity.When the asperity inclination was significant enough to provide interlocking,the load capacity of the dam was impacted by the strength of the rock in the foundation through influencing the load capacity of the asperity.The location of the asperity along the concrete-rock interface did not affect the failure mode,except for when the asperity was located at the toe of the dam,but had an influence on the load capacity when the failure occurred by rupture of the buttress or by sliding.By accounting for a single large-scale asperity in the concrete-rock interface of the analysed dam,a horizontal load capacity increase of 30%e160%was obtained,depending on the inclination and location of the asperity and the strength of the foundation material.
