Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Only

  • accurate only
  • activation only
  • active only
  • activity only
  • adult only
  • age only
  • alcohol only
  • analysis only
  • apparent only
  • applicable only
  • application only
  • area only
  • assessment only
  • attention only
  • available only
  • baseline only
  • behavior only
  • beneficial only
  • benefit only
  • bound only
  • boy only
  • brain only
  • capture only
  • care only
  • case only
  • cell only
  • change only
  • chemotherapy only
  • child only
  • comparable only
  • concentration only
  • condition only
  • control only
  • correlation only
  • data only
  • day only
  • decreased only
  • density only
  • dependent only
  • depression only
  • detectable only
  • determine only
  • diet only
  • difference only
  • direction only
  • disease only
  • distributed only
  • dose only
  • drug only
  • due only
  • effect only
  • effective only
  • effects only
  • equation only
  • evident only
  • examination only
  • exposure only
  • expression only
  • eye only
  • factor only
  • far only
  • feature only
  • female only
  • field only
  • form only
  • formation only
  • function only
  • gene only
  • group only
  • groups only
  • growth only
  • h only
  • high only
  • history only
  • hypertension only
  • important only
  • improvement only
  • increase only
  • individual only
  • infection only
  • information only
  • injury only
  • isolated only
  • knowledge only
  • larva only
  • lasting only
  • layer only
  • leaf only
  • level only
  • limited only
  • line only
  • location only
  • loss only
  • male only
  • man only
  • mean only
  • measure only
  • measurement only
  • method only
  • methods only
  • mode only
  • model only
  • molecule only
  • month only
  • mortality only
  • mother only
  • mouse only
  • mutation only
  • necrosis only
  • neuron only
  • number only
  • observable only
  • one case only
  • other only
  • outcome only
  • pain only
  • parameter only
  • part only
  • participant only
  • patient only
  • performance only
  • period only
  • phase only
  • place only
  • placebo only
  • plant only
  • play only
  • point only
  • population only
  • positive only
  • possible only
  • present only
  • present study only
  • pressure only
  • process only
  • production only
  • protein only
  • purpose only
  • questionnaire only
  • rat only
  • rate only
  • ratio only
  • reaction only
  • recurrence only
  • regions only
  • relate only
  • result only
  • sample only
  • second only
  • sensitive only
  • set only
  • show only
  • showing only
  • shows only
  • signal only
  • significance only
  • significant difference only
  • significant effect only
  • significant only
  • site only
  • soil only
  • species only
  • spectrum only
  • speed only
  • stable only
  • stage only
  • strain only
  • study only
  • subject only
  • success only
  • surface only
  • surgery only
  • survival only
  • symptom only
  • system only
  • temperature only
  • test only
  • therapy only
  • time only
  • tissue only
  • treatment only
  • true only
  • type only
  • urine only
  • use only
  • used only
  • useful only
  • valid only
  • value only
  • variable only
  • vehicle only
  • visible only
  • water only
  • week only
  • woman only
  • year only
  • yield only

  • Terms modified by Only

  • only a few
  • only a few case
  • only a few case report
  • only a few day
  • only a few minute
  • only a few month
  • only a few patient
  • only a few report
  • only a few species
  • only a few studies
  • only a few ten
  • only able
  • only abnormality
  • only account
  • only act
  • only adult
  • only affect
  • only age
  • only alternative
  • only apparent
  • only applicable
  • only article
  • only available
  • only beginning
  • only capable
  • only case
  • only cause
  • only cell
  • only change
  • only child
  • only common
  • only compound
  • only control
  • only cost
  • only country
  • only curative treatment
  • only dance
  • only data
  • only decrease
  • only decreased
  • only dependent
  • only depression
  • only detectable
  • only determinant
  • only determine
  • only difference
  • only effective
  • only effective treatment
  • only enzyme
  • only essential
  • only evident
  • only example
  • only exception
  • only factor
  • only fair
  • only family
  • only feasible
  • only feature
  • only female
  • only form
  • only function
  • only gene
  • only group
  • only half
  • only help
  • only hope
  • only ifn
  • only important
  • only increase
  • only independent factor
  • only independent predictor
  • only independent prognostic factor
  • only independent risk factor
  • only independent variable
  • only individual
  • only information
  • only intervention
  • only knowledge
  • only large
  • only lead
  • only leaf
  • only likely
  • only limited
  • only limited data
  • only limited evidence
  • only limited information
  • only limited success
  • only limited understanding
  • only little
  • only low amount
  • only low level
  • only make
  • only male
  • only manifestation
  • only marginal
  • only marker
  • only mean
  • only measure
  • only member
  • only method
  • only mild
  • only minimal
  • only minor
  • only minor change
  • only minor deviation
  • only minor difference
  • only minor effect
  • only minor effects
  • only moderate
  • only modest
  • only modest change
  • only modest effects
  • only n
  • only necessary
  • only need
  • only one allele
  • only one aspect
  • only one case
  • only one child
  • only one component
  • only one dimension
  • only one gene
  • only one individual
  • only one part
  • only one patient
  • only one report
  • only one species
  • only one study
  • only one third
  • only one type
  • only one-third
  • only ones
  • only opportunity
  • only option
  • only parameter
  • only part
  • only partial
  • only patient
  • only play
  • only positive
  • only possible
  • only predictive factor
  • only predictor
  • only preliminary
  • only present
  • only process
  • only product
  • only products
  • only protein
  • only relate
  • only relevant
  • only result
  • only risk factor
  • only sample
  • only sensitive
  • only sequence
  • only show
  • only shows
  • only sign
  • only significant
  • only significant difference
  • only significant factor
  • only significant predictor
  • only significant risk factor
  • only significant variable
  • only site
  • only slight
  • only slight change
  • only slight difference
  • only small
  • only small amount
  • only small change
  • only small difference
  • only solution
  • only source
  • only sparse data
  • only species
  • only structure
  • only studies
  • only study
  • only subject
  • only successful
  • only suitable
  • only support
  • only symptom
  • only take
  • only time
  • only trace amount
  • only traces
  • only transient
  • only treatment
  • only trials
  • only true
  • only type
  • only used
  • only useful
  • only valid
  • only variable
  • only very
  • only visible
  • only way
  • only weak
  • only weak evidence
  • only weakly
  • only weakly dependent
  • only weakly positive
  • only weakly relate
  • only woman
  • only work

  • Selected Abstracts


    Johan Christiaens
    Based on governmental accounting experiences and on the rising criticism of accrual accounting, this paper proposes that accrual accounting in governments will only succeed in businesslike (parts of) governments in the coming years. This proposition leans on the inappropriate transfer of the accrual accounting framework from the profit sector, the underestimation of difficulties considering accrual budgeting and the lack of attention to the political dimension. This paper points out that the advocates of accrual accounting have neglected some important considerations. [source]

    Emergency Medicine Practitioner Knowledge and Use of Decision Rules for the Evaluation of Patients with Suspected Pulmonary Embolism: Variations by Practice Setting and Training Level

    Michael S. Runyon MD
    Abstract Background Several clinical decision rules (CDRs) have been validated for pretest probability assessment of pulmonary embolism (PE), but the authors are unaware of any data quantifying and characterizing their use in emergency departments. Objectives To characterize clinicians' knowledge of and attitudes toward two commonly used CDRs for PE. Methods By using a modified Delphi approach, the authors developed a two-page paper survey including 15 multiple-choice questions. The questions were designed to determine the respondents' familiarity, frequency of use, and comprehension of the Canadian and Charlotte rules. The survey also queried the frequency of use of unstructured (gestalt) pretest probability assessment and reasons why physicians choose not to use decision rules. The surveys were sent to physicians, physician assistants, and medical students at 32 academic and community hospitals in the United States and the United Kingdom. Results Respondents included 555 clinicians; 443 (80%) work in academic practice, and 112 (20%) are community based. Significantly more academic practitioners (73%) than community practitioners (49%) indicated familiarity with at least one of the two decision rules. Among all respondents familiar with a rule, 50% reported using it in more than half of applicable cases. A significant number of these respondents could not correctly identify a key component of the rule (23% for the Charlotte rule and 43% for the Canadian rule). Fifty-seven percent of all respondents indicated use of gestalt rather than a decision rule in more than half of cases. Conclusions Academic clinicians were more likely to report familiarity with either of these two specific decision rules. Only one half of all clinicians reporting familiarity with the rules use them in more than 50% of applicable cases. Spontaneous recall of the specific elements of the rules was low to moderate. Future work should consider clinical gestalt in the evaluation of patients with possible PE. [source]

    Fat as a fuel: emerging understanding of the adipose tissue,skeletal muscle axis

    ACTA PHYSIOLOGICA, Issue 4 2010
    K. N. Frayn
    Abstract The early pioneers in the field of metabolism during exercise such as Lindhard and Krogh understood the importance of fat as a fuel for muscle contraction. But they could not have understood the details of the pathways involved, as neither the metabolic role of adipose tissue nor the transport role of non-esterified fatty acids (NEFA) in the plasma was clearly understood at the time. We now recognize that the onset of muscular contraction coincides with an increase in the delivery of NEFA from adipose tissue, probably coordinated by the sympatho-adrenal system. During light exercise, adipose tissue-derived NEFA make up the majority of the oxidative fuel used by muscle. As exercise is prolonged, the importance of NEFA increases. The onset of exercise is marked by an increased proportion of NEFAs entering ,-oxidation rather than re-esterification and recycling. At moderate intensities of exercise, other sources of fat, potentially plasma- and intramyocellular-triacylglycerol, supplement the supply of plasma NEFA. The delivery of NEFA is augmented by increased adipose tissue blood flow and by other stimuli such as atrial natriuretic peptide. Only during high-intensity exercise is there a failure of adipose tissue to deliver sufficient fatty acids for muscle (which is coupled with an inability of muscle to use them, even when fatty acids are supplied artificially). This limitation of adipose tissue NEFA delivery may reflect some feedback inhibition of lipolysis, perhaps via lactate, or possibly ,-adrenergic inhibition of lipolysis at very high catecholamine concentrations. [source]

    Is Functional Capacity Related to Left Atrial Contractile Function in Nonobstructive Hypertrophic Cardiomyopathy?

    Yukitaka Shizukuda MD
    The mechanisms underlying reduced exercise capacity in patients with nonobstructive hypertrophic cardiomyopathy (NHCM) could include perturbations of ventricular relaxation, diastolic compliance, or compensatory atrial systolic function. We hypothesized that a loss of atrial contractility in NHCM patients leads to reduced functional capacity. To test this hypothesis, we compared resting noninvasive left atrial ejection phase indices in 49 consecutive patients with NHCM (ages 36±10 years; 41% female) and normal left ventricular ejection fraction (mean, 68%±8%) with objective metabolic exercise parameters. Left atrial active emptying fraction, ejection force, and kinetic energy failed to predict exercise capacity. Only left atrial total and active emptying volumes correlated weakly with minute volume/CO2 production slope (r=0.31 and r=0.33; p<0.05 for both). Furthermore, when subjects were stratified by New York Heart Association symptomatology, exercise parameters,but not atrial contractility,differed between groups. These data, obtained at rest, fail to suggest that NHCM-related heart failure symptoms are due to an atrial myopathy. [source]

    The Assessment of Emergency Physicians by a Regulatory Authority

    Jocelyn M. Lockyer PhD
    Abstract Objectives To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program (360° evaluation) for emergency physicians. Methods Surveys with 16, 20, 30, and 31 items were developed to assess emergency physicians by 25 patients, eight coworkers, eight medical colleagues, and self, respectively, using five-point scales along with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management. Results Data from 187 physicians who identified themselves as emergency physicians were available. The mean number of respondents per physician was 21.6 (SD ± 3.87) (93%) for patients, 7.6 (SD ± 0.89) (96%) for coworkers, and 7.7 (SD ± 0.61) (95%) for medical colleagues, suggesting it was a feasible tool. Only the patient survey had four items with "unable to assess" percentages ,15%. The factor analysis indicated there were two factors on the patient questionnaire (communication/professionalism and patient education), two on the coworker survey (communication/collegiality and professionalism), and four on the medical colleague questionnaire (clinical performance, professionalism, self-management, and record management) that accounted for 80.0%, 62.5%, and 71.9% of the variance on the surveys, respectively. The factors were consistent with the intent of the instruments, providing empirical evidence of validity for the instruments. Reliability was established for the instruments (Cronbach's , > 0.94) and for each physician (generalizability coefficients were 0.68 for patients, 0.85 for coworkers, and 0.84 for medical colleagues). Conclusions The psychometric examination of the data suggests that the instruments developed to assess emergency physicians were feasible and provide evidence for validity and reliability. [source]

    Population Size, Genetic Variation, and Reproductive Success in a Rapidly Declining, Self-Incompatible Perennial (Arnica montana) in The Netherlands

    Sheila H. Luijten
    In 26 populations in The Netherlands we investigated the relationship between population size and genetic variation using allozyme markers. Genetic variation was low in A. montana ( He = 0.088). There were positive correlations between population size and the proportion of polymorphic loci, the number of effective alleles, and expected heterozygosity, but not with observed heterozygosity. There was a significantly positive correlation between population size and the inbreeding coefficient. Generally, small populations showed heterozygote excess, which decreased with increasing population size. Possibly, the heterozygous individuals in small populations are survivors from the formerly larger populations with relatively high fitness. The F statistics showed a moderately high level of differentiation among populations ( FST = 0.140 ± 0.02), implying a low level of gene flow. For three out of four allozyme loci, we found significant inbreeding ( FIS = 0.104 ± 0.03). Only 14 of 26 populations were in Hardy-Weinberg equilibrium at all four polymorphic loci. In a subset of 14 populations of various size, we investigated natural seed production and offspring fitness. Population size was positively correlated with seed set, seedling size, number of flowering stems and flowerheads, adult survival, and total relative fitness, but not with the number of florets per flowerhead, germination rate, or the proportion of germination. Offspring performance in the greenhouse was not associated with genetic diversity measured on their mothers in the field. We conclude that the fitness of small populations is significantly reduced, but that there is as yet no evidence that this was caused by inbreeding. Possibly, the self-incompatibility system of A. montana has been effective in reducing selfing rates and inbreeding depression. Resumen:Arnica montana es una especie de planta rara, en declinación rápida y autoincompatible. En 26 poblaciones de los Países Bajos investigamos la relación entre el tamaño poblacional y la variación genética mediante el uso de alozimas marcadoras. La variación genética fue baja en A. montana ( He = 0.088). Existió una correlación positiva entre el tamaño poblacional y la proporción de emplazamientos polimórficos, el número de alelos efectivos y la heterocigocidad esperada, pero no con la heterocigocidad observada. Existió una correlación positiva significativa entre el tamaño poblacional y el coeficiente de endogamia. Generalmente, las poblaciones pequeñas mostraron una heterocigocidad excesiva con disminuciones en el tamaño poblacional. Posiblemente, los individuos heterocigóticos de poblaciones pequeñas son sobrevivientes de poblaciones anteriormente grandes con una adaptabilidad relativamente alta. Las pruebas de F mostraron un nivel de diferenciación moderadamente alto entre poblaciones ( FST = 0.140 ± 0.02) lo que implica un nivel bajo de flujo de genes. Para tres de cuatro de los emplazamientos de alozimas encontramos una endogamia significativa ( FIS = 0.104 ± 0.03). Solamente 14 de las 26 poblaciones estuvieron en equilibrio Hardy-Weinberg para los cuatro emplazamientos polimórficos. En un subconjunto de 14 poblaciones de varios tamaños, investigamos la producción natural de semillas y la adaptabilidad de la descendencia. El tamaño poblacional estuvo positivamente correlacionado con el juego de semillas, el tamaño del almácigo, el número de tallos en flor y de inflorescencias, la supervivencia de adultos y la adaptabilidad total relativa, pero no con el número de flores por inflorescencia, la tasa de germinación ni la proporción de la germinación. El rendimiento de la descendencia en invernaderos no estuvo asociado con la diversidad genética medida en sus madres en el campo. Concluimos que la adaptabilidad de poblaciones pequeñas está significativamente reducida, pero no existe aún evidencia de que esto sea ocasionado por endogamia. Es posible que el sistema de autoincompatibilidad de A. montana haya sido efectivo en la reducción de tasas de autofecundación y depresión de la endogamia. [source]

    Dermatitis from common ivy (Hedera helix L. subsp. helix) in Europe: past, present, and future

    CONTACT DERMATITIS, Issue 4 2010
    Evy Paulsen
    Common ivy (Hedera helix subsp. helix) is a well-known native and ornamental plant in Europe. Reports on contact dermatitis from ivy have regularly appeared since 1899. Recently, it has been suggested that allergic contact dermatitis from the plant may be under-diagnosed, partly due to lack of commercial patch test allergens. The objective of the article is to present the results of aimed patch testing with the main common ivy allergen, falcarinol, during a 16-year period and review the newer literature. Consecutive patients tested with falcarinol 0.03% petrolatum from May 1993 to May 2009 were included. Cases published since 1987 were retrieved from the PubMed database. One hundred and twenty-seven Danish patients were tested with falcarinol and 10 (7.9%) tested positive. Seven were occupationally sensitized. Between 1994 and 2009, 28 new cases of contact dermatitis from ivy were reported, 2 of which were occupational. Only 11 of the 28 patients were tested with pure allergens. Falcarinol is not only widely distributed in the ivy family, but also in the closely related Apiaceae. Sensitization may occur in childhood or in adults pruning ivy plants or handling them in an occupational setting. In view of the ubiquity of falcarinol-containing plants and the relatively high prevalence of positive reactions in aimed patch testing, falcarinol should be the next plant allergen to be commercially available and included in the plant series worldwide. [source]

    Twenty-five years quaternium-15 in the European baseline series: does it deserve its place there?

    CONTACT DERMATITIS, Issue 4 2010
    Anton C. De Groot
    For allergens to be included in the European baseline series, they should have allergy rates of at least 1%. In several studies quaternium-15 had lower scores. Also, many cases of sensitization are already detected by formaldehyde contact allergy. The aim of this study was to evaluate whether quaternium-15 deserves continued inclusion in the baseline series on the basis of current criteria: 1% positive reactions, common occurrence in the environment, many relevant reactions. We used the literature survey method in this study. Only the United Kingdom has rates consistently over 1%. The mean for all other countries together and for many individual nations is lower than 1%. At least half of the reactions are already detected by formaldehyde sensitivity, which lowers rates for allergy to quaternium-15 per se (i.e. not caused or at least detected by formaldehyde sensitivity) to less than 0.6% for all countries except the United Kingdom. Neither common occurrence in the environment nor a high percentage of relevant reactions has been ascertained. It may well be argued that quaternium-15 does not deserve its place in the European baseline series and could be incorporated in a cosmetic screening series or preservative series instead. In the United Kingdom, routine testing should be continued. [source]

    Treatment of Parthenium dermatitis with methotrexate

    CONTACT DERMATITIS, Issue 2 2007
    Vinod K. Sharma
    Patients with parthenium dermatitis are often unresponsive to topical steroids, and immunosuppressive agents may be necessary to reduce their need for systemic corticosteroids. We evaluated the efficacy of methotrexate in parthenium dermatitis. Sixteen patients unresponsive to topical treatment were included after baseline investigations, and treated with oral methotrexate (15 mg/week). Clinical response was monitored using a dermatitis area and severity index (DASI). Seven patients completed ,6 months' follow-up, and their mean DASI fell to 5, 2.7 and 2.1 at the end of 1, 3 and 6 months respectively, from a baseline score of 10. Only 3/7 patients required oral prednisolone in the initial 2,4 weeks. Side effects were minor, being mainly folliculitis and furuncles. Methotrexate may hence be a useful alternative for patients with severe parthenium dermatitis. [source]

    The prognosis of occupational contact dermatitis in 2004

    CONTACT DERMATITIS, Issue 5-6 2004
    Jennifer Cahill
    The prognosis of occupational contact dermatitis (OCD) takes into account the extent of healing, effect on quality of life and employment, and financial costs for both the individual and the wider community. We reviewed 15 studies published between 1958 and 2002, reporting the complete clearance of dermatitis (range of 18,72%). 9 of the 15 studies reported a clearance rate of between 18 and 40%. Improvement was reported as an outcome in 3 studies between 1991 and 2002 (range of 70,84%). A number of common variables were identified as of possible influence. These include age, sex, atopy, patient knowledge, disease aetiology, duration of symptoms and job change; clinical, financial and social issues are also described. All of these factors need to be considered when managing a patient with OCD. Improved patient knowledge and early diagnosis may be associated with improved prognosis, whereas job change does not make a significant difference. Some patients will develop persistent post-occupational dermatitis, which has important implications for prognosis and workers' compensation. Only a small proportion of eligible patients receive workers' compensation, even though financially supported healing time soon after diagnosis may result in an improved prognosis. [source]

    P03 Type-I and -IV hypersensitivity to platinum salts

    CONTACT DERMATITIS, Issue 3 2004
    Willeke Kamphof
    A 28-year-old female analytical chemist visited our patch test clinic with initially complaints of severe hand dermatitis. Later on she developed rhinitis, bronchial asthma and tightness of the chest. The complaints seemed work related: her condition improved during holidays and on sick leaves. She worked in a laboratory with several platinum salts and used different kinds of gloves (latex, nitril, etc.). Methods:, Patch tests were performed with the European Standard series and prick tests with common inhalant allergens. Patch-, prick- and open patch tests were carried out with various aqueous dilutions of platinum chloride (PtCl2). Results:, Patch tests with 0.01,2% PtCl2 were positive on day 2, 3 and 6, and at 0.001% a follicular reaction was found. The prick-test was already positive at the lowest concentration tested (0.001%). The open patch test, carried out retro-auricular, showed a positive reaction at 1 and 2% PtCl2 after 20 min. Controls in healthy volunteers (n = 5) were all negative. Discussion:, It is well known that platinum salts can cause type-I hypersensitivity reactions like allergic rhinitis, conjunctivitis, bronchial asthma and urticaria, also referred to as platinosis. Contact dermatitis to platinum salts, however, is very rare. In our patch test clinic, 78 patients were tested between 1987 and 2001 with PtCl2 2%. Only 2 women showed a positive patch test for PtCl2. The patient presented here, stopped working with platinum salts and recovered from all complaints. We interpret our case as occupational type-I and type-IV hypersensitivity to platinum salts with mucosal and dermal manifestations. [source]

    Occupational immunologic contact urticaria from pine processionary caterpillar (Thaumetopoea pityocampa): experience in 30 cases

    CONTACT DERMATITIS, Issue 2 2004
    Jesús Vega
    Cutaneous lesions caused by the pine processionary caterpillar Thaumetopoea pityocampa (TP) are frequent in pinewood areas. In the present study, 30 patients diagnosed with occupational immunologic urticaria from this caterpillar were included. Immediate hypersensitivity was demonstrated by performing prick and IgE-immunoblotting tests. Workers were grouped according to their common tasks. Occupations at risk of exposure to TP were pine-cone collectors/woodcutters (14), farmers/stockbreeders (8), other forestry personnel (4), construction workers (2), residential gardeners (1) and entomologists (1). Besides contact urticaria, angioedema (60%), papular lesions of several days of evolution (30%) and anaphylactic reactions (40%) were also detected. The most frequently detected molecular weight bands by immunoblot were 15 (70%), 17 (57%) and 13 kDa (50%). The appearance of isolated bands corresponds with the least serious cases. Only 8 subjects had bands higher than 33 kDa, which was present in the 3 most severe cases of anaphylactic reactions. By presenting these cases, we wish to offer the largest series reported so far of occupational immunologic contact urticaria caused by TP. We include the first cases described in certain occupations, some of them not directly related to forestry work. Pine-cone or resin collectors, woodcutters, farmers and stockbreeders were the most frequently and severely affected workers. [source]

    Career counsellors and occupational contact dermatitis

    CONTACT DERMATITIS, Issue 4 2003
    Helen Saunders
    Career counsellors are in a unique position to provide timely preventive advice to young people at risk of developing occupational contact dermatitis. Career counsellors need to be aware of risk factors for this condition, including atopic eczema, and of high-risk occupations, such as hairdressing. A cross-sectional survey of 82 career counsellors was conducted at an Australian career counsellors' conference. 24 (29%, 95% confidence interval (95% CI) 19,40%) correctly identified eczema as a risk factor. 25 (30%, 95% CI 21,41%) indicated consideration of past skin problems during career counselling. 30 (36%, 95% CI 25,47%) correctly reported at least 1 high-risk occupation, with hairdressing being most frequently identified. Only 3 of the 82 (4%, 95% CI 0,7%) correctly answered all 3 questions. [source]

    Dispersion of Dust Acoustic Modes and Perturbations of Plasma Flux Balance

    V. Tsytovich
    Abstract Previous considerations of dust acoustic waves is demonstrated to be inconsistent - the required equilibrium state for perturbations was not defined since balance of plasma fluxes was neglecting. The self-consistent treatment shows that plasma flux perturbations are accompanying any collective waves propagating in dusty plasmas and can play an important role in wave dispersion, wave damping and can create instabilities. This is illustrated by the derivation of dispersion relation for dust acoustic modes taking into account the plasma flux balances and plasma flux perturbations by waves. The result of this approach shows that the dust acoustic waves with linear dependence of wave frequency on the wave number exist only in restricted range of the wave numbers. Only for wave numbers larger than some critical wave number for low frequency modes the frequency can be have approximately a linear dependence on wave number and can be called as dust acoustic wave but the phase velocity of these waves is different from that which can be obtained neglecting the flux balance and depends on grain charge variations which are determined by the balance of fluxes. The presence of plasma fluxes previously neglected is the main typical feature of dusty plasmas. The dispersion relation in the range of small wave numbers is found to be mainly determined by the change of the plasma fluxes and is quite different from that of dust acoustic type, namely it is found to have the same form as the well known dispersion relation for the gravitational instability. This result proves in general way the existence of the collective grain attractions of negatively charged grains for for large distances between them and for any source of ionization. The attraction of grains found from dispersion relation of the dust acoustic branch coincides with that found previously for pair grain interactions using some models for the ionization source. For the existing experiments the effective Jeans length for such attraction is estimated to be about 8 , 10 times larger than the ion Debye length and the effective gravitational constant for the grain attraction is estimated to be several orders of magnitude larger than the usual gravitational constant. The grain attraction at large inter-grain distances described by the gravitationlike grain instability is considered as the simplest explanation for observed dust cloud clustering, formation of dust structures including the plasma crystals. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    Board Monitoring, Regulation, and Performance in the Banking Industry: Evidence from the Market for Corporate Control

    Jens Hagendorff
    ABSTRACT Manuscript Type: Empirical Research Question/Issue: The specific monitoring effect of boards of directors versus industry regulation is unclear. In this paper, we examine how the interaction between bank-level monitoring and regulatory regimes influences the announcement period returns of acquiring banks in the US and twelve European economies. Research Findings/Insights: We study three board monitoring mechanisms , independence, CEO-chair duality, and diversity , and analyze their effectiveness in preventing underperforming merger strategies under bank regulators of varying strictness. Only under strict banking regulation regimes, do board independence and diversity improve acquisition performance. In less strict regulatory environments, corporate governance is virtually irrelevant in improving the performance outcomes of merger activities. Theoretical/Academic Implications: Our results indicate a complementary role between monitoring by boards and bank regulation. This study is the first to report evidence consistent with complementarity by investigating the effectiveness (rather than the prevalence) of governance arrangements across regulatory regimes. Practitioner/Policy Implications: Our work offers insights to policymakers charged with improving the quality of decision-making at financial institutions. Attempts to improve the ability of bank boards to critically assess managerial initiatives are most likely to be successful if internal governance is accompanied by strict industry regulation. [source]

    Androgen replacement therapy improves function in male rat muscles independently of hypertrophy and activation of the Akt/mTOR pathway

    ACTA PHYSIOLOGICA, Issue 4 2009
    C. Hourdé
    Abstract Aim:, We analysed the effect of physiological doses of androgens following orchidectomy on skeletal muscle and bone of male rats, as well as the relationships between muscle performance, hypertrophy and the Akt/mammalian target of rapamycin (mTOR) signalling pathway involved in the control of anabolic and catabolic muscle metabolism. Methods:, We studied the soleus muscle and tibia from intact rats (SHAM), orchidectomized rats treated for 3 months with vehicle (ORX), nandrolone decanoate (NAN) or dihydrotestosterone (DHT). Results:, Orchidectomy had very little effect on the soleus muscle. However, maximal force production by soleus muscle (+69%) and fatigue resistance (+35%) in NAN rats were both increased when compared with ORX rats. In contrast, DHT treatment did not improve muscle function. The relative number of muscle fibres expressing slow myosin heavy chain and citrate synthase activity were not different in NAN and ORX rats. Moreover, NAN and DHT treatments did not modify muscle weights and cross-sectional area of muscle fibres. Furthermore, phosphorylation levels of downstream targets of the Akt/mTOR signalling pathway, Akt, ribosomal protein S6 and eukaryotic initiation factor 4E-binding protein 1 were similar in muscles of NAN, DHT and ORX rats. In addition, trabecular tibia from NAN and DHT rats displayed higher bone mineral density and bone volume when compared with ORX rats. Only in NAN rats was this associated with increased bone resistance to fracture. Conclusion:, Physiological doses of androgens are beneficial to muscle performance in orchidectomized rats without relationship to muscle and fibre hypertrophy and activation of the Akt/mTOR signalling pathway. Taken together our data clearly indicate that the activity of androgens on muscle and bone could participate in the global improvement of musculoskeletal status in the context of androgen deprivation induced by ageing. [source]

    Characteristics of spousal homicide perpetrators: a study of all cases of spousal homicide in Sweden 1990,1999

    Professor Henrik Belfrage PhD
    Background In Sweden 20 000 cases of assault against women are reported to the police every year. Method All data on the perpetrators of spousal homicide in Sweden between 1990 and 1999 were investigated (n = 164). A control group of all other perpetrators of homicide in Sweden during the same period, i.e. cases of homicide not committed in the context of spouse violence (n = 690) was used. All verdicts, as well as all material in the police investigations, including interviews with all of the police investigators, were analysed. Copies of police examinations of the suspects, and forensic reports from the autopsies, were also examined. Data on all registered criminality were collected from the National Police Register, and in cases where the perpetrators had been subject to forensic psychiatric examinations, those reports were obtained from the Swedish National Board of Forensic Medicine. In addition, the Psychopathy Checklist: Screening Version scores were rated from the forensic psychiatric examinations. Results There was a four times higher suicide rate among the spousal homicide perpetrators (24%, n = 40) compared with the perpetrators in the control-group (6%, n = 39, chi-squared = 55,42df = 1 , p < 0.001). Consequently, suicidal ideation must be considered as an important risk factor for spousal homicide. In 79% of the cases the spousal homicide perpetrators were subject to forensic psychiatric examinations. All except 5% were diagnosed with at least one psychiatric diagnosis, and 34% were sentenced to forensic psychiatric treatment. If it is assumed that the psychiatric morbidity was high in the 24% of the perpetrators who committed suicide, then 80% of all perpetrators of spouse homicide during the study period can be characterized as mentally disordered. ,Psychopathic' perpetrators, who generally are over-represented in most violent criminality, were comparatively uncommon. Only seven (4%) in the study group met the diagnostic criteria for psychopathy as measured with the PCL:SV. Discussion The group of spouse killers studied here fits the dysphoric/borderline group of spouse assaulters. This is a group that may benefit from treatment. Perhaps police officers could help identify this kind of spouse assaulter before a fatality occurs. Copyright © 2004 Whurr Publishers Ltd. [source]

    Multicenter clinical experience with flow cytometric method for fetomaternal hemorrhage detection

    CYTOMETRY, Issue 6 2002
    Jenn C. Chen
    Abstract BACKGROUND Enumeration of fetal red blood cells (RBCs) is important in the management of fetomaternal hemorrhage (FMH), particularly in situations of Rh incompatibility. METHODS We evaluated results from three institutions using the flow cytometric method (FCM) to detect fetal RBCs based on the anti-hemoglobin F (HbF) monoclonal antibody method. RESULTS During 1997,2001, 69 of 1,248 patients (5.5%) had measurable fetal erythrocytes (RBCs) in maternal blood. Only 21 patients (1.7%) had more than 30 mL of fetal blood detected in maternal blood. Of the 11 patients with large FMH and clinical follow-up, 7 had fetal demise (64%). In positive samples, significant differences were found in the fluorescence intensity (FI) of anti-HbF antibody staining between HbF-negative erythrocytes (HbF-) and adult HbF containing erythrocytes (F cells; 4 ± 0 versus 57 ± 9 linear mean channels [LMC]; P < 0.001) and between HbF-cells and fetal RBCs (4 ± 0 versus 433 ± 136 LMC; P < 0.001). In addition, significant differences were observed in forward light scatter intensity between HbF-cells and fetal RBCs (298 ± 15 versus 355 ± 68 LMC, P = 0.03). The transportability of the test is also addressed by comparing results from two other laboratories. The experience of our three laboratories, as well as the results from the recently reinitiated College of American Pathologists survey, which compares FCM and manual methods, clearly documents the superiority of the FCM test over the manual Kleihauer-Betke (KB) test. CONCLUSIONS The FCM is a simpler, more objective, and more precise alternative to the KB method in clinical testing. The high mortality rate associated with large FMH and therapeutic implications of these results should give laboratories motivation to abandon the KB method with more robust FCM to detect FMH. Cytometry (Clin. Cytometry) 50:285,290, 2002. © 2002 Wiley-Liss, Inc. [source]

    Thinking about flagellar oscillation

    CYTOSKELETON, Issue 8 2009
    Charles J. Brokaw
    Abstract Bending of cilia and flagella results from sliding between the microtubular outer doublets, driven by dynein motor enzymes. This review reminds us that many questions remain to be answered before we can understand how dynein-driven sliding causes the oscillatory bending of cilia and flagella. Does oscillation require switching between two distinct, persistent modes of dynein activity? Only one mode, an active forward mode, has been characterized, but an alternative mode, either inactive or reverse, appears to be required. Does switching between modes use information from curvature, sliding direction, or both? Is there a mechanism for reciprocal inhibition? Can a localized capability for oscillatory sliding become self-organized to produce the metachronal phase differences required for bend propagation? Are interactions between adjacent dyneins important for regulation of oscillation and bend propagation? Cell Motil. Cytoskeleton 2008. © 2008 Wiley-Liss, Inc. [source]

    Axoneme-dependent tubulin modifications in singlet microtubules of the Drosophila sperm tail

    CYTOSKELETON, Issue 4 2008
    Henry D. Hoyle
    Abstract Drosophila melanogaster sperm tubulins are posttranslationally glutamylated and glycylated. We show here that axonemes are the substrate for these tubulin C-terminal modifications. Axoneme architecture is required, but full length, motile axonemes are not necessary. Tubulin glutamylation occurs during or shortly after assembly into the axoneme; only glutamylated tubulins are glycylated. Tubulins in other testis microtubules are not modified. Only a small subset of total Drosophila sperm axoneme tubulins have these modifications. Biochemical fractionation of Drosophila sperm showed that central pair and accessory microtubules have the majority of poly-modified tubulins, whereas doublet microtubules have only small amounts of mono- and oligo-modified tubulins. Glutamylation patterns for different ,-tubulins experimentally assembled into axonemes were consistent with utilization of modification sites corresponding to those identified in other organisms, but surrounding sequence context was also important. We compared tubulin modifications in the 9 + 9 + 2 insect sperm tail axonemes of Drosophila with the canonical 9 + 2 axonemes of sperm of the sea urchin Lytichinus pictus and the 9 + 0 motile sperm axonemes of the eel Anguilla japonica. In contrast to Drosophila sperm, L. pictus sperm have equivalent levels of modified tubulins in both doublet and central pair microtubule fractions, whereas the doublets of A. japonica sperm exhibit little glutamylation but extensive glycylation. Tubulin C-terminal modifications are a prevalent feature of motile axonemes, but there is no conserved pattern for placement or amount of these modifications. We conclude their functions are likely species-specific. Cell Motil. Cytoskeleton 2008. © 2008 Wiley-Liss, Inc. [source]

    Interventions for treating traumatized necrotic immature permanent anterior teeth: inducing a calcific barrier & root strengthening

    Mohammad A. D. Al Ansary
    This systematic review attempts to establish where the effects of interventions using multi-visit apexification, single visit apical plug techniques and root strengthening procedures are consistent and where they may vary significantly. Objectives:, To evaluate the relative effectiveness of apexification and apical plug techniques as well as root strengthening procedures for treating traumatized necrotic immature permanent anterior teeth through a systematic review of randomized controlled trials. Reported immediate and/or long-term adverse events and effects of the materials and techniques are also evaluated. Search strategy & selection criteria:, Structured electronic and hand search was performed with no restriction on the language of publication. Only randomized controlled trials comparing different apical barrier formation techniques and root strengthening procedures in traumatized necrotic immature anterior teeth were assessed. Results:, Two hundred studies were identified but only two were suitable for inclusion. Included studies investigated multi-visit apexification techniques using calcium hydroxide and tricalcium phosphate. There were no eligible studies investigating root strengthening procedures or any other intervention for apical barrier formation in necrotic immature anterior teeth. No reliable information was available on long-term adverse effects of the reported interventions or cost implications. Conclusions:, Based on two included studies, there is weak evidence supporting the use of either calcium hydroxide or tricalcium phosphate for apical barrier formation in necrotic immature anterior teeth employing multi-visit apexification techniques. The evidence is insufficient to provide guidelines for practice. There was no reliable evidence on adverse events or long-term effects after the use of calcium hydroxide or tricalcium phosphate justifying caution in their use in apical barrier formation techniques. [source]

    Studies on dentin grafts to bone defects in rabbit tibia and mandible; development of an experimental model

    Lars Andersson
    This property may possibly be used as an alternative or supplement to bone grafting to defective areas after trauma prior to treatment with osseointegrated implants. Hence, the objective of this study was to investigate if dentin can be used as a graft in bone defects in an experimental rabbit model. Materials and Methods:, Eight New Zealand White Rabbits were used to prepare bone cavities either in the angle of the mandible or tibia. Six of the eight tibial and six of the eight mandibular bone defects were filled with dentin blocks from human premolars which were extracted for orthodontic treatment. Two mandibular and two tibial bone cavities were used as controls and all the rabbits were sacrificed after 3 months. Radiographic and histological examinations were performed. Results:, There was a difference in healing pattern between the mandibular and tibial defects. In the mandible, the dentin blocks were resorbed to a larger extent and more often surrounded by fibrous tissue, probably due to the fact that the dentin blocks were mobile because of the thin mandibles and muscular activity in that area. Only some dentin blocks were ankylosed with the mandibular bone. In the tibia however, all dentin blocks were fused to bone over a large area. Osseous replacement resorption was seen. In control cavities, bone formation was seen but was never complete. No signs of inflammatory changes were seen in any fused grafts. Conclusions:, Dentin grafts have a potential to be incorporated in bone without inflammation and can be used as bone inducer and later replaced by bone. Thus, rabbit tibia served as a better model for further studies of this phenomenon when compared to the mandible. [source]

    An audit of the time to initial treatment in avulsion injuries

    Betul Kargul
    Good outcome requires education of the general public and non-dental professionals. Aim:, Retrospective observational survey of case records of avulsion injuries attending a dental hospital trauma clinic. Method:, Data collected included: hospital number, date of birth, gender, source of patient's referral, date of trauma, number of avulsed teeth, place of initial presentation, storage, hours till initial presentation, and initial treatment. Results:, One hundred and twenty teeth with avulsion were identified in 75 children. The mean age of the patients was 9.8 years (SD = 2.3 years) at the time of trauma with avulsions recorded in 44 (58.7%) boys and in 31 (41.3%) girls. Only 51 (42.5%) teeth were stored in an appropriate medium before attendance at any site and only 48 (40%) of the teeth were seen within 1 h. 83.3% received emergency treatment at general hospital, 89.7% in dental practice and 92.9% at dental hospital. Conclusions:, A minority of avulsion injuries were seen within the first hour and a minority were in appropriate storage medium at presentation. Geographical location plays a huge role in the time taken to reach secondary care. However, improving public and non-dental professional knowledge about tooth storage in avulsion injuries is critical to long-term prognosis of the teeth. [source]

    Dental squash injuries , a survey among players and coaches in Switzerland, Germany and France

    Robert Persic
    Abstract,,, Squash belongs to sporting activities with medium risk of causing dental trauma. Because of high velocity, close body contact and the use of rackets the injury potential in squash has increased. The aim of this work was to conduct a comparative study between Switzerland, Germany and France on a number of issues: the frequency of dental and facial injuries in squash, athletes' habits of wearing mouthguards, as well as the general level of information about emergency measures after a dental trauma and the resulting consequences. Using a standardized questionnaire a total of 653 individuals, 600 squash players and their 53 coaches, were interviewed. In each of the three countries 200 players belonging to four different divisions (juniors, amateurs, semi-professionals and professionals) were surveyed. Of these 653 interviewees 133 (20.4%) have already observed a dental injury; 27 (4.5%) have experienced a dental trauma themselves. Less than half of all interviewed players and coaches (47.6%) were aware of the possibility of replanting avulsed teeth. Just 5.1% were familiar with the tooth rescue kit. Only one individual wore a mouthguard. The results show that the area of squash requires more information about prevention through sports associations, coaches and dentists. [source]

    Oral piercing and oral trauma in a New Zealand sample

    J. A. Kieser
    Abstract,,, This study investigated the periodontal and dental trauma resultant from tongue and lip piercings in a convenience sample of 43 adult dental patients. Patients underwent an intra-oral examination followed by the administration of a questionnaire. Each patient was examined for lingual or buccal recession of the upper and lower incisors as well as the extent of abnormal toothwear or trauma on these teeth. Following bivariate analyses, regression analyses were conducted to test the study hypotheses and derive adjusted estimates for the dependent variables. Of the 43 individuals who participated (93.0% females; mean age 21 years; age range 14,34 years) 76.7% had a tongue piercing, 34.9% had a lip piercing, and 11.6% had both. Only four had had their piercing procedure provided by a doctor or dentist. Postpiercing complications were reported by 34.9%. Most of those with a labial piercing (80.0%) had 1+ labial site with gingival recession (GR), and almost one-third of those with a tongue piercing had at least one lingual site with GR. Age was a significant predictor of the prevalence of lingual recession, with the odds of having lingual recession increasing by 1.17 (95% CI 1.01, 1.35) for every year older than 14. Age was the only significant predictor of the number of lingual sites with recession, but was not a predictor of the prevalence of labial recession or the number of affected sites. There were no significant associations between piercings and abnormal toothwear or trauma. These findings suggest that oral piercings are associated with localized gingival recession, and that the providers of such procedures should ensure that, as part of the informed consent process, prospective patients are informed of the likelihood that their periodontal health may be compromised. [source]

    Level of information concerning dental injuries and their prevention in Swiss basketball , a survey among players and coaches

    Sandra Perunski
    Abstract,,, Basketball carries a medium risk of dental injuries. Swiss data are not available in this respect. Using a standardized questionnaire 302 basketball players from 29 Swiss teams and their 29 coaches were interviewed. The questions focused on the frequency of dental accidents, their prevention and subsequent procedure. The participating 302 players came from three divisions: semi-professional players of National League A and B (102), amateurs of Regional League 2 and 3 (100) and young people of up to the age of 18 (100). The data were evaluated in relation to division, sex and team function. Of the 331 interviewed persons 102 had already seen a dental trauma in basketball and 55 had already had a dental trauma. Only four of the interviewed persons wore mouthguards. The awareness of the procedure following a dental trauma was unsatisfactory. The results of the survey show that significantly more information and education is required in Swiss basketball not only through sports associations but also through coaches and dentists. [source]

    Prevalence of crown fractures in 8,10 years old schoolchildren in Canoas, Brazil

    Maximiano Ferreira Tovo
    Abstract,,, The objective of this work was to evaluate the prevalence of children with crown fractures in permanent anterior teeth in 206 schoolchildren (104 girls and 102 boys) between the ages of 8 and 10 years, enrolled in three public schools in the city of Canoas, Brazil. The prevalence found was 17% with no significant difference between boys and girls, as well as between the ages. The most affected tooth was the maxillary central incisor, and a majority of the children showed only one affected tooth (88.6%). The types of fracture most commonly found were oblique and horizontal, and the portions of dental structures most affected were ,enamel only' and ,enamel and dentin'. Only seven children (20%) sought out dental treatment. [source]

    Use of mouthguards by basketball players in Victoria, Australia

    Helen Cornwell
    Abstract ,,,Basketball is a popular sport in Australia. Although orofacial injuries are common, mouthguard (MG) wear in basketball appears to be low. The purposes of this study were: to measure mouthguard wear by basketball players before and after a promotional intervention; to assess players' knowledge of the value of mouthguards for prevention of injury; and to describe their experience of orofacial injury. Two questionnaires (baseline and follow-up) were administered to a convenience sample of 496 basketball players in Victoria, Australia. Players recruited were youths (12,15-year olds, n = 208) and adults (18 years and over, n = 288), from all basketball levels (social to elite). Completion of the baseline questionnaire was followed immediately by an intervention comprising written and verbal information, a mouthguard blank and instructions on mouthguard construction. The follow-up questionnaire was mailed to all respondents 10,12 weeks later; 135 youths (65%) and 157 adults (54%) completed this. Mouthguard wear at baseline was low but was more frequent at games (62%) than at training (25%). Despite 90% of players acknowledging the protective value of a mouthguard, wear by youths did not increase following the intervention, and wear by adults increased by only 14% for training and 10% at games. Previous orofacial injury was recorded at baseline by 23% of players, but few had requested compensation from Basketball Australia (youths, 17%; adults, 30%). Two predictor variables were statistically identified as related to mouthguard wear: previous orofacial injury and age group. Mouthguard wear was significantly more frequent amongst players with previous injury; such players were 2.76 times more likely to be wearers than those without previous injury. Youths were 2.31 times more likely to wear mouthguards than adults. Only 34 players (12% of respondents at follow-up) had a mouthguard constructed from the blank provided. Although youth and adult groups differed, the overall extent of mouthguard use was disappointingly low. Despite wide recognition of mouthguard value, the intervention had little effect on promoting their use. [source]

    Effects and distribution of the enamel matrix derivative Emdogain® in the periodontal tissues of rat molars transplanted to the abdominal wall

    Yoshioki Hamamoto
    Abstract , The enamel matrix derivative Emdogain® (EMD) has been found to promote regeneration of lost periodontal tissues. We have studied the effects and distribution of EMD in the periodontal tissues of maxillary rat molars transplanted to a subcutaneous position in the abdominal wall. The molars were transplanted with or without EMD either immediately after extraction or after drying for 30 min. After 2 days, 1, 2 or 4 weeks the rats were killed and the teeth were examined by means of light microscopy and immunohistochemistry with anti-amelogenin antibodies. Teeth transplanted immediately after extraction showed formation of alveolar bone separated from the dental roots by a periodontal space, regardless of the use of EMD. Among the teeth that were transplanted with EMD after drying for 30 min, new alveolar bone was formed in five out of eight teeth after 2 and 4 weeks. None of the teeth that were dried for 30 min and transplanted without EMD showed alveolar bone formation. Only one tooth transplanted with EMD showed root resorption after drying, while resorption was noted in all teeth transplanted without EMD. All teeth that were transplanted with EMD and none of the teeth that were transplanted without EMD showed an immunohistochemical reaction for amelogenin. After 2 days, amelogenin was precipitated on all surfaces exposed at the transplantation procedure. Later, the immunoreactive material was redistributed to cells at the root surface, where it was still demonstrable after 4 weeks. In conclusion, EMD is accumulated in cells at the root surface and promotes regeneration of the periodontal tissues of the transplanted teeth. It also seems to promote healing of root resorption. [source]

    Hospital Disaster Preparedness in Los Angeles County

    Amy H. Kaji MD
    Background There are no standardized measures of hospital disaster preparedness or hospital "surge capacity." Objectives To characterize disaster preparedness among a cohort of hospitals in Los Angeles County, focusing on practice variation, plan characteristics, and surge capacity. Methods This was a descriptive, cross-sectional survey study, followed by on-site verification. Forty-five 9-1-1 receiving hospitals in Los Angeles County, CA, participated. Evaluations of hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity (assessed by monthly emergency department diversion status, available beds, ventilators, and isolation rooms), decontamination capability, and pharmaceutical stockpiles were assessed by survey. Results Forty-three of 45 hospital plans (96%) were based on the Hospital Emergency Incident Command System, and the majority had protocols for hospital lockdown (100%), canceling elective surgeries (93%), early discharge (98%), day care for children of staff (88%), designating victim overflow areas (96%), and predisaster "preferred" vendor agreements (96%). All had emergency medical services,compatible radios and more than three days' worth of supplies. Fewer hospitals involved law enforcement (56%) or had mutual aid agreements with other hospitals (20%) or long-term care facilities (7%). Although the vast majority (96%) conducted multiagency drills, only 16% actually involved other agencies in their disaster training. Only 13 of 45 hospitals (29%) had a surge capacity of greater than 20 beds. Less than half (42%) had ten or more isolation rooms, and 27 hospitals (60%) were on diversion greater than 20% of the time. Thirteen hospitals (29%) had immediate access to six or more ventilators. Less than half had warm-water decontamination (42%), while approximately one half (51%) had a chemical antidote stockpile and 42% had an antibiotic stockpile. Conclusions Among hospitals in Los Angeles County, disaster preparedness and surge capacity appear to be limited by a failure to fully integrate interagency training and planning and a severely limited surge capacity, although there is a generally high level of availability of equipment and supplies. [source]