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Quasiclassical trajectory study of the Cl+CH4 reaction dynamics on a quadratic configuration interaction with single and double excitation interpolated potential energy surface.

An ab initio interpolated potential energy surface (PES) for the Cl+CH(4) reactive system has been constructed using the interpolation method of Collins and co-workers [J. Chem. Phys. 102, 5647 (1995); 108, 8302 (1998); 111, 816 (1999); Theor. Chem. Acc. 108, 313 (2002)]. The ab initio calculations have been performed using quadratic configuration interaction with single and double excitation theory to build the PES. A simple scaling all correlation technique has been used to obtain a PES which yields a barrier height and reaction energy in good agreement with high level ab initio calculations and experimental measurements. Using these interpolated PESs, a detailed quasiclassical trajectory study of integral and differential cross sections, product rovibrational populations, and internal energy distributions has been carried out for the Cl+CH(4) and Cl+CD(4) reactions, and the theoretical results have been compared with the available experimental data. It has been shown that the calculated total reaction cross sections versus collision energy for the Cl+CH(4) and Cl+CD(4) reactions is very sensitive to the barrier height. Besides, due to the zero-point energy (ZPE) leakage of the CH(4) molecule to the reaction coordinate in the quasiclassical trajectory (QCT) calculations, the reaction threshold falls below the barrier height of the PES. The ZPE leakage leads to CH(3) and HCl coproducts with internal energy below its corresponding ZPEs. We have shown that a Gaussian binning (GB) analysis of the trajectories yields excitation functions in somehow better agreement with the experimental determinations. The HCl(v'=0) and DCl(v'=0) rotational distributions are as well very sensitive to the ZPE problem. The GB correction narrows and shifts the rotational distributions to lower values of the rotational quantum numbers. However, the present QCT rotational distributions are still hotter than the experimental distributions. In both reactions the angular distributions shift from backward peaked to sideways peaked as collision energy increases, as seen in the experiments and other theoretical calculations.

Journal Article↗

Growth in the Rubinstein-Taybi syndrome.

In order to derive standard curves for height, weight, head circumference (OFC), weight-for-height, and height velocity, we obtained serial measurements in 95 patients with the Rubinstein-Taybi syndrome. Fifty individuals were part of an American study and 45 were ascertained in the Netherlands. Prenatal growth appears to be normal in the Rubinstein-Taybi syndrome, but height, weight, and OFC rapidly fall below the 5th centile in the first few months of life. Height velocity is somewhat below the mean but within the normal range except for the lack of a pubertal growth spurt. This phenomenon probably contributes to the short stature which is seen in these patients. Males are overweight for height during childhood while females are overweight during adolescence. The average OFC in males is smaller than in females. In general only a minority of adult patients are microcephalic.

Abnormalities, Multiple↗

Spontaneous thrombosis of a basilar artery traumatic aneurysm in a child.

Traumatic aneurysms are rare and occur most commonly in young adults; however, the relative frequency in the pediatric population is high, owing to the low prevalence of congenital saccular aneurysms in children. Traumatic aneurysms typically involve the anterior circulation, and spontaneous thrombosis is uncommon; hence, surgery is usually necessary. We present a case of a posttraumatic aneurysm in a child that occurred after a fall from a large height and that spontaneously thrombosed.

Accidental Falls↗

Age-related reductions in the strength of the femur tested in a fall-loading configuration.

UNLABELLED: To assess age-related changes in femoral strength as a component in the risk of fracture of the hip, we compared the loads at fracture of the proximal aspects of femora from the cadavera of older and younger individuals, as tested in a fall-loading configuration. To provide a basis for non-invasive in vivo estimates of femoral strength, we also determined the correlations between variables measured with dual-energy x-ray absorptiometry and these loads. Femora from the cadavera of eight older individuals (mean age, seventy-four years) and nine younger individuals (mean age, thirty-three years) were scanned with a Hologic QDR-2000 densitometer to obtain densitometric and geometric information. The femora were then tested mechanically in a loading configuration that simulated a fall on the greater trochanter. The femora from the older group were half as strong as those from the younger group (p < 0.001), and they absorbed one-third as much energy (p < 0.001). The area bone-mineral density of the femoral neck correlated strongly with the load at fracture (r2 = 0.92). CLINICAL RELEVANCE: The prevalence of fracture of the hip increases exponentially with age. 90 percent of those fractures are the result of a simple fall from a standing height.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

An evaluation of the underlying causes of fall-induced hip fractures in elderly persons.

BACKGROUND: Falls are the major cause of hip fractures in elderly patients. The aim of this prospective study was to investigate the underlying causes of fall-induced hip fractures in the elderly. METHODS: The study included 32 patients (18 males, 14 females; mean age 78 years; range 57 to 95 years) who had proximal femoral fractures following an unexpected and sudden fall from about a meter height at a moment of lying, sitting, or standing position. Underlying causes of falls were sought, including previous falls, stroke, polyneuropathy, motion disorders, dementia, vision problems, fainting, vestibular pathologies, and cardiac diseases. RESULTS: Eight patients (25%) had a history of previous falls and 12 patients (37.5%) had a history of stroke. Polyneuropathy, Parkinson's Disease, and dementia were diagnosed in eight (25%), three (9.4%), and five (15.6%) patients, respectively. Twenty-one patients (65.6%) had neurologic diseases, 11 patients (34.4%) had cataract or other vision problems, eight patients (25%) had osteoarthritis and rheumatoid arthritis, 10 patients (31.3%) had vestibular pathologies, and 17 patients (53.1%) had cardiac diseases such as heart failure, orthostatic hypotension, ischemic heart disease, and arrhythmia. CONCLUSION: In order to prevent recurrent falls, risk factors associated with falls should be determined and preventive treatment and measures should be put into practice in elderly patients who have fall-induced injuries.

Accidental Falls↗

Adolescents with cystic fibrosis in The Netherlands.

In a survey-study of all living Dutch patients with cystic fibrosis (CF) born before 1971 data have been gathered on sex, age, age at diagnosis; height and weight; treatment and social development. The group consists of 102 schoolchildren (8-11 years), 179 adolescents (12-21 years) and 28 young adults (22-40 years). Males are in the majority, especially in the 12 to 17 age group (61%). In 51% of all patients CF was diagnosed before the age of 2, and in 75% before the age of 5. Male CF patients are on average 6 cm (0.84 SD) shorter than normal and female patients 3 cm (0.48 SD). As far as weight for height is concerned, 54% of the CF patients fall below the 10th percentile. Weight for height is slightly lower in females than in males. CF patients usually leave primary school at an older age than their healthy peers. In comparison to healthy adolescents of the same age, adolescents with CF attend full-time day-school for a longer time, more of them receive general education and fewer take vocational training. Adolescents and young adults with CF do not stay longer than normal in the protective environment of their parental home.

Adolescent↗

[Characteristics of traumatic death of people in high mountains].

Lethal accidents with tourists who died of trauma in high mountains of Kabardino-Balkaria were retrospectively studied for the period from 1978 to 2003. The victims were 163 males and 17 females aged 14-72 years. Among causes of death most prevalent was a step-by-step blunt mechanical trauma as a result of falling from a great height. In such conditions the body obtains great kinetic energy causing a severe, often lethal, craniocerebral injury with destruction of the brain, blunt injury of the chest, thoracic and other organs.

Accidental Falls↗

A comparison of phenotypic plasticity in the native dandelion Taraxacum ceratophorum and its invasive congener T. officinale.

We compared plastic responses to variation in the light environment for sympatric populations of native and exotic dandelion species, Taraxacum ceratophorum and Taraxacum officinale. Plasticity in leaf size, inflorescence height, reproductive phenology and dispersal-related traits were measured under experimentally altered light quality (red : far-red light ratio, R : FR) and light intensity (photosynthetically active radiation, PAR). To test whether differences in means and reaction norms of dispersal-related traits between species affected colonization potential, we created seed-dispersal models based on seed-fall rate and release height. Differences in plasticity between species were not systematic, but varied in direction and magnitude among traits. Taraxacum officinale produced larger leaves that exhibited greater plasticity in size under variable light intensity than T. ceratophorum. Plasticity in scape length at flowering occurred in relation to R : FR ratio in both species, but tended to be greater in T. ceratophorum. Seed-bearing scapes of T. officinale were taller and more canalized in height across light regimes than scapes of T. ceratophorum. Seeds of T. officinale were smaller than seeds of T. ceratophorum. Models predict greater dispersal in T. officinale within open and vegetated habitats. In contrast to the idea that plasticity promotes invasiveness, results suggest that the lack of plasticity in dispersal-related traits enhances the colonization potential of T. officinale.

Adaptation, Physiological↗

Time requirement for young and elderly women to move into a position for breaking a fall with outstretched hands.

BACKGROUND: Risk for hip fracture during a fall is reduced by contacting the ground first with the outstretched hands. However, it is unclear whether the time required for young and elderly individuals to move the hands into a protective position exceeds that available during a typical fall. METHODS: We tested whether young (n = 30; aged 18-35 years) and elderly women (n = 30; aged 70-88 years) differed in the time required to move their hands into a protective position for breaking a fall. Participants stood either facing or sideways to shoulder-height targets (simulating forward and sideways falls, respectively), which they were instructed to contact as quickly as possible after hearing an aural go cue. Total contact time was partitioned into reaction time and movement time. RESULTS: Young women contacted the targets faster than elderly women in both forward (530 +/- 60 vs 615 +/- 88 ms; p <.001) and sideways trials (658 +/- 80 vs 799 +/- 145 ms; p <.001). This difference was due to faster movement times for young participants. There was no difference between groups in reaction time. CONCLUSIONS: Previous studies have shown that during actual falls from standing, wrist and pelvis contact occur at 680 +/- 116 and 715 +/- 160 ms, respectively. Comparing these values to our results suggests that the typical elderly woman should be able to move her hands quickly enough to break a forward fall, but not a sideways fall.

Accidental Falls↗

[Secondary prevention of osteoporosis and identification of high risk patients].

Low bone mass is a major determinant of bone fragility. With respect to hip fracture risk however, there is limited contribution of BMD to the exponential age-related increase in hip fracture incidence. Large prospective studies have identified a number of additional risk factors for hip fractures independent of bone density. These can be classified as skeletal factors and fall-related factors. Body height and hip axis length are positively correlated with fracture risk. Neuromuscular impairment with low gait speed, difficulty in doing a tandem walk, lower limb dysfunction, body sway or inability to rise from a chair without using one's arms predict future fracture risk. According to the concept of evidence-based medicine (EBM) preventive strategies are now available. Supplementation with calcium and vitamin D restores bone quality through suppression of secondary hyperparathyroidism and decreases the risk of falling through improvement of neuromuscular co-ordination and body sway. Treatment with the bisphosphonates alendronate and risedronate increase bone strength and result in a significant reduction of vertebral as well as non-vertebral fractures. Hip protectors absorb energy during a fall and reduce hip fracture risk by 56%. Risk factor based patient selection may improve the cost-effectiveness of therapy.

Bone Density↗

[Complex method of the diagnosis of the mandibular injury based of informational technologies].

Special method of complex diagnosis of mandibular injury is under consideration. It is based on the informational technologies. The study of the mechanisms of the injury's formation has been made on 109 patients of the skull-jaw-facial surgery department of the hospital were under investigation. Two main types of jaw-facial injuries have been revealed. The first type: falling down from the height of one's own size (stature). The second type: blow (stroke) of a blunt object. The decrease of the number of the inflammatory complications of the broken jaw due to the usage of new algorithms on the basis of informational technologies has been noted.

Accidental Falls↗

Elderly patients with closed head trauma after a fall: mechanisms and outcomes.

Falls in the elderly leading to closed head trauma represent a significant cause of morbidity and mortality in that population, but are not well-characterized. The purpose of this study was to determine the mechanism of fall, outcome, and additional risk factors in elderly patients who require cranial computed tomography (CT) scan after a fall. We conducted a retrospective case series of patients age 60 years and older with closed head trauma secondary to falling who underwent CT scan in the emergency department (ED). Data were gathered from ED and hospital records. The setting was an urban Level I trauma center. Our series consisted of 189 patients, of whom 31 (16%) had an abnormal head CT scan and four (2%) required neurosurgery. Cerebral contusions (38%) and subdural hematomas (33%) were the most common lesions seen on CT scan. Falls from standing (76%) were more common than falls on stairs (19%) or from height (5%), but the latter two were more likely to result in an abnormal CT scan (stairs 42%, height 40%). An abnormal neurologic examination was associated with a higher risk of the need for neurosurgery (risk ratio 11.5). We conclude that among elderly patients who fall and present to an ED with evidence of closed head trauma, a significant percentage will have abnormal CT scans but only a small minority will require neurosurgery. While falls from standing are more common, falls on stairs or from height are associated with a higher risk of having an abnormal CT scan. A focal neurologic examination is a strong predictor of the need for neurosurgical intervention.

Accidental Falls↗

Indirect reduction with a condylar blade plate for osteosynthesis of subtrochanteric femoral fractures.

Subtrochanteric fractures frequently occur as high energy trauma usually in younger patients and may lead to severe comminution of the medial cortex. The medial cortex of the proximal femur is exposed to high compressive forces which make fracture stabilization a difficult problem. Bone healing may be seriously compromised due to extensive comminution and fragment devitalization. This requires reduction techniques which do not cause additional damage to the vitality of the bone. With indirect reduction techniques and the use of a condylar blade plate the results have been significantly improved in these fracture types in our department (1). In this report the essential aspects of indirect reduction for subtrochanteric fractures using a condylar blade plate and the treatment results from our department from earlier years (1) and from the last 2 1/2 years will be presented. In the latter period, fifteen patients with a mean age of 49 years (19-87 years) were treated with this method. Fractures resulted from traffic incidents or falls from a great height in 11 cases (73%). Union was achieved in 14 cases (93%) with full weight-bearing after a mean of 3 months (1-4 1/2 months). Malunion was seen in two cases (13%) without the need for further surgery. Non union occurred in one patient (7%) with a III B open injury due to early infection. After repeated debridements, bone grafting and decortication, the fracture was stabilized with a replacement condylar blade plate and healed uneventfully.

Accidental Falls↗

[Medical-insurance aspects of atlantoaxial instability in children].

INTRODUCTION: An os odontoideum is mostly diagnosed coincidentally on the basis of neurological symptoms or painful movement of the cervical spine. Diagnostic work-up and therapy are currently subjects of controversial discussion in the literature. CASE: Our report is about an eleven-year-old boy with an unknown os odontoideum, who developed neurological symptoms with tetraparesis after a fall from 1.5 m height. Conventional X-ray examination resulted in the diagnosis of a suspected dens fracture, MRI showed atlanto-axial instability and an os odontoideum with significant dural sack compression but no signs of acute bony or ligamentous lesion. CONCLUSION: Because of the importance concerning not only medical but also legal/insurance aspects, a possible coincidental finding of an os odontoideum versus a dens fracture must be included in the differential diagnosis. In the case of an os odontoideum without instability in children, conservative therapy is justified after due enlightenment regarding possible risks. In the event of neurological symptoms and/or persistent instability the authors advocate early surgical stabilization even in patients with little infirmity, particularly in view of the possible consequences.

Accidental Falls↗

The usefulness of quantitative ultrasound at the hand phalanges in the detection of the different types of nontraumatic fractures.

The aim of this retrospective study was to determine whether quantitative ultrasound (QUS) at the hand phalanges has the ability to discriminate between individuals without and with different types of nontraumatic fractures. All women (n = 2466) (age range 38-88 years) not affected by metabolic diseases or under treatment with drugs known to interfere with bone metabolism were divided into controls without fractures (n = 1883) and women with nontraumatic previous fractures (n = 583). Fractures were the result of minimal trauma involving a fall from a standing height or less during normal daily activity. Fractured group was divided into subgroups on the basis of the types of fractures: hip, spine, wrist or other fractures. Skeletal status was assessed using the DBM Sonic 1200 (IGEA, Carpi, Italy) which measures the amplitude-dependent speed of sound, Ad-SoS (m/s) in the distal metaphyses of the proximal phalanges of the second through fifth finger of the dominant hand. Women with hip, spine, wrist or other fractures had significantly lower Ad-SoS values than controls (1814 +/- 60 m/s, 1829 +/- 57 m/s, 1870 +/- 64 m/s, 1893 +/- 66 m/s, respectively, vs. 1943 +/- 73 m/s, p < 0.001). Ad-SoS revealed the following areas under the ROC curve: 0.91 +/- 0.027 for hip fracture, 0.89 +/- 0.019 for spine fracture, 0.77 +/- 0.012 for wrist fracture and 0.70 +/- 0.023 for other fractures. By multiple logistic regression analysis, the probability of having fracture, estimated as odds ratio for each 1 SD reduction in Ad-SoS, was: 3.49 (95% CI, 1.57-7.75) for hip, 3.25 (95% CI, 1.94-5.45) for spine, 2.24 (95% CI, 1.86-2.70) for wrist and 1.81 (95% CI, 1.36-2.40) for other fractures. The present study demonstrates the ability of phalangeal QUS to discriminate between subjects with and without different types of nontraumatic fractures. Phalangeal QUS revealed the best sensitivity and specificity in discriminating hip- and spine-fractured patients from controls.

Accidental Falls↗

Undertreatment of osteoporosis in men with hip fracture.

BACKGROUND: Women are not aggressively treated for osteoporosis after hip fracture; the treatment status of men with hip fracture has not been extensively studied. OBJECTIVE: To evaluate the outcome and treatment status of men with hip fracture. METHODS: Data from medical records were obtained for 363 patients (110 men and 253 women) aged 50 years and older with atraumatic (low-energy) hip fracture who were admitted to St Luke's Episcopal Hospital between January 1, 1996, and December 31, 2000. Surveys were mailed to surviving patients. Main outcome variables were osteoporosis treatments (antiresorptive or calcium and vitamin D) at hospital discharge, current osteoporosis treatments at 1- to 5-year follow-up, bone mineral density testing, mortality, current disability, and living arrangements (home or institution). RESULTS: The mean age for men was 80 years vs 81 years for women. Most fractures (89% for men and 93% for women) resulted from falls from a standing height. At hospital discharge, 4.5% of men (n = 5) had treatment of any kind for osteoporosis, compared with 27% of women (n = 69) (P<.001). The 12-month mortality was 32% in men, compared with 17% in women (P =.003). Surveys were usable from 168 (87%) of 194 survivors. At 1- to 5-year follow-up, 27% (12/44) of men were taking treatment of any kind for osteoporosis, compared with 71% (88/124) of women (P<.001). Of those treated, 67% (8/12) of men and 32% (28/88) of women were taking calcium and vitamin D only. At 1- to 5-year follow-up, 11% of men had a bone mineral density measurement, compared with 27% of women. After hospital discharge, the number of men and women who required wheelchairs, walkers, and canes and who lived in institutions increased significantly. CONCLUSIONS: The burden of hip fracture is illustrated by the high incidence of postfracture disability and the high mortality rate in both men and women. Nevertheless, few men receive antiresorptive treatment.

Aged↗

ICP and MABP following traumatic subarachnoid hemorrhage in the rat.

Traumatic subarachnoidal hemorrhage (t-SAH) is a common finding in head-injured patients occurring with a frequency of 39% according to data of the Traumatic Coma Data Bank. The present study is the first description of a t-SAH-model with particular emphasis on patterns of intracranial pressure (ICP) changes and mean arterial blood pressure (MABP) response. Diffuse brain injury was produced in intubated and ventilated adult Sprague-Dawley rats (N = 24) using a brass weight (500 gm) free falling from a predetermined height (1.5 m) on a steel disc glued to the skull of the rat. Before induction of the injury, heparin was administered intra-arterially (i.a.) and antagonised after injury by protamine. MABP-recordings and ICP-recordings were performed continuously. Histopathology was undertaken. Following injury MABP decreased from 138 +/- 14 mmHg to 89 +/- 22 mmHg. During 5 to 15 min ICP increased up to 89.4 +/- 50.4 mmHg, decreasing slowly within 60 min in surviving animals. The mortality rate was 41.6%. All brains showed a severe subarachnoid hemorrhage in the basal cisterns and cell-loss within the brainstem. Experimental t-SAH is possible. Following t-SAH there is a subacute increase of ICP due to the actual bleeding. The model may provide deeper understanding in the basic physiological patterns of t-SAH.

Animals↗

The role of the acute phase reaction in inflammation.

Inflammation and injury to tissue results in a variety of local and systemic events, however although the local events of oedema formation and cellular infiltration have received considerably more attention the systemic response to inflammation is no less profound. The particular systemic event which forms the substance of this communication is the change in the circulating levels of plasma proteins which occurs after inflammatory injury, and the manner in which these changes in plasma concentration are controlled by changes in plasma concentration are controlled by changes in the rate of synthesis. A discussion of the role of the liver in controlling inflammatory events, in relation to the synthesis of an anti-inflammatory protein has been given; the present work is an extension of this and describes the changes in concentration and synthesis rate of albumin, fibrinogen and alpha1 acid glycoprotein during adjuvant arthritis in the rat. The changes which occur are regulated at the liver by alteration of the rate of synthesis of the individual protein. For example albumin at the height of adjuvant arthritis falls to a third of its normal plasma level whereas the level of alpha1 acid glycoprotein increases up to twenty-fold; these changes are reflected by similar changes in their synthesis rate by the liver. The effect of the fall in albumin concentration on the plasma binding of anti-inflammatory drugs (and their toxicity) in relation to these findings will be discussed along with the biological role of the acute phase plasma proteins and hence the influence of the liver in the response to injury.

Animals↗