다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

Deposits of clastic carbonate-dominated (calciclastic) sedimentary slope systems in the rock record have been identified mostly as linearly-consistent carbonate apron deposits, even though most ancient clastic carbonate slope deposits fit the submarine fan systems better. Calciclastic submarine fans are consequently rarely described and are poorly understood. Subsequently, very little is known especially in mud-dominated calciclastic submarine fan systems. Presented in this study are a sedimentological core and petrographic characterisation of samples from eleven boreholes from the Lower Carboniferous of Bowland Basin (Northwest England) that reveals a >250 m thick calciturbidite complex deposited in a calciclastic submarine fan setting. Seven facies are recognised from core and thin section characterisation and are grouped into three carbonate turbidite sequences. They include: 1) Calciturbidites, comprising mostly of highto low-density, wavy-laminated bioclast-rich facies; 2) low-density densite mudstones which are characterised by planar laminated and unlaminated muddominated facies; and 3) Calcidebrites which are muddy or hyper-concentrated debrisflow deposits occurring as poorly-sorted, chaotic, mud-supported floatstones. These

Phd by thesis

In 1997, the global value of ecosystem services was estimated to average $33 trillion/yr in 1995 $US ($46 trillion/yr in 2007 $US). In this paper, we provide an updated estimate based on updated unit ecosystem service values and land use change estimates between 1997 and 2011. We also address some of the critiques of the 1997 paper. Using the same methods as in the 1997 paper but with updated data, the estimate for the total global ecosystem services in 2011 is $125 trillion/yr (assuming updated unit values and changes to biome areas) and $145 trillion/yr (assuming only unit values changed), both in 2007 $US. From this we estimated the loss of eco-services from 1997 to 2011 due to land use change at $4.3–20.2 trillion/yr, depending on which unit values are used. Global estimates expressed in monetary accounting units, such as this, are useful to highlight the magnitude of eco-services, but have no specific decision-making context. However, the underlying data and models can be applied at multiple scales to assess changes resulting from various scenarios and policies. We emphasize that valuation of eco-services (in whatever units) is not the same as commodification or privatization. Many eco-services are best considered public goods or common pool resources, so conventional markets are often not the best institutional frameworks to manage them. However, these services must be (and are being) valued, and we need new, common asset institutions to better take these values into account.

/pdf/changes-in-the-global-value-of-ecosystem-services-1l97k9k1qb.pdf

Changes in the global value of ecosystem services

The global decline in estuarine and coastal ecosystems (ECEs) is affecting a number of critical benefits, or ecosystem services. We review the main ecological services across a variety of ECEs, including marshes, mangroves, nearshore coral reefs, seagrass beds, and sand beaches and dunes. Where possible, we indicate estimates of the key economic values arising from these services, and discuss how the natural variability of ECEs impacts their benefits, the synergistic relationships of ECEs across seascapes, and management implications. Although reliable valuation estimates are beginning to emerge for the key services of some ECEs, such as coral reefs, salt marshes, and mangroves, many of the important benefits of seagrass beds and sand dunes and beaches have not been assessed properly. Even for coral reefs, marshes, and mangroves, important ecological services have yet to be valued reliably, such as cross-ecosystem nutrient transfer (coral reefs), erosion control (marshes), and pollution control (mangroves). An important issue for valuing certain ECE services, such as coastal protection and habitat-fishery linkages, is that the ecological functions underlying these services vary spatially and temporally. Allowing for the connectivity between ECE habitats also may have important implications for assessing the ecological functions underlying key ecosystems services, such coastal protection, control of erosion, and habitat-fishery linkages. Finally, we conclude by suggesting an action plan for protecting and/or enhancing the immediate and longer-term values of ECE services. Because the connectivity of ECEs across land-sea gradients also influences the provision of certain ecosystem services, management of the entire seascape will be necessary to preserve such synergistic effects. Other key elements of an action plan include further ecological and economic collaborative research on valuing ECE services, improving institutional and legal frameworks for management, controlling and regulating destructive economic activities, and developing ecological restoration options.

https://esajournals.onlinelibrary.wiley.com/doi/pdf/10.1890/10-1510.1

The value of estuarine and coastal ecosystem services

The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper. A brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.

The ATLAS Experiment at the CERN Large Hadron Collider

Carving Out Some Space: A Guide to Land Preservation Strategies

Abstract Background Increased left ventricular (LV) mass is an independent predictor of cardiovascular morbidity and mortality. Primary aldosteronism (PA) is associated with increased LV mass regardless of concomitant essential hypertension. Therefore, we hypothesize that the findings of increased LV mass approximated by left-ventricular hypertrophy (LVH) on echocardiogram relate to renin-independent hyperaldosteronism. Methods We performed a retrospective review of patients who underwent echocardiography at our institution between April of 2013 and September of 2017 (n=98,007 individuals). Of this population, we identified patients who underwent transthoracic echocardiography who met criteria for LVH based on current American Society of Echocardiography guidelines using the interventricular septal thickness in diastole (IVSd) and left ventricular posterior wall thickness in diastole (LVPWd). We excluded patients who underwent isolated transesophageal imaging as well as those who had significant structural cardiac abnormalities other than LVH. This cohort was analyzed with an internal self-service data tool to determine if patients had undergone biochemical evaluation with serum aldosterone and renin, which defined the final analytical cohort. Results We identified 19,664 patients with LVH of whom 5.8% (n = 1132) underwent biochemical evaluation with serum aldosterone and corresponding plasma renin activity (PRA) or direct renin concentration (DRC). In all patients with LVH, the mean IVSd was 11.7 ± 1.2mm in those who underwent biochemical testing and 11.5 ± 1.2 mm in those who did not (p <0.001); the mean LVPWd was 11.4 ± 1.1 mm mm in those who underwent biochemical testing and 11.3 ± 1.1 mm in those who did not (p <0.001). Of African American patients with LVH, 9.8% underwent biochemical testing; 5.0% of Caucasian patients with LVH underwent testing. The median PRA was 0.9 ng/mL/h with a median aldosterone to renin activty ratio (ARR) of 8.9 ng/dL-ng/mL/h. . The majority (54.4%) of individuals who underwent testing with plasma renin activity had a PRA ≤ 1.0 ng/mL/h. Conclusion Patients with LVH are being evaluated with renin and aldosterone at a higher frequency than patients with resistant hypertension and other guideline based indications for PA screening. Individuals evaluated with renin and aldosterone had increased IVSD and LVPWd, suggestive of more extensive LVH, compared with other individuals with LVH. LVH may be a sensitive screening criterion for PA. Additional prospective studies are necessary. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

/pdf/psun52-patients-with-left-ventricular-hypertrophy-on-3tccfy0k.pdf

PSUN52 Patients with Left Ventricular Hypertrophy on Echocardiography are Frequently Evaluated with Renin and Aldosterone

Bacillus cereus pericarditits and concern for mycotic aortic aneurysm in a patient presenting with pericardial effusion


 Introduction:
 Despite widespread indications for concomitant treatment of hypertension and hyperlipidemia, the proportion of the U. S population eligible for both remains unknown. Further, although fixed-dose combinations of these drugs are associated with better adherence, few are available.
 
 
 Hypothesis:
 We hypothesized a significant proportion of the population would be eligible for antihypertensive medication and a statin.
 
 
 Methods:
 Data from the National Health and Nutrition Examination Survey from 2011 to 2018 with survey weighting to represent the noninstitutionalized U.S. population ≥18 years were utilized. Prevalence of individuals with dual indications for antihypertensive and statin therapy was determined using the 2017 ACC/AHA guidelines for hypertension and the 2019 ACC/AHA guidelines for primary prevention of cardiovascular disease, respectively.
 
 
 Results:
 Sociodemographic characteristics are shown in Table 1. Among those ≥18 years, there were 88 million (33.4%) individuals with an indication for antihypertensive medication and 88.5 million (33.9%) with an indication for a statin. 64.6 million adults or 24.8% (95% CI: 23.5 to 26.2) of the population had dual indications for antihypertensive medication and a statin. Notably, 73.4% of those indicated for antihypertensive medication were also indicated a statin.
 
 
 Conclusions:
 Quarter of the U.S. adult population and nearly three-quarters of hypertensive patients are eligible for antihypertensive medication and a statin. Combining antihypertensive medications with a statin in fixed-dose combinations could reduce medication disutility and increase adherence to optimize lipid and blood pressure goals.
 
 
 


James Boyd

Papers

Carving Out Some Space: A Guide to Land Preservation Strategies

PSUN52 Patients with Left Ventricular Hypertrophy on Echocardiography are Frequently Evaluated with Renin and Aldosterone

Bacillus cereus pericarditits and concern for mycotic aortic aneurysm in a patient presenting with pericardial effusion

Abstract 040: Prevalence Of Dual Indications For Antihypertensive Medications And Statins In The National Health And Nutrition Survey

Ecosystem Services: Evaluation