Oswego Community Hospital

X-shaped radio galaxies (XRGs) are those that exhibit two pairs of unaligned radio lobes (main radio lobes and "wings"), one of the promising models for the peculiar morphology is jet re-orientation. To clarify it, we conducted the European VLBI Network (EVN) 5 GHz observation of an XRG J0725+5835, which resembles the archetypal binary AGNs 0402+379 in radio morphology but it is larger in angular size. In our observation, two milliarcsec (mas) scale radio components with non-thermal radio emission are detected, each of them coincides with an optical counterpart with similar photometric redshift and (optical and infrared) magnitude, corresponding to dual active nuclei. Furthermore, with the improved VLA images, we find a bridge between the two radio cores and a jet bending in the region surrounding the companion galaxy, which further supports the interplay between the main and companion galaxies. In addition, we also report the discovery of an arcsec-scale jet in the companion. Given the projected separation of $\sim100$ kpc between the main and companion galaxies, XRG J0725+5835 is likely associated with a dual jetted-AGN system. In both EVN and VLA observations, we find signatures that the jet is changing its direction, which is likely responsible for the X-shaped morphology. On the origin of jet re-orientation, several scenarios are discussed.

The objective was to examine the 22 variables from the Sport Concussion Assessment Tool's 5th Edition Symptom Evaluation using a decision tree analysis to identify those most likely to predict prolonged recovery after a sport-related concussion. A cross-sectional design was used in this study. A total of 273 patients (52% men; mean age, 21 ± 7.6 yrs) initially assessed by either an emergency medicine or sport medicine physician within 14 days of concussion (mean, 6 ± 4 days) were included. The 22 symptoms from the Sport Concussion Assessment Tool's 5th Edition were included in a decision tree analysis performed using RStudio and the R package rpart. The decision tree was generated using a complexity parameter of 0.045, post hoc pruning was conducted with rpart, and the package carat was used to assess the final decision tree's accuracy, sensitivity and specificity. Of the 22 variables, only 2 contributed toward the predictive splits: Feeling like "in a fog" and Sadness. The confusion matrix yielded a statistically significant accuracy of 0.7636 (P [accuracy > no information rate] = 0.00009678), sensitivity of 0.6429, specificity of 0.8889, positive predictive value of 0.8571, and negative predictive value of 0.7059. Decision tree analysis yielded a statistically significant decision tree model that can be used clinically to identify patients at initial presentation who are at a higher risk of having prolonged symptoms lasting 28 days or more postconcussion.

A large water supply pipeline has been designed to carry water from the Willamette River in Gladstone, OR to the cities of Lake Oswego and Tigard, Oregon. The pipeline ranges in diameter from 24 to 48 inches and traverses more than 10 miles. The pipeline was part of an overall water supply project that included a raw water intake, a raw water pipeline, a water treatment plant, a finished water pipeline, and a reservoir. Finding a route for the pipeline was challenging as it traversed through many cities, and required a number of interagency agreements. Along with the routing challenges, there were many technical challenges such as crossing beneath the Willamette River. This crossing is 36-inches in diameter through basalt that varies in unconfined compressive strength, which exceeds 40,000 psi. An extensive trenchless evaluation was performed to determine the method that offered the highest chance of success with the lowest overall risk profile. Horizontal directional drilling (HDD) was chosen as the preferred trenchless installation technique. The length of the river crossing is 3,800 feet, making the 36inch diameter rock drill very challenging. In addition to the challenges of the drill, site and pipe layout was very restricted, further complicating and increasing the risk of the project.. Many aspects of the drill had to be thoroughly laid out during design, leaving little flexibility to the contractor.

Reasons for undertriage (transporting seriously injured patients to nontrauma centers) and the apparent lack of benefit of trauma centers among older adults remain unclear; understanding emergency medical services (EMS) provider reasons for selecting certain hospitals in trauma systems may provide insight to these issues. In this study, the authors evaluated reasons cited by EMS providers for selecting specific hospital destinations for injured patients, stratified by age, injury severity, field triage status, and prognosis. This was a retrospective cohort study of injured children and adults transported by 61 EMS agencies to 93 hospitals (trauma and nontrauma centers) in five regions of the western United States from 2006 through 2008. Hospital records were probabilistically linked to EMS records using trauma registries, state discharge data, and emergency department data. The seven standardized reasons cited by EMS providers for selecting hospital destinations included closest facility, ambulance diversion, physician choice, law enforcement choice, patient or family choice, specialty resource center, and other. "Serious injury" was defined as an Injury Severity Score (ISS) ≥ 16, and unadjusted in-hospital mortality was considered as a marker of prognosis. All analyses were stratified by age in 10-year increments, and descriptive statistics were used to characterize the findings. A total of 176,981 injured patients were evaluated and transported by EMS over the 3-year period, of whom 5,752 (3.3%) had ISS ≥ 16 and 2,773 (1.6%) died. Patient or family choice (50.6%), closest facility (20.7%), and specialty resource center (15.2%) were the most common reasons indicated by EMS providers for selecting destination hospitals; these frequencies varied substantially by patient age. The frequency of patient or family choice increased with increasing age, from 36.4% among 21- to 30-year-olds to 75.8% among those older than 90years. This trend paralleled undertriage rates and persisted when restricted to patients with serious injuries. Older patients with the worst prognoses were preferentially transported to major trauma centers, a finding that was not explained by field triage protocols. Emergency medical services transport patterns among injured patients are not random, even after accounting for field triage protocols. The selection of hospitals appears to be heavily influenced by patient or family choice, which increases with patient age and involves inherent differences in patient prognosis.

Intermediate mass black holes (IMBHs) with expected masses M_BH ~ 10^4 M_sun are thought to bridge the gap between stellar mass black holes (M_BH ~ 3 - 100 M_sun) and supermassive black holes found at the centre of galaxies (M_BH > 10^6 M_sun). Until today, no IMBH has been confirmed observationally. The most promising objects to host an IMBH as their central mass are globular clusters. Here, we present high sensitivity multi-epoch 1.6 GHz very long baseline interferometry observations of the globular cluster M15 that has been suggested to host an IMBH. Assuming the IMBH to be accreting matter from its surrounding we expect to detect it as a point source moving with the global motion of the cluster. However, we do not detect any such object within a radius of 6000 AU of the cluster centre in any of the five observations spread over more than one year. This rules out any variability of the putative IMBH on the time scale of one to two months. To get the most stringent upper limit for the flux density of the putative IMBH we concatenate the data of all five epochs. In this data we measure a 3{\sigma} upper flux limit of 10 {\mu}Jy for a central source. We employ the fundamental plane of black hole activity to estimate the mass of the central IMBH candidate. Based on previous X-ray observations of M15 our measurements indicate a 3{\sigma} upper mass limit of ~500 M_sun.

Why build a sewer in a lake? Why make it buoyant? Where has it been done before? Will it work? Will it last? Can we maintain it? City of Lake Oswego officials and their engineering consultant asked and answered these and many other questions while designing and constructing the innovative pipeline, completed in May 2011 after a 10-year planning, design, and construction process. Total program cost for the six projects is $90 million to replace undersized, deteriorating lines with a system designed to last at least 100 years. Its centerpiece is a buoyant gravity HDPE sewer (10,000 feet 22-inch to 42-inch outside diameter, with 12,000 feet of smaller, air-filled HDPE buoyancy pipe, all DR 11 and 13.5), held to proper grade 11 to 18 feet beneath the lake surface by 428 ground anchors and tethers. A serpentine alignment provides thermal expansion loops to maintain grade despite wide-ranging water temperature which causes the pipeline to lengthen and shorten +/– 14 feet over its 2-mile length. Stainless steel manholes are also buoyant and submerged, with access via removable caissons. Several manholes on upland tributary trunk sewers were converted to debris sumps to trap sand/gravel/sediment where it can be easily removed rather than accumulating in the in-lake system. Pile-support systems (354 18-inch steel pipe piles supporting 7,000 feet of HDPE sewer) and CIPP rehabilitation (6,000 feet of 18-inch to 36-inch) are also used for significant reaches. While much of the work was constructed with the lake full, final connections, and associated excavations, were made with the lake drawn down 24 feet and with extensive bypass and lake drawdown pumping/piping systems. This paper reviews the drivers for the project, the alternative solutions considered, and the development, design, installation, and maintenance of the buoyant system, including some of the numerous challenges overcome. Visit loisnew.com and view the professionally-produced webisodes to gain additional insight into this remarkable project.

The objective of this study was to identify the perceptions of secondary agriculture teachers and education professionals of Illinois regarding the potential impacts of the No Child Left Behind legislation on secondary programs. The Delphi technique for obtaining group consensus was employed to accomplish the stated objective of the study. A panel of 20 agriculture teachers and in-service education professionals were purposively selected to serve as the expert participants in the study. The panel received a series of four mailed questionnaires including a free response question, a Likert-type questionnaire, and two questionnaires indicating levels of agreement with specific themes. The impacts of the No Child Left Behind legislation as identified by secondary agriculture teachers and education professionals were: the certification of provisional agricultural teachers, core academic accreditation, budget constraints, loss of agriculture teachers, decrease of agricultural courses taught, loss of Perkins funding, loss of state career and technical education funding, elimination of career and technical education programs, career and technical education courses being raised to same level as core academic credit, students being discouraged to take agricultural courses, and more application of core academics in the agricultural classroom.

We performed high resolution hydrodynamical simulations of dense cool clouds embedded in supernova-driven galactic superwinds. Here we present preliminary results of our reference model in which the effect of heat conduction are taken into account. Significant dynamical differences occur between simulations with and without heat conduction. In absence of heat conduction the cloud fragments in few dynamical timescale. The inclusion of heat conduction has the effect to stabilize the cloud and inhibit the growth of Kelvin-Helmholtz and Reyleigh-Taylor instabilities. Furthermore in the conditions met in our simulations the strong heat flux at the cloud edge generates a converging shock which compresses the cloud. We also calculate the high energy emission (O{\sc vi} and soft X-ray) of the cloud and O{\sc vi} absorption line properties and compare the results with obvervations. Models in which heat conduction is taken into account seem to fit the observations much better. In general only a small fraction (0.1-0.4%) of the wind mechanical energy intersecting the cloud is radiated away. Finally some of our models are able to explain the low metallicity abundance seen in X-ray osservation of superwinds.

We report simultaneous observations at 1.2 and 2 mm, with a double channel photometer on the SEST Telescope, of the X-ray cluster RXJ0658-5557 in search for the Sunyaev-Zel'dovich (S-Z). The S-Z data were analyzed using the relativistically correct expression for the Comptonization parameter and we find from the detected decrement (2.60 +/- 0.79) ~ 10^{-4}, which is consistent with that computed using the X-ray (ROSAT and ASCA) observations. The uncertainty includes contributions due to statistical uncertainty in the detection and systematics and calibration. The 1.2 {mm} channel data alone gives rise to a larger Comptonization parameter and this result is discussed in terms of contamination from foreground sources and/or dust in the cluster or from a possible systematic effect. We then make use of the combined analysis of the ROSAT and ASCA X-ray satellite observations to determine an isothermal model for the S-Z surface brightness. Since the cluster is asymmetrical and probably in a merging process, models are only approximate. The associated uncertainty can, however, be estimated by exploring a set of alternative models. We then find as the global uncertainty on the Comptonization parameter a factor of 1.3. Combining the S-Z and the X-ray measurements, we determine a value for the Hubble constant. The 2 mm data are consistent with H_0(q_0 = 1/2)= 53^{+38}_{-28} km/s Mpc^{-1}, where the uncertainty is dominated by the uncertainty in models of the X-ray plasma halo.