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Rayleigh wave ellipticity measurements from seismic ambient noise recorded on the Greenland Ice Sheet (GrIS) show complex and anomalous behavior at wave periods sensitive to ice (T < 3–4 s). To understand these complex observations, we compare them with synthetic ellipticity measurements obtained from synthetic ambient noise computed for various seismic velocity and attenuation models, including surface wave overtone effects. We find that in dry snow conditions within the interior of the GrIS, to first order the anomalous ellipticity observations can be explained by ice models associated with the accumulation and densification of snow into firn. We also show that the distribution of ellipticity measurements is strongly sensitive to seismic attenuation and the thermal structure of the ice. Our results suggest that Rayleigh wave ellipticity is well suited for monitoring changes in firn properties and thermal composition of the Greenland and Antarctic ice sheets in a changing climate. Plain Language Summary: Surface meltwater is increasingly being routed and distributed through the Greenland Ice Sheet (GrIS) changing the mechanical and thermal properties of the ice and resulting in accelerated ice flow. Here we observe complex and anomalous Rayleigh wave ellipticity measurements at periods sensitive to the ice structure. We compare our observations with ellipticity measurements made on simulated seismic noise for various seismic velocity and attenuation models. We demonstrate that in the interior of the GrIS the ellipticity is sensitive to the accumulation and densification of snow as it compacts into glacier ice. The variation in the measurements is strongly sensitive to the thermal structure of the ice sheet which we estimate to be warmer than about −10°. These results demonstrate that Rayleigh wave ellipticity is well suited for monitoring changes in firn properties and thermal composition of the Greenland and Antarctic ice sheets in a changing climate. Key Points: Densification of snow into firn has a first order effect on ellipticity measurements at periods sensitive to the iceThe distribution of ellipticity measurements is sensitive to the thermal composition of the iceEllipticity is a promising method for long term monitoring of ice properties and thickness beneath the seismic station [ABSTRACT FROM AUTHOR]

Aim: People living with ulcerative colitis (UC) have two broad treatment avenues, namely medical or surgical therapy. The choice between these can depend on patient preference as well as the receipt of relevant information. The aim of this study was to define the informational needs of patients with UC. Method: A postal survey was designed to capture respondent demographics, treatment experienced within the previous 12 months and informational preferences by rating a long list of items. It was delivered through two hospitals that provide tertiary inflammatory bowel disease services. Descriptive analyses were performed to describe demographics and experiences. Principal component analysis was carried out using a varimax rotation to investigate informational needs. Results: A total of 101 responses were returned (20.1% response rate). The median age of respondents was 45 years and the median time since diagnosis was 10 years. Control preferences skewed towards shared (42.6%) or patient‐led but clinician‐informed (35.6%). Decision regret was low for the population (median 12.5/100, range 0–100). Key informational needs related to medical therapy were benefits and risks of long‐term therapy, burden of hospital attendance, reproductive health, need for steroid treatment and impact on personal life. For surgery, these were stoma information, effect on daily life, effect on sexual and reproductive health, risks and benefits and disruption of life due to surgery. Conclusion: This study has identified key areas for discussion when counselling patients about treatment decisions around medical therapy and surgery for UC. [ABSTRACT FROM AUTHOR]

We analyze observations of a solar energetic particle (SEP) event at Rosetta's target comet 67P/Churyumov‐Gerasimenko during 6–10 March 2015. The comet was 2.15 AU from the Sun, with the Rosetta spacecraft approximately 70 km from the nucleus placing it deep inside the comet's coma and allowing us to study its response. The Eastern flank of an interplanetary coronal mass ejection (ICME) also encountered Rosetta on 6 and 7 March. Rosetta Plasma Consortium data indicate increases in ionization rates, and cometary water group pickup ions exceeding 1 keV. Increased charge exchange reactions between solar wind ions and cometary neutrals also indicate increased upstream neutral populations consistent with enhanced SEP induced surface activity. In addition, the most intense parts of the event coincide with observations interpreted as an infant cometary bow shock, indicating that the SEPs may have enhanced the formation and/or intensified the observations. These solar transient events may also have pushed the cometopause closer to the nucleus. We track and discuss characteristics of the SEP event using remote observations by SOHO, WIND, and GOES at the Sun, in situ measurements at Solar Terrestrial Relations Observatory Ahead, Mars and Rosetta, and ENLIL modeling. Based on its relatively prolonged duration, gradual and anisotropic nature, and broad angular spread in the heliosphere, we determine the main particle acceleration source to be a distant ICME which emerged from the Sun on 6 March 2015 and was detected locally in the Martian ionosphere but was never encountered by 67P directly. The ICME's shock produced SEPs for several days which traveled to the in situ observation sites via magnetic field line connections. Key Points: We track a solar energetic particle (SEP) event in situ at Solar Terrestrial Relations Observatory Ahead, Mars and Rosetta and determine the main source to be a non‐local interplanetary coronal mass ejection shock distant to 67PIncreased solar wind charge exchange at 67P may indicate an increase in upstream neutral populations and associated SEP induced sputteringThe most intense parts of the SEP event at 67P coincide with observations of an infant bow shock and may have enhanced its formation [ABSTRACT FROM AUTHOR]

Clinical pharmacists are highly trained professionals who provide comprehensive medication management across a majority of health care settings. These clinicians have numerous responsibilities, which may include teaching, administrative, and scholarly responsibilities in addition to patient care activities. Many clinical pharmacists report a high degree of burnout and stress. In addition, practice models with limited options for buy‐downs or stipends (eg, for committees, projects, or residency program director roles), inability to generate revenue for services provided, public perception, and little upward mobility for career advancement have led to a perceived trend of clinical pharmacists leaving practice to pursue careers removed from patient care that favor work‐life balance. The purpose of this review is to summarize factors associated with premature attrition of clinical pharmacists, call attention to this trend, and provide suggestions for improvements. [ABSTRACT FROM AUTHOR]

The JUpiter ICy moons Explorer (JUICE) of the European Space Agency will investigate Jupiter and its icy moons Europa, Ganymede, and Callisto, with the aim to better understand the origin and evolution of our Solar System and the emergence of habitable worlds around gas giants. The Particle Environment Package (PEP) on board JUICE is designed to measure neutrals and ions and electrons at thermal, suprathermal, and radiation belt energies (eV to MeV). In the vicinity of Callisto, PEP will characterize the plasma environment, the outer parts of Callisto's atmosphere and ionosphere and their interaction with Jupiter's dynamic magnetosphere. Roughly 20 Callisto flybys with closest approaches between 200 and 5,000 km altitude are planned over the course of the JUICE mission. In this article, we review the state of the art regarding Callisto's ambient environment and magnetospheric interaction with recent modeling efforts for Callisto's atmosphere and ionosphere. Based on this review, we identify science opportunities for the PEP observations to optimize scientific insight gained from the foreseen JUICE flybys. These considerations will inform both science operation planning of PEP and JUICE and they will guide future model development for Callisto's atmosphere, ionosphere, and their interaction with the plasma environment. Key Points: Particle Environment Package (PEP) on JUpiter ICy moons Explorer (JUICE) will provide in situ and remote measurements of Callisto's atmosphere and its space environment during ∼20 flybysWe investigate operation plans and instrument capabilities to optimize science return from PEP observationsThe interactions of the atmosphere with the space environment and surface are complex and must be further analyzed in preparation for JUICE [ABSTRACT FROM AUTHOR]

The Pre‐Industrial climate model simulation is intended as an equilibrium control experiment that uses constant external forcing, yet in the Coupled Model Intercomparison Project Phase 6 (CMIP6) model HadGEM3‐GC31‐LL a distinct change in climate state occurs around year 500 of the 2000 year simulation. The global mean near surface air temperature increases by almost 0.5 K associated with a reduction in southern hemisphere sea ice area of almost 20%. Here we show this step change in the state of the climate to be a consequence of the onset of deep convection in the Weddell and Ross Sea gyres. The delayed onset of convection in the gyres is a consequence of a positive, downward, top‐of‐atmosphere radiative balance, and continual ocean heat up‐take during the model spin‐up and the initial pre‐industrial control simulation. Consequently, model spin‐up strategy should be revised to initialize pre‐industrial simulations that are in energy balance. Plain Language Summary: The Pre‐industrial control simulation of climate models is a reference for climate change simulations. Consequently it should simulate a stable climate. However, if the model is not in radiative equilibrium, the ocean continually accumulates heat, becoming unstable at high latitudes and generating large climate fluctuations. This results in a control simulation that is not a steady state. Consequently the methodologies used to initialize and formulate climate models should be revised to ensure a steady state is achieved. Key Points: The long timescales associated with deep ocean heat uptake suggests simulations may not be equilibriated before forcing is perturbedSouthern Ocean venting of heat reduces sea ice cover and increases global mean temperature, leading to a warmer climate stateNet top‐of‐atmosphere energy imbalance can have implications for the methodologies used for climate model spin‐up [ABSTRACT FROM AUTHOR]

Objectives: To explore the impact of COVID‐19 on the management and outcomes of acute paediatric mastoiditis across the UK. Design: National retrospective and prospective audit. Setting: 48 UK secondary care ENT departments. Participants: Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis. Main outcome measures: Cases were divided into Period 1 (01/11/19‐15/03/20), before the UK population were instructed to reduce social contact, and Period 2 (16/03/20‐30/04/21), following this. Periods 1 and 2 were compared for population variables, management and outcomes. Secondary analyses compared outcomes by primary treatment (medical/needle aspiration/surgical). Results: 286 cases met criteria (median 4 per site, range 0–24). 9.4 cases were recorded per week in period 1 versus 2.0 in period 2, with no winter increase in cases in December 2020‐Febraury 2021. Patient age differed between periods 1 and 2 (3.2 vs 4.7 years respectively, p < 0.001). 85% of children in period 2 were tested for COVID‐19 with a single positive test. In period, 2 cases associated with P. aeruginosa significantly increased. 48.6% of children were scanned in period 1 vs 41.1% in period 2. Surgical management was used more frequently in period 1 (43.0% vs 24.3%, p = 0.001). Treatment success was high, with failure of initial management in 6.3%, and 30‐day re‐admission for recurrence in 2.1%. The adverse event rate (15.7% overall) did not vary by treatment modality or between periods 1& 2. Conclusion: The COVID‐19 pandemic led to a significant change in the presentation and case mix of acute paediatric mastoiditis in the UK. [ABSTRACT FROM AUTHOR]

Climate change and a long legacy of fire suppression are leading to an increased prevalence of 'mega‐disturbances' such as drought and wildfire in terrestrial ecosystems. Evidence for the immediate effects of these novel disturbances on wildlife is accumulating, but little information exists on longer term impacts to species and ecosystems. We studied the occurrence dynamics of an iconic old‐forest species, the spotted owl (Strix occidentalis), on a long‐term study area in the Sierra Nevada, CA, USA from 1989 to 2020 to evaluate their multi‐scale population response following a 2014 megafire (the 'King' Fire) that affected a portion of our study area. We found that extensive severe fire within spotted owl sites resulted in both immediate site abandonment and prolonged lack of re‐colonization by owls six years post‐fire. Sites that experienced high pyrodiversity – a mosaic of burn severities – were more likely to persist after the fire, but this effect was only apparent at finer spatial scales. A potentially confounding factor, post‐fire salvage logging, did not explain variability in the probability of either owls persisting at sites or sites becoming re‐colonized; effects could be attributed only to severe fire extent and pyrodiversity. Our study demonstrates the prolonged effects of severe fire on the occupancy of this forest‐dependent species, suggesting that forest restoration that reduces megafires could benefit spotted owls. Our work emphasizes that long‐term monitoring can offer surprising learning opportunities and provide unparalleled value for understanding and addressing emerging environmental concerns. [ABSTRACT FROM AUTHOR]

Globally, the impacts of anthropogenic climate change can displace species into more favourable climates. Semi‐arid desert specialists, such as the sandhill dunnart, Sminthopsis psammophila, are typically susceptible to rainfall deficits, wildfires and extreme temperatures caused by anthropogenic climate change. We first used maximum entropy (MaxEnt) species distribution models (SDMs) to predict the current distribution of S. psammophila. Between 2016 and 2018, we ground validated the model's predictions throughout Western Australia, confirming S. psammophila in 18 locations in which it was predicted to occur. The predicted distribution of S. psammophila appears mostly constrained to within its known range. However, S. psammophila was verified 150 km north of its range in Western Australia and connectivity between the South Australian populations was correctly predicted. In 2019, we used updated occurrence data to project SDMs for S. psammophila during the mid‐Holocene, present day and under two future representative concentration pathways (RCPs) of RCP 4.5 (an optimistic emissions scenario) and RCP 8.5 ("business as usual") for 2050 and 2070. By 2050 (RCP 8.5), almost all Western Australian Great Victoria Desert (WAGVD) habitat is predicted to be unsuitable for S. psammophila. By 2070 (RCP 8.5), the climates of the WAGVD and Yellabinna Regional Reserve populations are predicted to become unsuitable, and the species' geographical range is predicted to contract in Australia by 80%. However, the 2070 (RCP 4.5) scenario predicts that this contraction could be halved. As a sandy desert specialist, the distribution of S. psammophila is geographically limited at its southern bounds due to the cessation of suitable spinifex (Triodia spp.) habitats, and so further extension of the range southwards is not possible. Sympatric desert species may be similarly affected, and we suggest that SDMs will be a useful tool in helping to predict the effects of climate change on their distributions. [ABSTRACT FROM AUTHOR]

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Biogenic emissions of dimethylsulfide (DMS) are an important source of sulfur to the atmosphere, with implications for aerosol formation and cloud albedo over the ocean. Natural aerosol sources constitute the largest uncertainty in estimates of aerosol radiative forcing and climate and thus, an improved understanding of DMS sources is needed. Coral reefs are strong point sources of DMS; however, this coral source of biogenic sulfur is not explicitly included in climatologies or in model simulations. Consequently, the role of coral reefs in local and regional climate remains uncertain. We aim to improve the representation of tropical coral reefs in DMS databases by calculating a climatology of seawater DMS concentration (DMSw) and sea‐air flux in the Great Barrier Reef (GBR), Australia. DMSw is calculated from remotely sensed observations of sea surface temperature and photosynthetically active radiation using a multiple linear regression model derived from field observations of DMSw in the GBR. We estimate that coral reefs and lagoon waters in the GBR (∼347,000 km2) release 0.03–0.05 Tg yr−1 of DMS (0.02 Tg yr−1 of sulfur). Based on this estimate, global tropical coral reefs (∼600,000 km2) could emit 0.08 Tg yr−1 of DMS (0.04 Tg yr−1 of sulfur), with the potential to influence the local radiative balance. Plain Language Summary: Coral reefs are important sources of biogenic sulfur through stress‐induced emissions of dimethylsulfide (DMS). This volatile sulfur compound has potentially important implications for atmospheric aerosol formation and cloud microphysical properties. However, coral reefs are not accounted for in global DMS climatologies or in model simulations. Consequently, the importance of coral reef‐derived DMS in local climate is uncertain. Here, a proxy for seawater DMS concentration in coral reefs is derived from field measurements taken in the Great Barrier Reef, Australia. This proxy is used to calculate a climatology of DMS flux from coral reefs to estimate the contribution to the global sulfur cycle. Key Points: Seawater dimethylsulfide concentration in coral reefs is parameterized as a function of surface temperature and irradianceIncluding coral‐air dimethylsulfide release at low tide in sea‐air flux calculations yields a more accurate estimate of coral reef fluxCoral reefs emit 0.03–0.04 Tg yr−1 of sulfur as dimethylsulfide, representing up to 0.2% of global sea‐air flux estimates [ABSTRACT FROM AUTHOR]

Aim: Approximately 20%–30% of patients with ulcerative colitis (UC) will undergo surgery during their disease course, the vast majority being elective due to chronic refractory disease. The risks of elective surgery are reported variably. The aim of this systematic review and meta‐analysis is to summarize the outcomes after elective surgery for UC. Methods: A systematic review was conducted that analysed studies reporting outcomes for elective surgery in the modern era (>2002). It was prospectively registered on the PROSPERO database (ref: CRD42018115513). Searches were performed of Embase and MEDLINE on 15 January 2019. Outcomes were split by operation performed. Primary outcome was quality of life; secondary outcomes were early, late and functional outcomes after surgery. Outcomes reported in five or more studies underwent a meta‐analysis of incidence using random effects. Heterogeneity is reported with I2, and publication bias was assessed using Doi plots and the Luis Furuya‐Kanamori index. Results: A total of 34 studies were included (11 774 patients). Quality of life was reported in 12 studies, with variable and contrasting results. Thirteen outcomes (eight early surgical complications, five functional outcomes) were included in the formal meta‐analysis, all of which were outcomes for ileal pouch–anal anastomosis (IPAA). A further 71 outcomes were reported (50 IPAA, 21 end ileostomy). Only 14 of 84 outcomes received formal definitions, with high inter‐study variation of definitions. Conclusion: Outcomes after elective surgery for UC are variably defined. This systematic review and meta‐analysis highlights the range of reported incidences and provides practical information that facilitates shared decision making in clinical practice. [ABSTRACT FROM AUTHOR]

Polar mesospheric cloud (PMC) imaging and lidar profiling performed aboard the 5.9‐day PMC Turbo balloon flight from Sweden to northern Canada in July 2018 revealed a wide variety of gravity wave (GW) and instability events occurring nearly continuously at approximately 82 km. We describe one event exhibiting GW breaking and associated vortex rings driven by apparent convective instability. Using PMC Turbo imaging with spatial and temporal resolution of 20 m and 2 s, respectively, we quantify the GW horizontal wavelength, propagation direction, and apparent phase speed. We identify vortex rings with diameters of 2–5 km and horizontal spacing comparable to their size. Lidar data show GW vertical displacements of ±0.3 km. From the data, we find a GW intrinsic frequency and vertical wavelength of 0.009 ± 0.003 rad s−1 and 9 ± 4 km, respectively. We show that these values are consistent with the predictions of numerical simulations of idealized GW breaking. We estimate the momentum deposition rate per unit mass during this event to be 0.04 ± 0.02 m s−2 and show that this value is consistent with the observed GW. Comparison to simulation gives a mean energy dissipation rate for this event of 0.05–0.4 W kg−1, which is consistent with other reported in situ measurements at the Arctic summer mesopause. Key Points: Gravity wave breaking and associated vortex rings are observed in imaging and lidar data of polar mesospheric cloudsAnalysis of the data gives parameters of the gravity wave and rates of energy and momentum transfer due to its breakingObserved vortex ring parameters agree with predictions by numerical resolutions of gravity wave breaking [ABSTRACT FROM AUTHOR]

OPTIMISING HOLISTIC CARE OF WOMEN AT RISK OF OR LIVING WITH BIA-ALCL: A SURVEY OF UK HEALTH CARE PROFESSIONALS B Introduction: b Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was classified by the World Health Organisation in 2016. Breast surgeons made up the largest proportion of respondents (36%, 28/78) with over half of respondents having cared for a patient with BIA-ALCL (58% 42/78). [Extracted from the article]

The disturbance, damage and destruction of roosts are key drivers of bat population declines worldwide. In countries where bats are protected by law, bat roost surveys are often required to inform ecological impact assessments. Yet, evidence‐based information on survey methodology to detect bat roosts is crucially lacking, and failing to detect a roost can lead to serious errors during decision‐making processes. Here, we assess the efficacy of bat roost surveys in buildings as implemented in the UK. These consist of a daytime inspection of buildings, followed by a series of acoustic surveys at dusk/dawn if during the daytime inspection evidence of bats is found, or if the absence of bats cannot be verified. We reviewed 155 ecological consultants' reports to (1) compare survey outcome between daytime inspection and acoustic surveys and (2) determine the minimum sampling effort required during acoustic surveys to be confident that no bats are roosting within a building. We focused on two genera of bats most frequently found in buildings in Europe – Pipistrellus (crevice roosting species with high‐intensity echolocation calls that can be easily detected by ultrasound detectors) and Plecotus (species that roost in open spaces and which emit faint echolocation calls that are difficult to detect). Daytime inspections were efficient in detecting open‐roosting species such as Plecotus species but were likely to miss the presence of crevice‐dwelling ones (here Pipistrellus species) which may lead to erroneous conclusions if no acoustic surveys are subsequently prescribed to confirm their absence. A minimum of three and four acoustic surveys are required to be 95% confident that a building does not host a roost of Pipistrellus species and Plecotus species, respectively, thus exceeding current recommendations. Overall, we demonstrated that reports submitted as part of an ecological impact assessment provide suitable data to test and improve survey methods. [ABSTRACT FROM AUTHOR]

The moon Dione orbits Saturn at 6.2 Saturn radii RS deep in the Kronian magnetosphere. In situ studies of the moon‐magnetosphere interaction processes near Dione were possible with the Cassini/Huygens mission which flew by close to Dione five times at distances between 99 and 516 km. In addition, Cassini crossed Dione's L‐shell more than 400 times between 2004 and 2017 and documented the variability of Saturn's magnetosphere. Different flyby geometries allowed to study the interaction processes upstream, in the low‐energy wake, and above the north pole of Dione. We describe here the energetic particle measurements from the Low Energy Magnetospheric Measurement System (LEMMS), part of the Magnetosphere Imaging Instrument (MIMI) onboard Cassini. We also use hybrid simulation results from "A.I.K.E.F." to interpret the signatures in the particle fluxes. This paper is a continuation of Krupp et al. (2013, https://doi.org/10.1016/j.icarus.2013.06.007) and Kotova et al. (2015, https://doi.org/10.1016/j.icarus.2015.06.031). The key results are as follows: (1) Saturn's magnetosphere at Dione's orbit is highly variable with changes in energetic charged particle fluxes by 1–2 orders of magnitude. (2) The dropout signatures near Dione are basically consistent with a fully absorbing obstacle, but some features point to more complex interaction processes than plasma and energetic particle absorption. (3) Absorption signatures are found to be asymmetric with respect to the orientation of the moon, indicative of the presence of radial drift components for electrons. (4) The deepest absorption signatures were observed at the edge of the low‐energy wake pointing to gradient‐B drifts strongest in that part of the interaction region. Key Points: Dropout signatures in energetic particle fluxes near Dione are basically consistent with a fully absorbing obstacleAbsorption signatures are found to be asymmetric with respect to the orientation of the moon, pointing to radial drift of electronsThe deepest absorption signatures were observed at the edge of the low‐energy wake pointing to gradient‐B drifts [ABSTRACT FROM AUTHOR]

Aim: One in three patients with Crohn's disease will develop a perianal fistula, but only a few achieve long‐term healing. Treatment is both medical and surgical. Since there is no 'best' surgical procedure, patient preference is important in selecting the appropriate treatment for this condition. The aim of this study was to investigate the informational and decisional preferences of patients when surgical treatment is being considered. Method: Patients who had undergone surgery for Crohn's anal fistula underwent face‐to‐face semi‐structured interviews. These explored the experience of treatments for fistula, of receiving information and of participation in decision‐making. Transcripts were analysed by two investigators through inductive thematic analysis. Saturation was assessed for at 12 interviews and then after each subsequent interview. Results: Seventeen patients completed interviews, and saturation was achieved. Five themes were identified, of which two (desired information and decision‐making) were relevant to this study. Other themes included experience of Crohn's disease, experience of receiving information and procedure‐specific comments. Participants wanted to have information on any risks, high‐level outcomes (e.g. success), impact on day‐to‐day life and aftercare. Participants felt they did not always receive the information they needed to select the best treatment option. Participants felt uninvolved in treatment decisions and would have liked to trade off operations to reach their treatment goal. Conclusion: Information provided to patients about surgical treatment of Crohn's perianal fistula does not meet their needs. Clinicians should address aftercare, impact on quality of life and the risks and benefits of the any proposed procedure. [ABSTRACT FROM AUTHOR]

Variability in atmospheric dimethylsulfide (DMSa) and the potential influence on atmospheric aerosols was investigated at Heron Island in the southern Great Barrier Reef (GBR), Australia. This work compiles previously published DMSa data (reported in Swan, Jones, Deschaseaux, & Eyre, 2017, https://doi.org/10.1007/s00216‐017‐0385‐8), with additional surveys of DMSa, atmospheric particle number concentration, and other oceanic and atmospheric data sets. DMSa was higher in summer (mean 3.2 nmol m−3/78 ppt) than winter (mean 1.3 nmol m−3/32 ppt), reflective of seasonal shifts in phytoplankton biomass and emissions from corals in the southern GBR. Seasonally extreme spikes in DMSa were detected during low tide and low wind speed, supporting findings that the coral reef can be an important source of DMSa above background oceanic emissions. A significant link was present between DMSa and aerosol concentration (ranging from 0.5 to 2.5 μm) during calm, daylight hours, when conditions were optimal for the local oxidation of DMSa to sulfate aerosol precursors. This link may reflect condensational growth of existing fine particles (< 0.5 μm), which is the dominant pathway by which biogenic trace gases influence aerosols in the marine boundary layer. Aerosol concentration significantly correlated with reduced surface solar irradiance and sea surface temperature, which is potential evidence of a local negative feedback mitigating coral physiological stress. These findings provide a step toward a better understanding of the processes influencing DMSa and aerosol concentrations and of the consequences for the local radiative balance over coral reefs; an increasingly important topic with ongoing ocean warming and coral bleaching. Key Points: Coral reefs are an important source of atmospheric dimethylsulfideA significant link exists between atmospheric dimethylsulfide and marine aerosols in the southern Great Barrier ReefMarine aerosols reduced surface solar irradiance and sea surface temperature, potentially mitigating coral physiological stress [ABSTRACT FROM AUTHOR]

We investigate a possible negative ion feature observed by the Cassini Plasma Spectrometer (CAPS) during a flyby of Saturn's moon Dione that occurred on 7 April 2010. By examining possible particle trajectories, we find that the observed particles are consistent with negative pickup ions originating near the moon's surface. We find that the mass of the negative pickup ions is in the range of 15–25 u and tentatively identify this species as O−, likely resulting from ionization and subsequent pickup from Dione's O2‐CO2 exosphere. Our estimates show that the negative ion density is ~3 × 10−3 cm−3. This is comparable to, but slightly smaller than, that previously reported for the density of O2+ pickup ions for the same flyby, indicating that negative pickup ions may represent a major loss channel for Dione's exosphere. Key Points: Analysis of data from the Cassini Plasma Spectrometer confirms negative pickup ions originating from Saturn's moon DioneThe negative pickup ions are consistent with O− originating from Dione's exosphereDensity estimates indicate that negative pickup ions may represent a significant loss channel for Dione's exosphere [ABSTRACT FROM AUTHOR]

Ion velocities have been measured during the Enceladus E3 and E5 flybys using the Cassini Plasma Spectrometer (CAPS) instrument on the Cassini spacecraft. Data from three sensors in the CAPS instrument have been examined from two flybys that occurred during 2008. Positive ion measurements from the CAPS Ion Beam Spectrometer and Ion Mass Spectrometer have been used to measure positive ion velocities. The CAPS Electron Spectrometer has been used to complement the positive ion findings with measurements of negative ion velocities. Two velocities for the positive ions are found, with the fast ions (2.3–5.8 km/s) originating from the high‐speed neutral gas emission and slow ions (0.2–2.2 km/s) associated with the low‐speed thermal gas emission from Enceladus. Negative ions were found to be near stationary or northerly traveling, implying a deceleration mechanism within the plume. A tentative detection of fast negative ions was also recorded for one of the flybys. These findings will aid in future modeling of plume dynamics. Key Points: Velocities of positive and negative ions have been measured in the Enceladus plume using CAPS sensorsTwo distinct ion velocities are found, in agreement with fast gas and slow thermal emissions of neutralsThermal negative ions are near stationary relative to Enceladus, implying a deceleration mechanism such as an ambipolar electric field [ABSTRACT FROM AUTHOR]

Aim: To investigate the incretin axis in people with cystic fibrosis. Methods: Adults with cystic fibrosis‐related diabetes, cystic fibrosis without diabetes, and controls (adults without cystic fibrosis and without diabetes) underwent an oral glucose tolerance test and then a closely matched isoglycaemic i.v. glucose infusion. On each occasion, glucose, insulin, C‐peptide, total and active glucagon‐like peptide‐1 and gastric inhibitory polypeptide responses were recorded and incremental areas under curves were calculated for 60 and 240 min. Results: Five adults with cystic fibrosis‐related diabetes, six with cystic fibrosis without diabetes and six controls, matched for age and BMI, completed the study. Glucose during oral glucose tolerance test closely matched those during isoglycaemic i.v. glucose infusion. The calculated incretin effect was similar in the control group and the cystic fibrosis without diabetes group (28% and 29%, respectively), but was lost in the cystic fibrosis‐related diabetes group (cystic fibrosis‐related diabetes vs control group: –6% vs 28%; p=0.03). No hyposecretion of glucagon‐like peptide‐1 or gastric inhibitory polypeptide was observed; conversely, 60‐min incremental area under the curve for total glucagon‐like peptide‐1 was significantly higher in the cystic fibrosis‐related diabetes group than in the control group [1070.4 (254.7) vs 694.97 (308.1); p=0.03] Conclusions: The incretin effect was lost in cystic fibrosis‐related diabetes despite adequate secretion of the incretin hormones. These data support the concept that reduced incretin hormone insulinotropic activity contributes significantly to postprandial hyperglycaemia in cystic fibrosis‐related diabetes. What's new?: This study is the first to measure the incretin effect in people with cystic fibrosis (CF).The incretin effect is lost in people with cystic fibrosis‐related diabetes (CFRD) despite adequate secretion of glucagon‐like peptide‐1 and gastric inhibitory polypeptide.In people with CF but not diabetes, the incretin effect is similar to that in people without CF.These data suggest the lack of incretin effect contributes to postprandial hyperglycaemia, a hallmark of CFRD, most likely as a consequence of reduced β‐cell mass. [ABSTRACT FROM AUTHOR]

The inner boundary of Saturn's electron radiation belts, near the planet's A ring (∼2.27 Rs), is studied using Cassini's proximal orbit measurements. We find that variable convective flows transport energetic electrons to the A ring, which absorbs them instantaneously, forming the inner belt boundary. These flows are also responsible for a variable and longitudinally asymmetric boundary configuration. Prenoon, the boundary oscillates toward and away from the A ring with a 2‐week period. Postnoon, it maps persistently near the F ring (∼2.32 Rs) and coexists with localized MeV electron intensity enhancements (microbelts). We propose that the microbelts contain electrons in drift resonance with corotation, trapped in local time‐confined trajectories, which result from the aforementioned convective flows. The microbelts' collocation with the F ring implies either a local, secondary electron production due to galactic cosmic ray collisions with F ring dust or an enhanced resonant electron trapping due to an electrodynamic interaction between the F ring and Saturn's magnetosphere. Plain Language Summary: The material density of Saturn's main rings is large enough to instantaneously remove even the highest energy particles of the planet's radiation belts that come in contact with them. Even though this interaction does not sound trivial, Cassini observations indicate the opposite. The transition between Saturn's electron radiation belts and the Saturn's A ring, the outermost component of the main rings, was crossed 45 times during Cassini's final orbits. In all cases, the expected signature of electron depletion by the rings was observed but only twice this depletion mapped on the outer edge of the A ring. All other times, it was found several thousand kilometers away from its expected location. On certain areas in the afternoon sector of the radiation belts, the dropout was preceded by an unexpected, sharp increase of high‐energy electron intensities, which we named microbelts. Both the microbelts and the electron depletions map closer to Saturn's F ring, a highly structured, narrow ring of Saturn. The study investigates the topological properties of the microbelts and the electron belt depletion to demonstrate that the ring belts transition likely combines complex electron flows and a local F ring‐driven electron source that make its structure much more complex than ever anticipated. Key Points: The radial transport of energetic electrons onto Saturn's rings is dominated by convectionThe F ring contains regions of MeV electron pileup evolving separately from Saturn's electron beltsThe F ring may be both a source and a sink of energetic electrons [ABSTRACT FROM AUTHOR]

Background: There are few controlled studies of the effect of different doses of vitamin D3 on bone mineral density (BMD).Objectives: We conducted a randomized placebo-controlled trial of increasing doses of vitamin D3 in 163 Caucasian and 31 African American women with serum 25-hydroxyvitamin D (25OHD) ≤50 nmol/L. This is an analysis of secondary outcome BMD to see if there is an association between percent change in BMD and dose of vitamin D3.Methods: Participants were randomly assigned to placebo, vitamin D3 400, 800, 1600, 2400, 3200, 4000, or 4800 IU/day; calcium supplements, average 600mg, were given to provide a total calcium intake of 1200 mg/d. The primary outcome was 12-month serum 25OHD level. Analysis methods include ANOVA and Pearson correlations.Results: The mean percent increase (±SD) in BMD at 12 months for all women was small; total body, 0.62% (± 2.72), femoral neck 0.59% (±3.58) and spine 0.43% (±2.80). There was no difference in BMD or serum N-telopeptide in response to vitamin D by dose or race. The increase in total body, spine and hip BMD in elderly women given vitamin D doses between 400 and 4800 IU daily and calcium supplementation is small, unrelated to dose or 12-month serum 25OHD, free 25OHD or 1,25(OH)2D. There was no evidence of a threshold change in BMD with increasing serum 25OHD or free 25OHD in this population.Conclusions: We found no significant effect of daily vitamin D dose ranging from 400 to 4800 IU/day on BMD or serum N-terminal telopeptides in elderly women with initially low serum 25OHD. [ABSTRACT FROM AUTHOR]

Abstract: Aim: YouTube™ is an open‐access, nonpeer‐reviewed video‐hosting site and is used as a source of publicly available healthcare information. This study aimed to assess the thematic content of the most viewed videos relating to surgery and Crohn's disease and to explore the viewer interactions with these videos. Method: A search of YouTube™ was carried out using one search string. The 50 most viewed videos were identified and categorized by source and content themes and assessed for viewer interactions. Video comments were used to describe the usefulness of the video content to viewers. Results: The majority of videos were uploaded by patients (n = 21).The remainder were uploaded by individual healthcare professionals (n = 9), hospital/speciality associations (n = 18) and industry (n = 2). The median number of likes for patient videos was significantly higher than for hospital/speciality association videos (P < 0.001). Patient videos received more comments praising the video content (n = 27) and more comments asking for further information (n = 14). The median number of likes for ‘experience of surgery’ (P < 0.001) and ‘experience of disease’ (P = 0.0015) themed videos were significantly higher than for ‘disease management’ themed videos. Conclusion: Crohn's disease patients use YouTube™ as a surgical information source. The content of patient‐sourced videos focused on surgical and disease experience, suggesting that these themes are important to patients. Current patient developed videos provide limited information, as reflected by viewers requesting further information. Storytelling patient‐centred videos combined with clinical evidence may be a good model for future videos. [ABSTRACT FROM AUTHOR]

Abstract: Cutting height is an important factor controlling the yield and persistence of grass swards harvested for conserved feed. The objective of this experiment was to determine the effect of four cutting heights (5, 10, 15 and 20 cm) on the yield, composition and productivity based on deviation from a size/density compensation line for swards of orchardgrass (Dactylis glomerata L.) and an orchardgrass/alfalfa (Medicago sativa L.) mixture harvested nine times over three growing seasons. Yield was greatest for the 5 cm cutting height through the course of the experiment but ground cover of orchardgrass declined. Prior to the final harvest, tiller weight and density were determined. The 10‐, 15‐ and 20‐cm treatments fell on an apparent size/density compensation line with slope ‐1·779 (R2 = ·99; p = ·008) while the 5‐cm treatment fell considerably below that line indicating a reduction in productivity or relative persistence. Harvest at 10 cm appears to optimize yield while maintaining stand productivity in infrequently harvested orchardgrass swards. [ABSTRACT FROM AUTHOR]

A statistical study of the energetic proton environment at Titan's orbit as captured by the MIMI/LEMMS and MIMI/CHEMS instruments is performed. The data analyzed cover all the dedicated flybys of Titan by Cassini as well as the orbit crossings that happen far from the moon. The energetic environment is found to be highly variable on timescales comparable to that of the duration of a flyby. Analysis of H+ ion fluxes reveals a weak asymmetry in Saturn local time with the highest fluxes occurring in the premidnight sector of the magnetosphere. A correlation between the energetic ion fluxes and the location of Cassini in the magnetosphere with respect to the center of the current sheet can be observed. Finally, an empirical model of proton spectra for energies above 20 keV is derived based on fits to Kappa distribution functions. This model can be used to better understand the interaction of Titan with the magnetosphere and the energy deposition by energetic particles below the main ionospheric peak. Key Points: Energetic particle environment at Titan's orbit is highly variableIon data present SLT asymmetry with higher fluxes in the premidnight sectorDerivation of empirical model of ion spectra based on Kappa distribution function is presented [ABSTRACT FROM AUTHOR]

Abstract: Aims: Previous evidence has demonstrated that participation in the Dose Adjustment for Normal Eating (DAFNE) education programme can reduce HbA1c and severe hypoglycaemia in people with Type 1 diabetes. In a number of studies, increased HbA1c variability has been associated with higher diabetic morbidity and mortality. No studies have examined the impact of structured education on HbA1c variability in Type 1 diabetes. Methods: People with Type 1 diabetes who had attended DAFNE were identified for inclusion from the Scottish Care Information‐Diabetes dataset. HbA1c median and variability, expressed as coefficient of variation (CV) before and after DAFNE was calculated. Results: Some 1061 individuals participated in DAFNE education and 687 met the inclusion criteria. A significant median reduction in HbA1c [−3.5 mmol/mol (−0.3%)] was seen at 12 months with a significant reduction [−1.5 mmol/mol (−0.1%)] still seen at 60 months of follow‐up. HbA1c variability as measured by CV was significantly lower during the post‐DAFNE period: 0.08 (IQR 0.05–0.12) reduced to 0.07 (IQR 0.05–0.10); P = 0.002. Conclusion: The data confirm that DAFNE participation improves glycaemic control in Type 1 diabetes with benefits being sustained for 5 years. This study is the first to demonstrate reduced HbA1c variability after completion of structured education. This is new evidence of the beneficial impact of DAFNE on glycaemic profile. [ABSTRACT FROM AUTHOR]

Abstract: Saturn's largest icy moon, Rhea, hosts a tenuous surface‐sputtered exosphere composed primarily of molecular oxygen and carbon dioxide. In this Letter, we examine Cassini Plasma Spectrometer velocity space distributions near Rhea and confirm that Cassini detected nongyrotropic fluxes of outflowing CO 2 + during both the R1 and R1.5 encounters. Accounting for this nongyrotropy, we show that these possess comparable along‐track densities of ∼2 × 10−3 cm−3. Negatively charged pickup ions, also detected during R1, are surprisingly shown as consistent with mass 26 ± 3 u which we suggest are carbon‐based compounds, such as CN−, C 2 H −, C 2 −, or HCO−, sputtered from carbonaceous material on the moon's surface. The negative ions are calculated to possess along‐track densities of ∼5 × 10−4 cm−3 and are suggested to derive from exogenic compounds, a finding consistent with the existence of Rhea's dynamic CO2 exosphere and surprisingly low O2 sputtering yields. These pickup ions provide important context for understanding the exospheric and surface ice composition of Rhea and of other icy moons which exhibit similar characteristics. [ABSTRACT FROM AUTHOR]

Abstract: The Electron Spectrometer (ELS) of the Cassini Plasma Spectrometer has observed photoelectrons produced in the plume of Enceladus. These photoelectrons are observed during Enceladus encounters in the energetic particle shadow where the spacecraft is largely shielded from penetrating radiation by the moon. We present a complex electron spectrum at Enceladus including evidence of two previously unidentified electron populations at 6–10 eV and 10–16 eV. We estimate that the proportion of “hot” (>15 eV) to “cold” (<15 eV) electrons during the Enceladus flybys is ≈ 0.1–0.5%. We have constructed a model of photoelectron production in the plume and compared it with ELS Enceladus flyby data by scaling and energy shifting according to spacecraft potential. We suggest that the complex structure of the electron spectrum observed can be explained entirely by photoelectron production in the plume ionosphere. [ABSTRACT FROM AUTHOR]

This study compared adaptations in fascicle lengths, pennation angles, and muscle thickness of the lateral and medial gastrocnemii in response to 6 weeks of stretch training. The nondominant plantar flexors of 11 males were stretched five times per week for 6 weeks and compared with the contralateral leg and a nonstretched control group of 10 males. During stretch training, instantaneous electromyography was utilized to ensure passive muscle stretch. At baseline, week three, week six and 1 week after the conclusion of stretch training, ultrasound was used to measure fascicle lengths, pennation angles, muscle thickness of the lateral gastrocnemius and medial gastrocnemius, and Achilles tendon thickness and length. Plantar flexion torque was measured, and voluntary activation was assessed. Muscle thickness increased 5.6% after 6 weeks of stretch training ( P=.009). The fascicles in the lateral gastrocnemius lengthened to a greater extent than the medial. Overall, fascicles lengthened 25% ( P<.001) in the muscle tendon junction and 5.1% ( P<.001) in the muscle belly. Pennation angles were unchanged in the medial gastrocnemius but decreased in the lateral gastrocnemius 7.1% ( P=.02). There was no change in maximal voluntary contraction, voluntary activation, tendon length, or thickness. This study demonstrates that stretch training is a viable modality to alter muscle architecture of the human gastrocnemius through lengthening of muscle fascicles, decreasing pennation angles, and increasing muscle thickness, albeit adaptations are unequal between the lateral and medial heads. [ABSTRACT FROM AUTHOR]

Artificial illumination at night ( ALAN) alters many aspects of animal behaviour. Commuting and foraging bats have been found to be affected by ALAN, but no study has yet addressed the impact of lighting on drinking activity, despite its critical importance for bats. We experimentally illuminated cattle troughs used by drinking bats at four forest sites in Italy, and compared drinking activity and foraging activity under lit and dark conditions. We predicted that (1) the number of bat species and drinking events will be lower under illumination and (2) forest bat species will be more affected than edge specialists. We recorded 2549 drinking events from 12 species or species groups, most of which decreased drinking activity under illumination. The effects of ALAN on drinking were stronger than on foraging. Forest species never drank when the light was on. Edge-foraging species reduced drinking activity while also increasing foraging under lit conditions. We highlight a previously overlooked negative effect of ALAN on bats, whose implications may be locally catastrophic. Given the importance of water sites for both bat foraging and drinking, their illumination should be forbidden, appropriately mitigated or, if necessary, compensated for with the creation of alternative drinking sites. [ABSTRACT FROM AUTHOR]

Background and purpose Intracerebral hemorrhage ( ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 ( MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. Methods Patients with acute onset (<12 h from symptom onset) ICH and small initial hematoma volume (<30 ml) were randomized to high-dose (10 mg/kg) intravenous minocycline or placebo. The outcome events included adverse events, change in serial National Institutes of Health Stroke Scale score assessments, hematoma volume and MMP-9 measurements, 3-month functional outcome (modified Rankin score) and mortality. Results A total of 20 patients were randomized to minocycline ( n = 10) or placebo ( n = 10). The two groups did not differ in terms of baseline characteristics. No serious adverse events or complications were noted with minocycline infusion. The two groups did not differ in any of the clinical and radiological outcomes. Day 5 serum MMP-9 levels tended to be lower in the minocycline group (372 ± 216 ng/ml vs. 472 ± 235 ng/ml; P = 0.052). Multiple linear regression analysis showed that minocycline was associated with a 217.65 (95% confidence interval −425.21 to −10.10, P = 0.041) decrease in MMP-9 levels between days 1 and 5. Conclusions High-dose intravenous minocycline can be safely administered to patients with ICH. Larger randomized clinical trials evaluating the efficacy of minocycline and MMP-9 inhibition in ICH patients are required. [ABSTRACT FROM AUTHOR]

Aim Despite evidence of morbidity, no evidence exists on the relationship between HbA1c variability and mortality in Type 1 diabetes. We performed an observational study to investigate whether the association between HbA1c variability and mortality exists in a population of people with Type 1 diabetes. As a secondary outcome, we compared onset of first hospital admission between groups. Methods People with Type 1 diabetes were identified for inclusion from the Scottish Care Information - Diabetes data set. This database includes data of all people known to have diabetes who live within Scotland. A survival analysis was carried out over a 47-month period comparing two groups; group 1 with a HbA1c coefficient of variation ( CV) above the median CV value, and group 2 with a CV below the median value. Time to death or first admission was also analysed. A Cox proportional hazard model was used to compare time to death, adjusting for appropriate covariables. Results Some 6048 individuals with Type 1 diabetes were included in the analysis. Median HbA1c CV was 7.9. The hazard ratio ( HR) for mortality for those with an HbA1c CV above the median value is 1.5 over 47 months of follow-up ( P < 0.001). HR for survival to either the first admission to hospital or death for those with an HbA1c CV above the median value was 1.35 (95% confidence interval 1.25-1.45) over 730 days of follow-up ( P < 0.001). Conclusion Our results show that people with greater HbA1c variability have a higher rate of mortality and earlier hospital admission in Type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background: Substance P (SP) is a pain- and inflammation-related neuropeptide which preferentially binds to the neurokinin receptor 1 (NK1 ). SP and NK1 receptors have been implicated in joint pain, inflammation and damage in animal models and human studies of osteoarthritis (OA). The aim of this study was to test if genetic variation at the neurokinin 1 receptor gene (TACR1) is associated with pain in individuals with radiographic knee OA.Methods: Participants from the Genetics of OA and Lifestyle study were used for the discovery group (n = 1615). Genotype data for six SNPs selected to cover most variation in the TACR1 gene were used to test for an association with symptomatic OA. Replication analysis was performed using data from the Chingford 1000 Women Study, Hertfordshire Cohort Study, Tasmanian Older Adult Cohort Study and the Clearwater OA Study. In total, n = 1715 symptomatic OA and n = 735 asymptomatic OA individuals were analysed.Results: Out of six SNPs tested in the TACR1 gene, one (rs11688000) showed a nominally significant association with a decreased risk of symptomatic OA in the discovery cohort. This was then replicated in four additional cohorts. After adjusting for age, gender, body mass index and radiographic severity, the G (minor) allele at rs11688000 was associated with a decreased risk of symptomatic OA compared to asymptomatic OA cases (p = 9.90 × 10-4 , OR = 0.79 95% 0.68-0.90 after meta-analysis).Conclusions: This study supports a contribution from the TACR1 gene in human OA pain, supporting further investigation of this gene's function in OA.Significance: This study contributes to the knowledge of the genetics of painful osteoarthritis, a condition which affects millions of individuals worldwide. Specifically, a contribution from the TACR1 gene to modulating pain sensitivity in osteoarthritis is suggested. [ABSTRACT FROM AUTHOR]

Background and purpose The Beagley-Gibson ( BG) grading system utilizes microtopographical skin changes to generate an individualized, objective estimate of cumulative, lifetime ultraviolet radiation ( UVR) exposure. However, predictors of BG grade are ill-defined, particularly in older populations. The aim of this cross-sectional study was to describe the factors associated with skin damage as measured by the BG method in 835 community-dwelling older adults. Methods Study participants aged 53-83 years had silicone casts taken from the dorsum of both hands and graded by the BG method. Lifetime sun exposure, skin phenotypic traits and smoking status were assessed by questionnaire. 25-hydroxyvitamin D and melanin density were measured using radioimmunoassay and spectrophotometry, respectively. Ordered logistic regression was used to compute a single odds ratio ( OR) by taking BG grade as the outcome variable. Results Higher 25-hydroxyvitamin D was associated with increasing BG grade ( OR = 1.39, P = 0.02) in adjusted analysis. Age ( OR = 1.14, P < 0.001), occupational sun exposure ( OR = 1.62, P < 0.001), ability to tan ( OR = 1.40, P < 0.001), melanin density ( OR=0.79, P = 0.001), lifetime leisure time sun exposure ( OR = 1.21, P = 0.004), current smoking ( OR = 1.82, P = 0.007), propensity to sunburn ( OR = 1.18, P = 0.016), and waist-hip ratio ( OR = 1.10, P = 0.02) were independent predictors of BG grade. Hair colour, number of sunburns, body mass index and gender were not independent predictors of BG grade. Conclusions Beagley-Gibson skin cast grade is a biologically relevant marker of UVR exposure in older adults influenced by both intrinsic and extrinsic factors. [ABSTRACT FROM AUTHOR]

It was tested whether the pajama cardinalfish Sphaeramia nematoptera (Apogonidae) could home by displacing individuals up to 250 m within and among isolated reefs. Contrary to expectations, only two of 37 (5·4%) displaced S. nematoptera returned home and another 16 (43·2%) were found to have joined other social groups and did not home after 26 months of observations; while over the same period, 94% of control S. nematoptera remained associated with home corals, demonstrating strong site attachment. Hence, while this species has the potential to return home, being able to do so may not be as critical as previously assumed. [ABSTRACT FROM AUTHOR]

Background Progress testing is well established as a longitudinal form of assessment in undergraduate medical programmes to measure growth in knowledge. Peninsula Dental School is the first school to use progress testing and remains the only one to do so. Aims To share the experience of developing progress testing in an undergraduate dental programme as a major summative assessment tool at a newly established dental school in the United Kingdom. Methods Data were collected for progress tests conducted from 2007 to 14. The tests were formative in the first 2 years of the programme and summative in subsequent years. Each test was based on 100 single best answer multiple-choice items with an appropriate vignette. The students chose their answer from 5 options. A score 1 mark is awarded for each correct answer, minus 0.25 for an incorrect answer and 0 for 'don't know' (DK). The standard setting for each sitting was carried out using Angoff and Hofstee methods. Results There were two tests per year with each cohort undertaking eight tests in their 4 years of study providing a total 14 test occasions. The reliability of each test for each student cohort tests was measured using Cronbach's alpha. The average reliability over 42 test/cohort combinations was 0.753 (±SD 0.08). Data analyses show growth in knowledge of dental students across successive years with the largest increase in knowledge observed between tests 1 and 5 and concomitant reduction in DK responses. Conclusion This is the first study to report the establishment and use of progress testing as the principle form of written summative testing in an undergraduate dental curriculum. Progress testing is a valid and reliable tool to assess growth in knowledge longitudinally over the duration of a dental programme. Although a labour-intensive process, progress testing merits more widespread use in dental programmes. [ABSTRACT FROM AUTHOR]

Objective: To determine the associations between body adiposity and change in serum 25-(OH)D levels over 2.6 years, and if these associations are mediated by metabolic and inflammatory factors in older adults.Methods: This is a longitudinal study of 859 randomly selected subjects (mean 62 years, range 51-80, 49% women). Serum 25-hydroxyvitamin D [25-(OH)D] was assessed by radioimmunoassay at baseline and 2.6 years later. Baseline serum level of leptin was assessed by radioimmunoassay and interleukin (IL)-6 by a chemiluminescent immunoassay in the first 183 subjects.Results: In multivariable analyses, body mass index, trunk fat percentage and waist-to-hip ratio were significant predictors of increased incident vitamin D deficiency [a 25-(OH)D < 50 nmol L⁻¹ at follow-up when ≥50 nmol L⁻¹ at baseline] and decreased recovery of vitamin D deficiency [a 25-(OH)D ≥ 50 nmol L⁻¹ at follow-up when < 50 nmol L⁻¹ at baseline]. Change in 25-(OH)D levels per annum was also independently predicted by baseline leptin (β: -0.09/unit, 95% CI: -0.17, -0.03), IL-6 (β: -0.68/quartile, 95% CI: -1.35, -0.02) and total cholesterol/high-density lipoprotein (HDL) ratio (β: -0.51, 95% CI: -0.88, -0.14). The associations between body adiposity measures and change in 25-(OH)D completely disappeared after adjustment for leptin, diminished after adjustment for IL-6, but remained unchanged after adjustment for total cholesterol/HDL ratio. All associations were independent of season and sun exposure.Conclusions: Body fat is not simply a passive reservoir for 25-(OH)D. In addition to season and sun exposure, 25-(OH)D levels appear to be determined by metabolic and, to a lesser extent, inflammatory factors, and these appear to mediate the effects of adiposity on change in 25-(OH)D. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Large-scale expansion of no-take closures within the Great Barrier Reef has not enhanced fisheries production," by W. J. Fletcher and colleagues in the 2015 issue.

Osteoarthritis is the leading musculoskeletal cause of disability in the Western society. Despite this, it is still difficult to gain a precise definition of what osteoarthritis actually is. The methods used for the study are narrative review and viewpoint focussing on the knee. It is well known that there is a modest correlation between X-ray changes and pain. Improvements in imaging have shown that osteoarthritis should be regarded as an umbrella term for a number of pathophysiological processes leading to pain and/or cartilage loss. If these are inside the joint (such as bone marrow lesions, cartilage defects or meniscal tear) then they can be considered osteoarthritis, while those outside the joint (such as obesity, weak muscles and vitamin D deficiency) could be considered the osteoarthritis syndrome. These improvements in basic science are leading to lesion-specific therapies indicating the importance of trying to pinpoint causes of pain in the individual. [ABSTRACT FROM AUTHOR]

Grapevine varietal suitability is strongly linked to regional environmental conditions and growers tend to select varieties that are best suited to these conditions. A high agreement between current growing regions and optimal climatic zones is thus anticipated for a given variety. A changing climate is, however, expected to impose new challenges to this long-term varietal selection. The present research examines the spatial distribution of the main grapevine varieties in Portugal, establishing current and future optimal climatic zones for each variety. The spatial locations of 44 varieties are assessed, and their growing degree-day (GDD) requirements are computed using a high resolution climatic dataset (<1 km). A clustering methodology is applied to the spatial patterns of the optimal GDD of each variety, leading to three varietal groupings (early, intermediate and late). Future changes (2041-2060) in those patterns are then analysed using a 17 model-ensemble and two scenarios (RCP4.5 and 8.5). Results indicate that Portuguese varieties have high adaptability, because they are grown over a large range of thermal conditions. Although the three clusters provide a good agreement with the current growth conditions, a strong warming trend is projected in the future, resulting in projections of a northward shift and move to higher elevations for the cluster patterns. Hence, other European regions may experience improved growing conditions for the settlement of these Portuguese varieties. Nonetheless, future varietal selection will heavily depend on the interest of winemakers and global market policies for the production of specific wines. Adaptation measures may indeed be required for maintaining the current varietal distribution. [ABSTRACT FROM AUTHOR]

Organisms sharing the same habitats may differ in small-scale microhabitat requirements or benefit from different management. In this study, set in Italy, we focused on two species of high conservation value, the cerambycid beetle R osalia alpina and the bat B arbastella barbastellus, which often share the same forest areas and in several cases the same individual trees. We compared the potential distribution and, at two spatial scales, the niches between such species. The predicted distributions largely overlapped between the beetle and the bat. The niches proved to be similar on a broad scale, yet not on the plot one. Compared with B . barbastellus, R . alpina tends to occur at lower altitude in more irradiated sites with lower canopy closure and uses shorter trees with wider diameters. B . barbastellus occurred more often in trees within forest or along its edges, whereas R . alpina lays eggs in trees found in clearings. B . barbastellus plots were more frequent in forest, R . alpina plots in forested pasture and open-shredded forest. Overall, exposure to sun influenced more critically site and tree selection by R . alpina, as a warm microclimate is essential for larval development. Although B . barbastellus reproduction may be favored by warmer roosting conditions, bats may also find such conditions in dense forest and in strongly irradiated cavities high up in tall trees that project above the canopy. We emphasize that subtle differences in the ecological requirements of syntopic taxa could be missed at broad scales, so multiple-scale assessment is always advisable. [ABSTRACT FROM AUTHOR]

An abstract of the article "Three cases of cervical distortion secondary to incarceration of a retroverted gravid uterus: ultrasound features and management challenges" by I. Babic is presented.