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Objective Assess the safety and efficacy of intradiscal fibrin sealant in adults with chronic discogenic low back pain. Design Prospective, nonrandomized Food and Drug Administration approved pilot study. Setting Three centers in the United States. Subjects Fifteen adults with chronic, single, or contiguous two-level lumbar discogenic pain confirmed through meticulous provocation discography. Interventions Volume- and pressure-controlled intradiscal delivery of BIOSTAT BIOLOGX(®) Fibrin Sealant with the Biostat(®) Delivery Device into symptomatic lumbar disc(s). Outcome measures Assessments were performed at baseline, 72 hours, and 1, 4, 13, 26, 52, and 104 weeks following intervention. Potential adverse events were evaluated with serial assessment of neurological status, radiographic, and magnetic resonance imaging (MRI). Efficacy measures included serial assessments of low back pain visual analog scale (VAS) measurements and the Roland-Morris Disability Questionnaire (RMDQ). Results Safety neurological assessments, X-ray, and MRI showed no significant changes. Adverse events were reported in nine subjects. Two instances of low back muscle spasm and one case of discitis were the only events considered related to the procedure or product. Efficacy Mean low back pain VAS scores (mm) decreased from 72.4 (95% confidence interval 64.6-80.3) at baseline to 31.7 (17.4-46.1), 35.4 (17.7-53.1), and 33.0 (16.3-49.6); mean RMDQ score improved from 15.2 (12.7-17.7) at baseline to 8.9 (5.3-12.5), 6.2 (3.4-9.1), and 5.6 (2.9-8.4) at 26, 52, and 104 weeks, respectively. Conclusion Intradiscal injection of BIOSTAT BIOLOGX Fibrin Sealant with the Biostat Delivery Device appears safe and may improve pain and function in selected patients with discogenic pain.

Background: Childhood malnutrition is the leading risk factor for the global burden of disease. Guinea- Bissau is a politically unstable country with high levels of childhood malnutrition and mortality. Aim: To determine the nutritional status of children on three remote islands of the Bijagos Archipelago, Bubaque, Rubane and Soga, and to identify factors associated with malnutrition and anaemia in this population in order to provide a baseline for future public health interventions. Methods: A cross-sectional, population-based, door-to-door household survey of randomly selected households was undertaken to collect data on children aged 0-59 months (n5872). Dietary information was collected using a validated questionnaire. Anthropometric measurements were collected using World Health Organization techniques. Capillary blood samples were analysed using a HemocueH, with anaemia defined as Hb,11 g/dl. Results: The prevalences of stunted, wasted and underweight children were 21.8%, 9.4% and 3.7%, respectively. These figures indicate moderate chronic malnutrition. The significant predictor variables for stunting were: age in months (OR 1.03), rural residence (OR 2.32), anaemia (OR 3.55) and residence on Soga island (OR 0.44). Stunting was more prevalent in males (25.4%) than in females (18.6%) (P50.03). The prevalence of anaemia was 80.2%. Age (OR 0.96), male gender (OR 1.81) and stunting (OR 2.87) were significant predictors. The Minimum Acceptable Diet was achieved by only 8.7% of children. Conclusion: The prevalence of malnutrition on the Bijagos Archipelago is less than half that on the mainland. This study is the first to determine the prevalence of anaemia in Guinea-Bissau, which, at 80.2%, is of severe public health concern. Future research should focus on the aetiology of stunting and anaemia, especially the contribution of infectious diseases and mother-child interaction. Iron supplementation should be strongly considered in this population.

In this paper, an example problem is presented that illustrates the importance of strong objectivity in kinematic algorithms for large-deformation finite element applications. The example problem involves cyclic simple shearing of a hypoelastic material, wherein the increments of stretch and of rotation are of comparable magnitude. It is demonstrated that two kinematic algorithms that are in common use, and which are only weakly objective, give rise to an accumulative error in the normal stress components. The error is surprisingly large, even for very small strain increments. This behaviour arises due to a coupling between the stretch and rotation increments that is exhibited by weakly objective algorithms, and is perhaps especially serious in the context of models for jointed rock and other frictional materials, in which the shear response may depend strongly on the normal components of stress.

Four atmospheric transmittance models, LOWTRAN 7, MODTRAN 3, FASCOD3P, and the Thomason model, are investigated to quantify the relationship between water vapor transmittance as function of water vapor amount, Tw(U), for an instrument specific band pass in the 0.94-μm region. In a second step an empirical Tw(U) function is established using long term measurements with our high-precision Sun photometer (SPM) in Bern, Switzerland along with 1300 simultaneous and collocated water vapor retrievals performed with a dual-channel microwave radiometer (MWR). In order to avoid a possible bias in the empirical Tw(U) function, the MWR data set is prescreened by comparing retrievals coincident with radiosonde ascents. Over a 2½-year period of common observations, radiosondes and SPM agreed to within 0.19 cm (13%) of columnar water vapor (CWV) using the empirical Tw(U) relationship. Completely independent comparisons with an additional MWR and two Fourier transform spectrometers yielded agreement within 13% and 9%, respectively. Comparing empirical and modeled results, we found that with respect to the experimental data, LOWTRAN 7, MODTRAN 3, and FASCOD3P reported higher water vapor transmittances over almost the entire range of realistic absorber amounts. By relating these differences to differences in retrieved CWV for the case of two standard atmospheres, we found that using Tw(U) predicted by LOWTRAN 7, MODTRAN 3, and FASCOD3P leads to an overestimate of CWV by about 18–30%, 7–20%, and 2–18%, respectively. The Thomason model yields good agreement with respect to the experimental data up to medium absorber amounts, whereas at slant path amounts larger than 10 cm, errors up to 60% in retrieved CWV occurred. We also show in this work that a misinterpretation of the LOWTRAN 7 water vapor output counterbalances incorrectly predicted Tw, leading to results that agree well with experimental ones.

Octa-substituted phthalocyanines carrying either one or two hydroxyalkyl chains have been synthesised and their liquid crystalline behaviour characterised by polarised light microscopy and differential scanning calorimetry. The compounds form discotic columnar mesophases with hexagonal or rectangular symmetry. Examples have been used as precursors for the synthesis of mesogenic di-nuclear and tri-nuclear phthalocyanines, ie derivatives containing two or three phthalocyanine rings. These compounds have been characterised by elemental analysis and low resolution field desorption mass spectrometry, FD-MS. 1H NMR spectroscopy and gel permeation chromatography of selected examples provide supporting data. Visible region spectroscopy of dilute solutions of the multinuclear phthalocyanines in cyclohexane (down to a concentration of 5 × 10−7 mol dm−3 where intermolecular aggregation is expected to be minimal) suggests that the compounds exist as an equilibrium between a ‘closed’ conformer where the two rings are arranged cofacially (broad band centred at ca 645nm) and an open form having an absorption band similar to that of the simpler precursor phthalocyanines, λmax ca. 730 nm. The closed conformer is favoured in more polar media eg 10% toluene - 90% ethanol. Examples have been deposited as spin coated films of even thickness on glass slides.

Mixed crop-livestock systems provide livelihoods for a billion people and produce half the world’s cereal and around a third of its beef and milk. Market orientation and strong and growing demand for food provide powerful incentives for sustainable intensification of both crop and livestock enterprises in smallholders’ mixed systems in Africa. Better exploitation of the mutually reinforcing nature of crop and livestock systems can contribute to a positive, inclusive growth trajectory that is both ecologically and economically sustainable. In mixed systems, livestock intensification is often neglected relative to crops, yet livestock can make a positive contribution to raising productivity of the entire farming system. Similarly, intensification of crop production can pay dividends for livestock and enhance natural resource management, especially through increased biomass availability. Intensification and improved efficiency of livestock production mean less greenhouse gases per unit of milk and more milk per unit of water. This paper argues that the opportunities and challenges justify greater investment in research for development to identify exactly where and how ‘win-win’ outcomes can be achieved and what incentives, policies, technologies and other features of the enabling environment are needed to enable sustainable, integrated and productive mixed crop-livestock systems.

The effects of animal size and feeding frequency on the foregut evacuation rates by Cherax quadricarinatus, that fed voluntarily on pellet food (meal size eaten, 1.3-1.4% body weight), were determined using a modified serial slaughter method. Evacuation rates did not differ significantly between size-groups (medium, large) and between feeding frequency-groups (fed daily, fed every second day). However, models that best described the evacuation process were different for each group (i.e., linear model for the crayfish fed daily, arcsine model for those fed every second day). This variation indicates the potential for a crayfish to regulate its digestion processes according to food availability. Faecal production rates did not differ significantly between feeding frequencies. Return of appetite, measured in terms of voluntary feed intake at bi-hourly intervals following satiation meals, was shown to be related to the foregut evacuation process, but it was probably the supply of fresh gastric fluid after ca. 4 h following a meal which mainly influenced the increase of appetite. The rapid return of appetite in crayfish implies that they can resume feeding while a considerable proportion of an earlier meal is still being processed in the foregut. This indicates that crayfish are capable of optimising the frequency of feeding during active foraging periods.

Methods which aid and enhance the teaching of surgical procedures to trainees are beneficial to both trainer and trainee. In this article, we suggest a simple way of performing suction diathermy which allows the trainer to provide a template for the trainee to reproduce. Related articles have suggested the use of additional equipment, such as an endoscope; however, the method we describe requires no additional technical elements. Thus, it represents a sound and efficient teaching tool.

Introduction Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

In sub-Saharan Africa the importance of nutrient cycling in mixed farming systems is poorly understood, and there is a paucity of information in the literature. The vital role played by livestock in regulating fluxes through nutrient cycles is often ignored in experimentation and crop modelling although, in farming practice, the animal is an integral part of the system. The aim of this review is to highlight animal-related factors which can influence the dynamics of nitrogen (N) cycling in mixed farming systems on the sub-continent. Marked changes in seasonal feed availability and nutritive value occur which affect both the quantity and quality of excreta. The partition of N excretion between urine and faeces can also fluctuate widely with changes in diet composition, and may be influenced by the degradability of the dietary protein in the rumen. The presence of tannins in feeds has been shown to be negatively correlated with protein degradability and digestibility. Different species and classes of livestock produce excreta with varying nutrient concentrations. By controlling animal movements, adjusting carrying capacity in a grazing situation, or storing and distributing excreta from animals kept in confinement, a farmer can influence the proportions of nutrients returned to the soil. Losses of nutrients in storage and on application can be appreciable. The management of the soil and the returned nutrients will determine the losses incurred after application and the quantity potentially available to the crop. The farmer will also decide on the crops to be grown and their management. Crops differ in their nutrient requirements and the efficiency of utilisation. The partition of nutrients between grain and the vegetative parts of the plant affect the nutritive value of the components. When residues are grazed in situ, consumption will depend on animal numbers and the length of time spent grazing. Animals select preferred plant parts, and appreciable losses due to trampling and soiling may occur. The many factors influencing nutrient cycling provide opportunities for decision-making by the farmer. This process can be helped by mathematical modelling where the effects of different management options can be simulated. In taking account of animal-related factors, more realistic simulation models can be developed for the study of crop production in mixed farming systems in sub-Saharan Africa.

The Langmuir monolayer and Langmuir-Blodgett (LB) deposition behaviour of asymmetrically substituted 1,4-bis(6-hydroxyhexyl)−8,11,15,18,22,25-hexa-octylphthalocyanine (1) and a phthalocyanine dimer (2) and trimer (3) have been investigated. The materials were also deposited onto glass by the spin coating (SC) technique. The spin coated films were exceptionally smooth, even and free from crystallites. X-ray reflectivity measurements reveal varying degrees of order. Unpolarized UV-visible absorption spectra of the films deposited by the two techniques were closely similar. The LB technique has the advantage of introducing some degree of anisotropic ordering of the molecules within the films of the monomer and dimer whereas the SC method has the advantage of convenience.

Summary The comparative morphology of the foregut during development from embryonic larva to adult in Cherux quadricarinatus was examined by light and scanning electron microscopy. Major ontogenetic changes occurred in the gastric mill dentition in terms of denticle shape, appearance of vertical ridges in the lateral teeth, roughness of masticating surfaces, degree of sclerotization and proportional sizes of the median tooth components. Natural food types appropriate for the various life history stages during artificial rearing of C. quadricarinatus may be inferred from the morphology of the gastric mill dentition of those stages. Cardiopyloric valves and the gland filter appeared prior to development of functional gastric mill teeth. Compared with the foregut of adult astacid crayfish, that of adult C. quadricarinatus shows differences in the ventral cardiopyloric valve, pyloric funnel and lateral valves.

To determine whether cardiopulmonary resuscitation (CPR) performance is influenced by a rescuer's preferred side of approach.Eighty-three first-year healthcare students were enrolled in a prospective randomised crossover study comparing chest compression quality during uninterrupted chest compression CPR after approach from both their preferred and non-preferred sides.Chest compression quality was not dependent on rescuers' sidedness preference; neither mean compression rate and depth nor hand positioning differed between sides of approach.No link exists between the side from which a rescuer approaches, or prefers to approach, a casualty and chest compression quality.

Intervertebral disc (IVD) degeneration is a complex process characterized by elevated concentrations of proinflammatory cytokines and proteolytic enzymes. Because of pro-healing constituents, we hypothesized that fibrin sealant (FS) can reduce inflammation and augment soft tissue healing within the damaged or degenerative IVD. To test this, human and porcine nucleus pulposus (NP) and annulus fibrosus (AF) cells were extracted from tissues and encapsulated into alginate beads (NP cells) and type I collagen sponges (AF cells). Half of the alginate and collagen scaffolds were embedded in FS. To provoke inflammatory behaviours, the constructs were cultured with and without continuous IL-1α (10 ng/ml) for 4, 7 and 14 days. ELISA was used to quantify the cellular synthesis (ng/µg DNA) of clinically relevant cytokines, proteolytic enzymes and growth factors. In NP cell constructs with IL-1α, the syntheses of TNFα, IL-1β, IL-6, IL-8 was elevated at all culture durations. In the presence of FS, secretion of several pro-inflammatory cytokines were significantly reduced [IL-6 and IL-8 (porcine); and TNFα, IL-1β, IL-6, IL-8 (human)]. Consistent with these reductions, human NP cultures exposed to FS and FS + IL-1α synthesized significantly reduced amounts of MMP-1 and -3 compared to constructs with IL-1α. For porcine and human AF cells, there were no significant differences in the synthesis of the inflammatory or proteolytic cytokines relative to controls (without IL-1α) at any culture duration. However, the porcine AF cells exposed to FS synthesized elevated amounts of the anti-inflammatory cytokine IL-4. The results suggest that FS may have beneficial effects for patients with degenerated intervertebral discs.

Graphene oxides (GOs), beyond their widely reported use as precursors for single-layer graphene sheets, are in fact excellent materials themselves (polymers in two-dimension, polyelectrolyte-like, aqueous solubility and biocompatibility, etc.). In this reported work we used aqueous GOs to effectively disperse few-layer graphene sheets (GNs) in suspension for facile wet-processing into nanocomposites of GNs embedded in GOs (as the polymeric matrix). The resulting lightweight and plastic-like nanocomposite materials remained mechanically flexible even at high loadings of GNs, and they were found to be highly efficient in thermal transport, with the experimentally determined thermal diffusivity competitive to those typically observed only in well-known thermally conductive metals such as aluminum and copper. As demonstrated, GOs apparently represent a unique class of two-dimensional polymeric materials for potentially "all-carbon" nanocomposites, among others, which may find technological applications independent of those widely proclaimed for graphene sheets.

The mode of presentation of coeliac disease has been changing to more atypical or silent disease. Few studies described the clinical presentation of adult coeliac disease in Ireland in recent years. We retrospectively collected the clinical data for all patients who had a diagnosis of coeliac disease made in our centre between January 07 and December 08. Forty seven adults, predominantly females (n = 30), had a confirmed diagnosis of coeliac disease made during the study period. In our patient cohort, the presenting symptom was diarrhoea in 19 (40%) patients, while 16 patients (34%) did not have any G.I. symptoms, 10 (21%) presented with anaemia. Females presented at a significantly younger age compared to males, with median ages at diagnosis of 44.5 and 57 years, respectively (p = 0.04). Females also presented more commonly with non G.I. symptoms (p = 0.07). The reasons behind this gender difference need further study.

STUDY DESIGN Surgically denucleated porcine intervertebral discs (IVD) were injected with BIOSTAT BIOLOGX Fibrin Sealant (FS), and the in vivo effects were assessed over time by histological, biochemical, and mechanical criteria. OBJECTIVE The objectives were to test whether the intradiscal injection of FS stimulates disc healing. SUMMARY OF BACKGROUND DATA Disc avascularity prevents the deposition of a provisional fibrin scaffold that typically facilitates soft tissue repair. Poor disc wound healing leads to disc damage accumulation and chronic inflammation characterized by overproduction of proinflammatory cytokines and proteolytic enzymes. METHODS Four lumbar IVDs from each of 31 Yucatan minipigs were randomized to untreated controls; degenerative injury (nucleotomy); and nucleotomy plus FS injection. Animals were killed at 1, 2, 3, 6, and 12 weeks postsurgery. IVDs were harvested to quantify (1) architecture using morphological and histological grading; (2) proteoglycan composition using DMMB assay; (3) cytokine content using ELISA; and (4) mechanical properties using quantitative pressure/volume testing. RESULTS There was progressive invasion of annular tissue into the nucleus of nucleotomy discs and concomitant reduction in proteoglycan content. By contrast, FS supplementation inhibited nuclear fibrosis and facilitated proteoglycan content recovery over time. FS discs synthesized significantly less TNF-α than degenerate discs (66% vs. 226%, P < 0.05) and had upregulation of IL-4 (310% vs. 166%) and TGF-β (400% vs. 117%) at 2 to 3 weeks posttreatment. At the third week postsurgery, the denucleated discs were less stiff than controls (pressure modulus 779.9 psi vs. 2754.8 psi; P < 0.05) and failed at lower pressures (250.5 psi vs. 492.5 psi; P < 0.05). The stiffness and leakage pressure of the FS-treated discs recovered to control values after 6 and 12 weeks, respectively. CONCLUSION FS facilitated structural, compositional, and mechanical repair of the surgically damaged IVD. These FS-derived benefits are likely due to its conductive scaffold properties and metabolically active constituents such as thrombin, factor XIII, and aprotinin acetate.

Food choice by Cherax quadricarinatus was measured from video recordings of the time spent feeding on decayed plant material and zooplankton. Crayfish within the size range 20–75 mm spent a significantly longer time feeding on plant material, whilst crayfish at independent stage 1 (with yolk) did not spend a significantly different time at either of the two food types. Plant material, but not zooplankton, was often picked up to be consumed near or within shelters, which is consistent with ease of handling of plant material and with shelter dependence shown by redclaw crayfish.

Graphene oxides (GOs) in terms of both structure and property are essentially polyelectrolytes in a two-dimensional sheet configuration. As is well-established in the literature, polyelectrolytes are, in general, good dispersion agents for single-walled carbon nanotubes (SWNTs), which are otherwise in bundles because of strong van der Waals interactions. We report here a study in which GOs were used to disperse SWNTs, both as-purified and separated semiconducting SWNTs, for solution-like homogeneous suspensions. As a demonstration for their potentials, the optically transparent dispersions were used in a more accurate determination of the absorptivities for the band-gap transitions in semiconducting SWNTs. Results on exploration of the use of the GO-dispersed SWNTs in the development of unique carbon nanocomposite materials are also presented and discussed.

Sudden death is the sudden and unexpected death of an individual within 24 hours of symptom onset. The vast majority of these cases are found, at autopsy, to be due to underlying ischaemic cardiac disease. We retrospectively reviewed all adult post mortems performed at Beaumont Hospital over a decade (1999-2008). Our aim was to identify all sudden death cases (natural and accidental) and subclassify them according to age profile and organ system involved. We identified 1230 sudden death cases in the review period with 775 (63%) deaths attributable to ischaemic heart disease. The rate of sudden death remained constant over the decade with 663 (54%) deaths occurring in the first five years. Our negative autopsy rate was 2.8% corresponding to 35 cases. This is the first Irish study to retrospectively review all adult sudden deaths within a defined catchment area and analyse them as outlined above.

Pigs, 32 male and 32 female housed at a constant temperature of 25 °C were fed, ad libitum over the liveweight range 25–55 kg, diets containing 0, 100, 200 and 300 g kg−1 of copra meal which were balanced for their essential amino acid compositions. Inclusion of 100 g kg−1 copra meal resulted in slightly poorer growth rates compared with the control diet, but no further deterioration was observed up to 300 g kg−1 (P = 0.044). Increasing copra meal content of the diet was associated with a progressive reduction (P = 0.017) in the voluntary feed intakes of the animals, although feed conversion ratio was unaffected by dietary treatment. With increasing inclusion of copra meal, backfat thickness decreased at points P2 (P = 0.018) and P1 + P3 (P = 0.017). Increasing level of inclusion of copra meal was associated with increases (P < 0.001) in levels of lauric acid (C12:0) and myristic acid (C14:0) and decreases (P < 0.001) in stearic acid (C18:0) and linoleic acid (C18:2) in the bsckfat. Thsse changes reflected, to varying degrees, changes in the fatty acid composition of the dietary oil as the proportion of coconut oil in the diet was increased.

Although Aedes aegypti (L.) are capable of some wavelength discrimination, behavioral experiments demonstrated that color was not a stimulus to which they responded. Optical stimuli that did affect Ae. aegypti behavior were luminous reflectance, vertical contrast, and movement. Stationary objects of low reflectance and solid color were the most attractive to males and females.

The reaction between tantalum ethoxide and an inorganic, silicon-carbon based polymer known as polycarbosilane resulted in a modified polymer that could be thermally converted into a binary ceramic of SiC and TaC. In this report, the initial reaction of the precursors and the high temperature transformations that resulted in the mixed ceramic carbide are discussed. The synthesis of this modified polymer was characterized using 29Si, 13C NMR, and infrared spectroscopy. The reaction involved cross-linking of polycarbosilane through bridging carbon bonds and the formation of Si–OCH2CH3 ligands. According to these data and to the low-angle x-ray diffraction data, the structure of the reaction product can be described as a network of modified polycarbosilane with intimately dispersed tantalum oxide particles. The structural transformations that occurred during inert atmosphere pyrolysis of the polymer product were determined using 29Si, 13C MAS NMR, infrared and x-ray diffraction spectroscopy. Inert atmosphere pyrolysis at temperatures below 500 °C involved continued cross-linking of polycarbosilane through the endothermic formation of bridging carbon bonds. During pyrolysis at 500 °C, an exothermic reaction between the modified polycarbosilane and the intimately dispersed tantalum oxide particles was observed. This reaction involved the formation of an inorganic, amorphous oxycarbide phase that can be described as a continuous network of C–Si–O and C–Ta–O bonds. At pyrolysis temperatures exceeding 1000 °C, carbothermal reduction of the oxide constituents initiated. Further pyrolysis at temperatures exceeding 1200 °C resulted in the crystallization of zinc-blend β–SiC and NaCl structured TaC.

Polycarbosilane was modified by reaction with an aluminum alkoxide to get a precursor for Si-Al-C-O ceramics. The precursor was essentially characterized by magic-angle spinning nuclear magnetic resonance (29Si, 27Al, and 13C) and appeared as a dispersion of Al(OH)3-based particles in a polycarbosilane chain matrix. After the material was heat-treated under argon at 1500°C, X-ray diffraction showed that it crystallized mainly as SiC 2H. The presence of this rather unusual polytype for polycarbosilane-derived ceramics seemed to be related to the presence of aluminum atoms.

A 2-year longitudinal survey was carried out to investigate factors affecting milk yield in crossbred cows on smallholder farms in and around an urban centre. Sixty farms were visited at approximately 2-week intervals and details of milk yield, body condition score (BCS) and heart girth measurements were collected. Fifteen farms were within the town (U), 23 farms were approximately 5 km from town (SU), and 22 farms approximately 10 km from town (PU). Sources of variation in milk yield were investigated using a general linear model by a stepwise forward selection and backward elimination approach to judge important independent variables. Factors considered for the first step of formulation of the model included location (PU, SU and U), calving season, BCS at calving, at 3 months postpartum and at 6 months postpartum, calving year, herd size category, source of labour (hired and family labour), calf rearing method (bucket and partial suckling) and parity number of the cow. Daily milk yield (including milk sucked by calves) was determined by calving year (p < 0.0001), calf rearing method (p = 0.044) and BCS at calving (p < 0.0001). Only BCS at calving contributed to variation in volume of milk sucked by the calf, lactation length and lactation milk yield. BCS at 3 months after calving was improved on farms where labour was hired (p = 0.041) and BCS change from calving to 6 months was more than twice as likely to be negative on U than SU and PU farms. It was concluded that milk production was predominantly associated with BCS at calving, lactation milk yield increasing quadratically from score 1 to 3. BCS at calving may provide a simple, single indicator of the nutritional status of a cow population.

A 2-year longitudinal survey was carried out to investigate factors affecting reproduction in crossbred cows on smallholder farms in and around an urban centre. Sixty farms were visited at approximately 2-week intervals and details of reproductive traits and body condition score (BCS) were collected. Fifteen farms were within the town (U), 23 farms were approximately 5 km from town (SU). and 22 farms approximately 10 km from town (PU). Sources of variation in reproductive traits were investigated using a general linear model (GLM) by a stepwise forward selection and backward elimination approach to judge important independent variables. Factors considered for the first step of formulation of the model included location (PU, SU and U), type of insemination, calving season, BCS at calving, at 3 months postpartum and at 6 months postpartum, calving year, herd size category, source of labour (hired and family labour), calf rearing method (bucket and partial suckling) and parity number of the cow. The effects of the independent variables identified were then investigated using a non-parametric survival technique. The number of days to first oestrus was increased on the U site (p = 0.045) and when family labour was used (p = 0.02). The non-parametric test confirmed the effect of site (p = 0.059), but effect of labour was not significant. The number of days from calving to conception was reduced by hiring labour (p = 0.003) and using natural service (p = 0.028). The non-parametric test confirmed the effects of type of insemination (p = 0.0001) while also identifying extended calving intervals on U and SU sites (p = 0.014). Labour source was again non-significant. Calving interval was prolonged on U and SU sites (p = 0.021), by the use of AI (p = 0.031) and by the use of family labour (p = 0.001). The nonparametric test confirmed the effect of site (p = 0.008) and insemination type (p > 0.0001) but not of labour source. It was concluded that under favourable conditions (PU site, hired labour and natural service) calving intervals of around 440 days could be achieved.

The hypothesis that dairy cows partially suckling their calves would ovulate following removal of calves when restored to positive energy balance by a short-term increase in supplementation was investigated in 65 crossbred cows. Five treatments (T1, T2, T3, T4, and T5) that differed in the amount of total concentrate fed from calving to week 24 were involved. Calves were allowed to suck residual milk to 12 weeks of age. Energy balance was estimated by measuring intake, milk yield and organic matter digestibility. The occurrence of ovulation was determined by the analysis of milk progesterone (P4) concentration. Four groups that were receiving additional supplementation were restored to positive energy balance, while the control group (T1) remained in negative energy balance. The percentage of cows ovulating was 36%, 58%, 92%, 90% and 60% for T1, T2, T3, T4 and T5, respectively (p = 0.026). Comparison of the timing of ovulation for combined results from T1+T2 and T3+T4+T5 estimated mean time to fail to ovulate as 110+/-9.0 and 87+/-7.6 days, respectively (p = 0.023). The percentage of the cows showing oestrus was 9%, 8%, 33%, 40% and 40% for T1, T2, T3, T4 and T5, respectively (p = 0.197). Short-term increases in supplementation are unlikely to be an attractive means of reducing calving intervals.

Accurate prenatal diagnosis of central nervous system (CNS) abnormalities is essential in counselling parents, as they are the most common developmental abnormalities causing considerable mortality. Currently, the standard in prenatal imaging is ultrasound scanning (USS). The introduction of fast acquisition magnetic resonance imaging (MRI) has lead to increased diagnostic confidence and information available for parents. Frequently USS initially identifies CNS abnormalities as ventriculomegaly alone. However, it is known that ventriculomegaly is commonly associated with other CNS pathology, which may adversely affect the prognosis. As MRI has superior soft tissue resolution and can be used at any time postnatally, it is expected to identify disorders of myelination that may result from prenatal ventriculomegaly. This study will evaluate the role of MRI as a postnatal imaging tool in patients that had a prenatal USS diagnosis of isolated ventriculomegaly. This was a retrospective review of patient notes and scan reports. The postnatal MRI study group consisted of 9 patients that had been diagnosed initially with prenatal isolated ventriculomegaly on USS, and followed up with postnatal MRI (cases of spina bifida and Dandy-Walker malformations were excluded). Findings from the scan reports were recorded and analysed. Both MRI and prenatal USS gave the same information in 55.6 % of the patients. In the remaining 44.4 %, MRI added to the information provided by the prenatal USS. An interesting finding was that MRI missed a small fluid-filled cyst and an arachnoid cyst in 2 cases. 55.6 % of patients went on to develop other CNS abnormalities prenatally, whereas 33.3 % showed prenatal regression of VM with no other pathology. 11.1 % showed postnatal persistence of isolated VM. As USS has the advantage of being cheap and easy to perform, it will remain as the primary imaging tool in obstetric care. MRI can provide significant additional information that can affect parent counselling, prenatal intervention, and postnatal management. Postnatally, MRI can give some idea of prognosis by evaluating myelination patterns, which is not possible with USS.

Lack of consideration of the geomechanical interaction between salt bodies and surrounding formations has led to documented drilling failures adjacent to salt diapirs1–3, in some cases resulting in individual well abandonment costs of tens of millions of dollars. To address this issue, a three-dimensional non-linear finite element geomechanical simulation effort was initiated to analyze the in situ stress state existing in and adjacent to salt bodies before drilling as well as under producing conditions. This work leverages unique expertise in salt mechanics and computational geomechanical modeling. Non-linear finite element geomechanical models were developed for four idealized deepwater Gulf of Mexico geometries including a spherical salt body, a horizontal salt sheet, a columnar salt diapir, and a columnar salt diapir with an overlying tongue. The analyses reveal that at certain locations for specific geometries: shear stresses may be highly amplified; horizontal and vertical stresses may be significantly perturbed from their far-field values; principal stresses may not be vertical and horizontal (i.e., the vertical stress may not be the maximum stress); and anisotropy in the horizontal stresses may be induced. For some geometries, the vertical stress within and adjacent to the salt is not equal to the gravitational load; i.e., a stress-arching effect occurs. Analogously, the assumption that the horizontal stress within a salt body is equal to the lithostatic stress is shown to be incorrect sometimes. The modeling also suggests an alternative explanation for the so-called rubble zones thought to occur beneath and/or adjacent to salt diapirs, in that they may be an intrinsic consequence of the equilibrium stress field needed to satisfy the different stress states that exist within the salt body and in the non-salt surrounding formations. We demonstrate with an example how this work can enable more rigorous planning of well locations and trajectories by providing more accurate estimates of the vertical and horizontal stresses around and within salt bodies for wellbore stability analyses so as to avoid areas of potential geomechanical instability, and to enable accurate fracture gradient prediction while entering, drilling through, and exiting salt bodies.

Prophylactic mastectomy (PM) is a risk-management option for women at high familial risk of breast cancer (BC). This study describes the PM experience of women enrolled in a large observational cohort study involving families with a history of hereditary breast cancer. Within 357 multiple-case BC families [119 (33%) BRCA1 or BRCA2 mutation positive], identified via family cancer clinics, 49 cases of PM [21 (43%) BRCA1 or BRCA2 mutation positive] were identified and their clinical, pathological and genetic features reviewed. Families with at least one incidence of PM displayed stronger breast/ovarian cancer histories than did families without PM. Median age at time of PM was 45 years (range 28-58). Ten cases (21%) were bilateral PMs in unaffected women and 39 cases were contralateral PMs in women with prior invasive BC (71%) or ductal carcinoma in situ (DCIS) (8%). Most (88%) underwent total mastectomy. Unnecessary axillary surgery occurred in eight subjects (16%). Malignant histology was found in three PM specimens (6%). Prior to genetic testing, PM was performed in two women who were subsequently shown not to carry the mutation specific to their family. Optimal utilization of genetic testing to guide surgical decision making, appropriate surgical technique and careful pathology examination of PM specimens, are important issues to consider prior to PM in women at high familial risk of BC.

The history of ideas concerning extratropical cyclones has been intimately intertwined with that of meteorology itself. In this chapter, aspects of this history will be brought out with particular reference to the points in that history where the thinking has been influenced by, and has influenced, fundamental mathematics and physics. Many giants of physics and meteorology have contributed to the story—Fitzroy, Helmholtz, Shaw, Bjerknes, Charney, Eady, Sawyer, Eliassen and Kleinschmidt (to name only some prior to the more modern era). Specific examples of the free association between meteorological and basic physical ideas, relevant to the cyclone story, are: fluid dynamical analogies to electromagnetic phenomena, leading to the Bjerknes' circulation theorem; electrostatic analogies to guide potential vorticity thinking; geometrical concepts, such as transformations and rearrangement theory, illuminating quasi- and semi-geostrophic models of cyclones; and chaotic dynamics and the limits of cyclone predictability. Probably the most famous school of meteorology—the Bergen school-devoted itself to understanding and forecasting these phenomena. Their ideas have been pervasive in providing a useful conceptual framework, or an inflexible straightjacket depending on one's viewpoint. Where has this rich history taken us to today? Whilst we have become accustomed to the routine successes of numerical weather prediction in forecasting these storms we remain struck by notable failures. Some say that this success has not obviously been driven by these profound theoretical ideas on cyclones although one would argue that it has influenced the human forecasters' contribution. On the other hand, the quest throughout this history for the all-encompassing “conceptual model” of the generic extratropical cyclone remains as elusive as ever, particularly as we probe into the mesoscale and small-scale structure of the cyclone. The future holds open the prospect, for example, of improved predictive skill by targeted observations being made in predicted “sensitive” zones by controllable robotic aircraft.

A girl aged 13 years presented with spontaneous intracerebral haemorrhage. Initially, no cause could be found but she was later found to have a low grade pilocytic astrocytoma. This very uncommon presentation was not considered before surgery.

This paper addresses a new way for handling distributed design know as the Macro concept. It is based round the assumption that future design teams will become more distributed in nature as industry exploits the Internet and other integrated communication and data exchange systems. The paper notes that this concept is part of an attack on the problems associated with the total process of Distribute Multi-Disciplinary design and Optimisation. The concepts rely on the creation of distributed self-building and self-organising teams made up from members who are globally distributed. The paper describes both the approach adopted and its implementation in a prototype software system operating over the Internet. In essence the work presented is describing a novel method for implementing a distributed design process which is far from complete but which is producing challenging ideas.

Depending on reaction conditions, treatment of GeCl2(1,4-dioxane) with [Li(µ-NHAr)(L)]2(L = OEt2 or OC4H8) yields Ge(NHAr)21 or the first binuclear group 14 element(II) amides [Ge(µ-NAr)]22 or ArN[Ge(NHAr)]2(µ-NAr)3; X-ray structural data are presented on the tin analogue of 1 and on the germetane 2.

The next generation of high energy laser systems for ICF research demands an unprecedented volume of laser glass to be produced over a limited manufacturing period while still meeting ambitious targets of internal quality and overall cost. To meet this challenge, Schott has conceived a continuous manufacturing unit capable of producing 5,000 meter class PH 4 slabs of platinum particle-free phosphate laser glass within a three-year time period. This manufacturing unit concept draws on years of prior production experience with phosphate laser glass and other high quality optical materials but still represents a significant departure from the proven discontinuous manufacturing technology successfully employed over the last ten years for platinum-free phosphate laser glass. In addition, Schott has developed a new phosphate laser glass that simultaneously offers improvements in properties that relate to both laser performance and to characteristics related to forming the glass into large, high quality slabs. In this paper we will describe the key technology issues addressed in the manufacturing development and present a brief description of the planned manufacturing method to be employed. Lastly, the status of the development will be reviewed including characterization of pilot production melts of the new laser glass and the schedule for completion of the development program.© (1997) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Dural sinus thrombosis (DST) is a rare fetal cerebral abnormality. We present 6 cases of DST detected prenatally with ultrasound and magnetic resonance imaging (MRI). In 4 cases, the DST spontaneously resolved with good longterm neonatal outcome. Two patients chose to terminate their pregnancies. The women presented with ultrasound findings of posterior fossa abnormalities or cysts between 20 and 27 weeks gestation. On MRI, the DST was seen as a lesion of low signal intensity with a centrally placed higher signal lesion consistent with a thrombus. The lesion was often continuous with the saggital sinus and transverse sinus with displacement of the cerebellum and occipital horns of the cerebral hemispheres. The remaining brain appeared normal. In all cases, MRI captured the spontaneous resolution. There is a lack of information on longterm prognosis because of the small numbers of cases reported. In many cases, parents opt for termination of pregnancy because of the uncertainty about the longterm prognosis. In conclusion, from our case series and review of the literature, it appears that spontaneous resolution of DST in the antenatal period may suggest a good long term neonatal prognosis. Where the thrombus remains extensive, prognosis should be guarded. MRI is useful for delineating resolution or regression of the thrombus. MRI can be an essential adjunct to ultrasound in the diagnosis and management of DST.

Multilayers are used in x-ray optics as mirrors.1 They usually consist of a stack of bi-layers of two different materials. For x-ray optics, the thickness of the bi-layer, or the d-spacing of the multilayer, ranges from 2 nm to 20 nm. Since x-ray multilayers are usually made by evaporation or sputtering technique, most of materials in multilayers are amorphous or polycrystalline.

Aim Existing ERC BLS/AED accreditation procedures allow BLS instructors to assess the capability of BLS/AED providers, without undergoing additional training as an assessor. The reliability of instructor-based assessment has been questioned. This study sought to determine the efficacy of a simple training programme for BLS/AED instructors aimed at standardising assessment decisions. Methods An Assessment Training Programme (ATP) which provides additional, assessment-focused tuition for BLS instructors was introduced. Eighteen ERC accredited instructors participated in the study. Nine received standard ERC training (instructors); nine received additional training through the ATP (assessors). The assessment of 73 students’ BLS/AED capabilities was carried out by an assessor, ERC instructor and ERC instructor trainer concurrently. Participants independently completed an ERC assessment form. Decisions for instructors and assessors were compared to the instructor trainers’ decisions; those not agreeing were deemed to be incorrect. Results Instructors (49.3%) had lower raw pass rates than assessors (67.1%) and instructor trainers (64.4%). There was a significant difference in overall decisions between instructors and instructor trainers ( p = 0.035), and instructors and assessors ( p = 0.015). There was no difference between assessors and instructor trainers ( p = 0.824). Instructors were more prone to incorrectly failing candidates than assessors (sensitivities of 80.5% and 63.8% respectively, p = 0.077). AED-capability decisions were significantly different from instructor trainers in both the instructor ( p = 0.007) and assessor groups ( p = 0.031). Conclusion BLS instructors incorrectly fail candidates for reasons that should not normally constitute a true assessment failure. The ATP is an effective intervention to reduce false-failure rates and improve compliance with an experienced instructor trainer's decision. Consideration should be made to integrate such programmes into current BLS instructor accreditation procedures.