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Background: Tropical forests are critical for the global carbon budget, yet they have been threatened by deforestation and forest degradation by fire, selective logging, and fragmentation. Existing uncertainties on land cover classification and in biomass estimates hinder accurate attribution of carbon emissions to specific land covers. In this study, we used textural metrics derived from PlanetScope images to implement a probabilistic classification framework to identify intact, logged and burned forests in three Amazonian sites. We also estimated biomass for these forest classes using airborne lidar and compared biomass uncertainties using the lidar-derived estimates only to biomass uncertainties considering the land cover classification as well. Results: Our classification approach reached overall accuracy of 0.86, with accuracy at individual sites varying from 0.69 to 0.93. Logged forests showed variable biomass changes, while burned forests showed an average carbon loss of 35%. We found that including uncertainty in forest degradation classification significantly increased uncertainty and decreased estimates of mean carbon density in two of the three test sites. Conclusions: Our findings indicate that the attribution of biomass changes to forest degradation types needs to account for the uncertainty in land cover classification. By combining very high-resolution images with lidar data, we could attribute carbon stock changes to specific pathways of forest degradation. This approach also allows quantifying uncertainties of carbon emissions associated with forest degradation through logging and fire. Both the attribution and uncertainty quantification provide critical information for national greenhouse gas inventories.

Aims Dislocation is the most common indication for further surgery following total hip arthroplasty (THA) when undertaken in patients with a femoral neck fracture. This study aimed to assess the complication rates of THA with dual mobility components (THA-DMC) following a femoral neck fracture and to compare outcomes between THA-DMC, conventional THA, and hemiarthroplasty (HA). Methods We performed a systematic review of all English language articles on THA-DMC published between 2010 and 2019 in the MEDLINE, EMBASE, and Cochrane databases. After the application of rigorous inclusion and exclusion criteria, 23 studies dealing with patients who underwent treatment for a femoral neck fracture using THA-DMC were analyzed for the rate of dislocation. Secondary outcomes included reoperation, periprosthetic fracture, infection, mortality, and functional outcome. The review included 7,189 patients with a mean age of 77.8 years (66.4 to 87.6) and a mean follow-up of 30.9 months (9.0 to 68.0). Results THA-DMC was associated with a significantly lower dislocation rate compared with both THA (OR 0.26; 95% CI 0.08 to 0.79) and HA (odds ratio (OR) 0.27; 95% confidence interval (CI) 0.15 to 0.50). The rate of large articulations and of intraprosthetic dislocation was 1.5% (n = 105) and 0.04% (n = 3) respectively. Conclusion THA-DMC when used in patients with a femoral neck fracture is associated with a lower dislocation rate compared with conventional arthroplasty options. There was no increase in the rates of other complication when THA-DMC was used. Future cost analysis and prospective, comparative studies are required to assess the potential benefit of using THA-DMC in these patients. Cite this article: Bone Joint J 2020;102-B(7):811–821.

Despite attempts at active maintenance in the focus of attention, the fragile nature of the visual nonverbal memory trace may be revealed when the retention interval between target memoranda and probed recall on a trial is extended. In contrast, a passively maintained or unattended visual memory trace may be revealed as persisting proactive interference extending across quite extended intervals between trials in a recent probes task. The present study, comprising five experiments, used this task to explore the persistence of such a passive visual memory trace over time. Participants viewed some target visual items (for example, abstract colored patterns) followed by a variable retention interval and a probe item. The task was to report whether the probe matched one of the targets or not. A decaying active memory trace was indicated by poorer performance as the memory retention interval was extended on a trial. However, when the probe was a member of the target set from the preceding trial, task performance was poorer than a comparison novel probe, demonstrating proactive interference. Manipulations of the intertrial interval revealed that the temporal persistence of the passive memory trace of an old target was impressive, and proactive interference was largely resilient to a simple ‘cued forgetting’ manipulation. These data support the proposed two-process memory conception (active–passive memory) contrasting fragile active memory traces decaying over a few seconds with robust passive traces extending to tens of seconds.

In older adults facing knee arthroplasty, the ability to resume downhill skiing postoperatively is unclear. This study aimed to determine the perspectives of Alberta orthopedic surgeons and senior residents regarding downhill skiing after total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA).In May 2019, a Web-based survey was sent through the Alberta Orthopaedic Society to poll orthopedic surgeons performing arthroplasty and senior orthopedic residents (postgraduate year 4 or 5) in Alberta regarding the permissibility of downhill skiing after TKA or UKA. The survey also elicited information regarding under which conditions or restrictions, if any, surgeons would allow patients to return to downhill skiing, whether these recommendations were evidence based, and whether surgeons had seen complications from downhill skiing in their patients who had undergone knee arthroplasty.Of the 41 respondents, 21 (51%) were full-time fellowship-trained orthopedic surgeons, 15 (37%) were specialists with some arthroplasty in their practice, and 5 (12%) were orthopedic residents. Ten of 40 respondents (25%) would allow unrestricted downhill skiing after TKA, and 1 (2%) would not allow any skiing at all. The remaining 29 (72%) indicated that they might allow downhill skiing under specific conditions, with the top 3 being limitations on speed and intensity (29 [71%]), return of full range of motion and strength in the operative knee (26 [63%]), and years of downhill ski experience (23 [56%]). Fourteen respondents (34%) would allow unrestricted downhill skiing after UKA, and 27 (66%) would allow skiing with the same top 3 conditions as for TKA. Thirty-two respondents (78%) reported that their decisions were not evidence based, and 35 (85%) had never seen complications from downhill skiing after TKA or UKA.Alberta orthopedic surgeons and senior residents are cautious regarding skiing after knee arthroplasty. The majority reported that their restrictions were not evidence based, which indicates the need for further investigation to develop an approach for surgeons to consistently and safely address return to downhill skiing after TKA or UKA.Chez les adultes âgés qui doivent subir une arthroplastie du genou, la capacité de reprendre la pratique du ski alpin n’a pas été clairement évaluée. Cette étude visait à clarifier le point de vue des chirurgiens et résidents séniors en orthopédie de l’Alberta au sujet de la pratique du ski alpin après une intervention pour prothèse totale du genou (PTG) ou prothèse partielle du genou (PPG).En mai 2019, un sondage en ligne a été envoyé par l’entremise de l’Alberta Orthopaedic Society afin d’interroger les chirurgiens et résidents séniors (résidents 4 ou 5) en orthopédie pratiquant des arthroplasties en Alberta au sujet de l’autorisation à recommencer le ski alpin après une PTG ou une PPG. Le sondage portait aussi sur les conditions ou les restrictions, le cas échéant, imposées aux patients par leurs chirurgiens pour leur permettre de recommencer à skier, si ces recommandations étaient fondées sur des données probantes, et si les chirurgiens avaient observé des complications chez leurs patients ayant repris le ski après une PTG ou une PPG.Sur les 41 répondants, 21 (51 %) étaient des médecins spécialistes en chirurgie orthopédique à temps complet, 15 (37 %) étaient des spécialistes ayant déjà effectué des arthroplasties dans le cadre de leur pratique et 5 (12 %) étaient des résidents en orthopédie. Dix répondants sur 40 (25 %) disaient qu’ils permettraient la pratique du ski alpin sans restrictions après la PTG et 1 (2 %) ne la permettrait pas du tout. Les 29 autres (72 %) ont indiqué qu’ils autoriseraient la pratique du ski alpin à certaines conditions, les 3 principales étant le contrôle de la vitesse et de l’intensité (29 [71 %]), le retour de la pleine amplitude de mouvement et de la force au genou opéré (26 [63 %]) et le nombre d’années d’expérience en ski alpin (23 [56 %]). Quatorze répondants (34 %) permettraient la reprise du ski alpin sans restrictions après la PPG et 27 (66 %) l’autoriseraient en appliquant les 3 mêmes conditions que pour la PTG. Trente-deux répondants (78 %) ont indiqué que leur décision ne reposait pas sur des données probantes et 35 (85 %) n’avaient observé aucune complication après la reprise de la pratique du skin suite à une PTG ou une PPG.Les chirurgiens et les résidents séniors en orthopédie de l’Alberta émettent des réserves relativement à la reprise de la pratique du skin après une arthroplastie du genou. Chez la majorité, les restrictions préconisées ne reposent pas sur des données probantes, ce qui indique que la recherche à ce sujet mérite d’être approfondie afin qu’on puisse élaborer une approche cohérente et sécuritaire en orthopédie pour la reprise de la pratique du ski alpin après une PTG ou une PPG.

In this study the application of porous carbon microparticles for the transport of a sparingly soluble material into cells is demonstrated. Carbon offers an intrinsically sustainable platform material that can meet the multiple and complex requirements imposed by applications in biology and medicine. Porous carbon microparticles are attractive as they are easy to handle and manipulate and combine the chemical versatility and biocompatibility of carbon with a high surface area due to their highly porous structure. The uptake of fluorescently labeled microparticles by cancer (HeLa) and normal human embryonic Kidney (HEK 293) cells was monitored by confocal fluorescence microscopy. In this way the influence of particle size, surface functionalization and the presence of transfection agent on cellular uptake were studied. In the presence of transfection agent both large (690 nm) and small microparticles (250 nm) were readily internalized by both cell lines. However, in absence of the transfection agent the uptake was influenced by particle size and surface PEGylation with the smaller nanoparticle size being delivered. The ability of microparticles to deliver a fluorescein dye model cargo was also demonstrated in normal (HEK 293) cell line. Taken together, these results indicate the potential use of these materials as candidates for biological applications.

Dislocation is the most common indication for further surgery following total hip arthroplasty (THA) when undertaken in patients with a femoral neck fracture. This study aimed to assess the complication rates of THA with dual mobility components (THA-DMC) following a femoral neck fracture and to compare outcomes between THA-DMC, conventional THA, and hemiarthroplasty (HA).We performed a systematic review of all English language articles on THA-DMC published between 2010 and 2019 in the MEDLINE, EMBASE, and Cochrane databases. After the application of rigorous inclusion and exclusion criteria, 23 studies dealing with patients who underwent treatment for a femoral neck fracture using THA-DMC were analyzed for the rate of dislocation. Secondary outcomes included reoperation, periprosthetic fracture, infection, mortality, and functional outcome. The review included 7,189 patients with a mean age of 77.8 years (66.4 to 87.6) and a mean follow-up of 30.9 months (9.0 to 68.0).THA-DMC was associated with a significantly lower dislocation rate compared with both THA (OR 0.26; 95% CI 0.08 to 0.79) and HA (odds ratio (OR) 0.27; 95% confidence interval (CI) 0.15 to 0.50). The rate of large articulations and of intraprosthetic dislocation was 1.5% (n = 105) and 0.04% (n = 3) respectively.THA-DMC when used in patients with a femoral neck fracture is associated with a lower dislocation rate compared with conventional arthroplasty options. There was no increase in the rates of other complication when THA-DMC was used. Future cost analysis and prospective, comparative studies are required to assess the potential benefit of using THA-DMC in these patients. Cite this article

To determine whether single or double screw (DS) fixation of medial malleolar fractures results in better long-term health outcomes.Randomized clinical trial; sealed envelope technique.Level 1 Trauma Hospital at University of Calgary, Canada.One hundred forty patients were randomized to receive either 1 or 2 screws to reduce a medial malleolar fracture. Thirteen patients were excluded because of loss to follow-up (n = 127).Surgical fixation of the medial malleolar fracture was performed using 1 or 2 stainless steel screws.Primary outcome was comparison of physical functioning summary score on Short Form 36 questionnaires between patients in the 2 groups. Secondary objectives were to compare the Ankle Hindfoot Scale and operating room time. Clinical and radiographic assessment occurred at the time of injury and 2, 6 weeks, 3, 6, 12, and 24 months postoperatively.Fourteen patients crossed over from the DS group to the single screw (SS) group based on intraoperative decisions by the surgeon (fragment too small for 2 screws), leaving the SS (n = 75) and DS groups (n = 52). There was no difference in the operating room time, SF36, or Ankle Hindfoot Scale at all follow-up time points.SS medial malleolar fixation provides an equally safe and effective method of fracture care as compared to DS fixation. Twenty percent of patients receiving 2 screws can be expected to crossover to receive SS fixation as a safer alternative.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Background: The use of digital technology in health and social care is developing rapidly. It is promoted in UK policy and research which suggests varied results surrounding its implementation and outcomes. Introduction: This article aimed to test the implementation and outcomes of a short messaging service sent to a dedicated phone. The target cohort were drug treatment clients in two sites in Northern England. Materials and methods: Through staff focus groups and interviews with a small cohort of clients, the implementation and perceptions of the system were examined. Results: A total of 19 participants were recruited to site 1 (15 male, 4 female, average age=37.7 years) and 12 participants were recruited to site 2 (9 male, 3 female, average age=40.3 years). One outcome that was of interest was wellbeing in treatment which, in this study, was described as an overall sense of feeling better rather than just focusing on the rehabilitation aspect of the programme. Other outcomes included: the successful completion of treatment and for clients to report and instance of a relapse/re-presentation. Discussion: The system shows some evidence of its ‘social actor’ role; however, its implementation was hindered by staff citing that it called for increased resources. For future implementation, the use of clients' own phones may be considered which may help to embed the system more fully in recovery planning and targeting clients at a different treatment stage. Conclusions: Despite some indications of positive results for clients and a perception that the system may have value as an addition to existing clinical interventions, more evaluation is required to determine whether this system can be implemented in a drug treatment setting.

This trial was conducted to determine the medium-term functional outcome of displaced tibial plateau fracture patients treated with closed fluoroscopic assisted reduction and internal fixation (CRIF) versus patients treated with standard open reduction with sub-meniscal arthrotomy and internal fixation (ORIF). A prospective trial was conducted in adult patients with displaced AO/OTA 41 B and 41 C tibial plateau fractures. Patients were assigned to treatment based upon the standard treatment of the surgeon involved following the call schedule for the day, either CRIF or ORIF. Postoperative radiographs and CT were performed on all patients and patients were followed for a minimum of 2 years. Primary outcome measures were the KOOS, SMFA and SF-36. Seventy patients were recruited with 2 year follow-up on 35 patients in the CRIF group and 27 patients in the ORIF group. Postoperative CT scans showed that reductions were better with the ORIF group especially in the posterolateral quadrant as compared to the CRIF group. The frequency of mal-reductions was higher in the CRIF group. The KOOS, at two years, showed that the CRIF had significantly less good outcomes in the subcategories of SPORT (p = 0.03) and QOL (p = 0.01) measurements. ORIF with a sub-meniscal arthrotomy provides better quality reductions and better medium-term results as compared to CRIF for tibial plateau fractures. This may provide more long-term benefit from osteoarthritic symptoms in this patient group. Therapeutic, Level 2.

This work partially supported by a small grant from the Royal Society of Edinburgh to KB, in association with the Mither Kirk Project. Special thanks to John Edwards and Aberdeen City Council; Chris Croly and Jeff Oliver (Aberdeen); Jackson Armstrong and William Hepburn (Aberdeen; https://aberdeenregisters.org/); and Takumi Tsutaya (Kyoto University).

Emissions from road transport are routinely prepared at the national scale in many countries under different national and international policies, directives and legislation. Scaling down this emission to the smaller geographical area is considered as a top-down approach. Several methods have been previously applied to scaling down emission, however these have often reported inconsistent findings in comparison with emission distribution using a bottom-up approach. Carbon dioxide and particulate matter (smaller than about 2.5 μm) emissions from a national road transport estimation in Ireland were disaggregated among four counties in the Greater Dublin Area and subsequently distributed at a finer spatial scale (0.5 × 0.5 km2). Spatial coverage of the proxy variables, spatial weight distribution and appropriate representation of the fleet characteristics were identified as main sources of difference in distributed spatial emissions between top-down and bottom-up approaches. The first two issues were addressed in this paper by predicting missing or absent traffic volume from limited datasets, and the later was addressed by considering the fleet and mileage data from national annual vehicle test data at county level. A neural network model was applied to predict traffic volume which showed a 51% precision in prediction performance. Emission distribution was also performed for comparison purposes using a more conventional road density-based approach, where a correlation analysis showed an inconsistency between the two approaches. The results of this study highlighted that if the fleet characteristics at county level were not considered, the estimated emission would be different by −1.6 to −8.6% (Carbon dioxide) and −12.6 to 0.03% (Particulate matter) for passenger cars and −3.57–13.6% (Carbon dioxide) and −0.054–16.8% (Particulate matter) for light and heavy duty vehicles, depending on the counties in question. This study revealed that a share of 22.6% and 21.1% of national carbon dioxide and particulate matter emission occurred in Dublin County alone, and Dublin city was attributed to approximately 10.5% carbon dioxide and 9.8% particulate matter of the national total. The particulate matter in Dublin County was 14.3–22.4% higher than surrounding counties, and carbon dioxide emissions in Dublin city were two times higher than that of the towns and urban areas in the surrounding three counties. This study provides a combination of methods for producing finer scale spatial estimation of emission to facilitate abatement strategies and mitigation action plans at county and municipality level for the reduction of emission, better air quality and climate. The study highlights the necessity of reliable spatial distribution methods for assigning emission at a finer scale.

Previous research has highlighted the dangers of considering air pollution policy and climate change policy separately. Measures to reduce CO2 emissions have been adopted in several countries, and in some instances, these have resulted in increases in some air pollution emissions and vice versa. Research has also highlighted the potential co-benefits of air pollution and climate change mitigation policy where these are considered together. This paper addresses the co-benefits of climate change mitigation policies to reduce the air pollution (PM2.5) and climate change (CO2) impacts of passenger cars, using a scenario-based approach in Ireland. Scenario-based approaches have previously been adopted for these pollutants in several co-benefit studies. However, a detailed disaggregation of non-exhaust PM2.5 by brake, tyre and road abrasion, and a disaggregation of both PM2.5 and CO2 by a number of current and future passenger car technologies have not been considered to date. The current study, therefore provides deeper insights into the impact of policy on exhaust and non-exhaust emissions. In order to derive detailed disaggregated emission, an add-on module was developed for a well-known emission modelling software (COPERT). The add-on module adopted concepts and parameters from previous research papers and analysis from the COPERT software to estimate fuel-based emissions e.g. exhaust and disaggregated non-exhaust PM2.5 and CO2 emissions. To analyse future scenarios (2015–2035), estimation was initially conducted using that software for the current Irish fleet data. This estimation was later replicated using the add-on module, as a baseline scenario considering a different disaggregation of the same passenger car fleet. Two additional estimations were conducted in the add-on module: An Electric Vehicle policy scenario, and a scenario to show the effects of a ban on the sale of conventional vehicles by 2030. The results revealed that CO2 emissions continuously decreased in the projection period, however, reductions of PM2.5 reversed from the year 2028 due to increases in the non-exhaust component of PM2.5 emissions. Under the two alternative scenarios, a 52–69% reduction of CO2 could be possible whereas only a 9–15% reduction in PM2.5 could be achieved by 2035. In conclusion, non-exhaust PM2.5 was found to have a larger share (as much as 34 times that of exhaust emissions) in 2035 where passenger cars with alternative technologies represented a major share in the fleet. The research also provided a methodology capable of detailing the CO2 and PM2.5 emissions in future scenarios for a range of vehicle technologies. This research also highlights an urgent need for investigation of emission factors for several emerging passenger car technologies.

Road transport is a major source of CO 2 emissions in Ireland and accounts for almost 96% of the total CO 2 emissions from the transport sector. Following the recent adopted UNFCCC reporting guidelines on annual inventories [24/CP.19], this study applied the 2006 IPCC Guidelines for National Greenhouse Gas Inventories (2006 IPCC GLs) tier 3 approach to estimate CO 2 emissions from road transport at the vehicle category level, for the first time in Ireland. For this, disaggregated datasets were prepared based on year of vehicle registration and mileage since registration of the vehicle. Such an approach provided a more realistic national scenario in comparison to the use of average mileage degradation in emission calculations. This investigation comprised a recalculation of previous emissions estimates (1990–2012) and an estimation of CO 2 emissions in 2013 using a previously unavailable level of data disaggregation for vehicle mileage as well as using vehicle class specific data and an improved bottom-up estimation methodology in COPERT. Historic vehicle fleet data were restructured, annual mileage data were estimated in relation to the fleet data and back extrapolated using a regression approach. The results showed that the mileage degradation was not only subject to fuel technology, engine size, and age but also the emissions class and vehicle category. It was also observed that the disaggregated level of data provided a different CO 2 emissions split among the vehicle categories than that of previous estimations which were based on an aggregated level of data. Previous emissions inventories (1990–2012) were shown to have underestimated the share from diesel fuelled passenger cars by more than 56% in 2012. Diesel fuelled passenger cars were also found to account for the majority of CO 2 emissions from road transport activities in Ireland in 2013. The level and trend assessment showed that emissions from Euro-II and Euro-III classed vehicles especially for passenger cars, which have a significant contribution to the total emission in 2013 have caused an increase in fleet level emissions in Ireland. In addition, the results also showed that the emissions share from Light Duty Vehicles and Heavy Duty Vehicles were overestimated by previous investigations. This paper highlights the importance of the resolution of data used in emissions inventory preparation which may impact upon future projections and policy formulation. The findings of this investigation are also discussed in relation their implications for road transport policy, including carbon taxation and future policy options aimed at achieving EU emissions target in 2020.

This article provides a close study of the University of Iowa Electronic Music Studios. The point of such a detailed account of one studio is to shed light on activity within the field of electronic music that previously did not occupy a place in the literature. Few of the studios listed in Hugh Davies’s International Electronic Music Catalog have received detailed attention. Until a wider range of close studies that pay attention to the particularities of individual cases becomes available, it will be difficult to do the comparative work necessary to gain an appropriately textured overall account of the development of electronic music in the post-war period. As these detailed studies, based largely on first-hand documentation, increase the resolution of electronic music’s history, they may highlight significant but previously unnoticed, or at least under-appreciated, patterns in the development of electronic music and act as an effective barometer of changing trends.

To define the incidence, risk factors, and anatomic location of articular malreductions in operatively treated lateral tibial plateau fractures.Prospective Cohort Study.Academic Level 1 Trauma Centre.Study subjects were patients entered into a prospective cohort study of tibial plateau fractures.Surgical fixation of tibial plateau fractures and postoperative computed tomographies (CTs).The primary outcome was incidence of articular malreduction. Secondary outcomes included risk factors for malreduction and a descriptive analysis of malreduction location.Sixty-five postoperative CTs were reviewed. Twenty-one reductions (32.3%) had a step or gap more than 2 mm. The frequency of malreductions in patients undergoing submeniscal arthrotomy or fluoroscopic-assisted reduction alone was 16.6% and 41.4%, respectively (P = 0.0021). Age, body mass index, OTA/AO fracture type, operative time, use of bone graft or bone graft substitute, and use of locking plates were not predictive of malreduction. Malreductions were heavily weighted to the posterior quadrants of the lateral tibial plateau.When examined using cross-sectional imaging the rate of articular malreductions was high at 32.3%. Fluoroscopic reduction alone was a predictor for articular malreduction. Most malreductions were located in the posterior quadrants of the lateral plateau.Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Community archaeology in Ireland has developed as a hybrid of public outreach and community-based projects, each having its own opportunities and challenges. Despite community participation in archaeology becoming increasingly popular over the recent years, funding, conflicting expectations, and sustainability are proving to be issues. It is therefore timely to review the participation of both practitioners and communities. In this chapter, the authors will use their specific perspectives—local authority, community-based, field school—to assess the models and value of community archaeology in Ireland.

Case We present a case of acute disseminated intravascular coagulation (DIC) after prophylactic femoral intramedullary stabilization in a patient with metastatic prostate cancer. Preoperative international normalized ratio of 1.4 was attributed to malnutrition, and the patient was not medically optimized. DIC developed 1 hour postoperatively and was managed with blood product resuscitation. At the 4-month follow-up, the patient presented with bilateral pulmonary emboli and was transitioned to palliative care. Conclusions DIC after intramedullary stabilization in patients with metastatic bone disease is a rare condition with high mortality rate. Early recognition, blood product resuscitation, and involvement of appropriate subspecialty services are imperative in DIC management.

The problems presented by counterfeit products and documentation are discussed. Limitations of existing holograms for anti-counterfeit applications are described. We describe the advantages of full holographic serialization and the requirements in terms of materials and techniques for mass production of true serialized holograms. These requirements having been met, we report for the first time the mass production of fully serialized holograms. The novelty of the approach consists of the direct use of the product manufacturer’s information as the object in a holographic recording system along with a self-processing photopolymer and modular optical system to facilitate mass production of truly serialized volume holograms. Various types of serialized holograms for overt and covert authentication are described. We discuss briefly the application of Optrace’s manufacturing methods for future generation holographic devices.

Background\ud \ud Communities In Charge of Alcohol (CICA) takes an Asset Based Community Development (ABCD) approach to reducing alcohol harm. Through a cascade training model, supported by a designated local co-ordinator, local volunteers are trained to become accredited ‘Alcohol Health Champions’ to provide brief opportunistic advice at an individual level and mobilise action on alcohol availability at a community level. The CICA programme is the first time that a devolved UK region has attempted to coordinate an approach to building health champion capacity, presenting an opportunity to investigate its implementation and impact at scale. This paper describes the protocol for a stepped wedge randomised controlled trial of an Alcohol Health Champions programme in Greater Manchester which aims to strengthen the evidence base of ABCD approaches for health improvement and reducing alcohol-related harm.\ud \ud Methods\ud \ud A natural experiment that will examine the effect of CICA on area level alcohol-related hospital admissions, Accident and Emergency attendances, ambulance call outs, street-level crime and anti-social behaviour data. Using a stepped wedged randomised design (whereby the intervention is rolled out sequentially in a randomly assigned order), potential changes in health and criminal justice primary outcomes are analysed using mixed-effects log-rate models, differences-in-differences models and Bayesian structured time series models. An economic evaluation identifies the set-up and running costs of CICA using HM Treasury approved standardised methods and resolves cost-consequences by sector. A process evaluation explores the context, implementation and response to the intervention. Qualitative analyses utilise the Framework method to identify underlying themes.\ud \ud Discussion\ud \ud We will investigate: whether training lay people to offer brief advice and take action on licensing decisions has an impact on alcohol-related harm in local areas; the cost-consequences for health and criminal justice sectors, and; mechanisms that influence intervention outcomes. As well as providing evidence for the effectiveness of this intervention to reduce the harm from alcohol, this evaluation will contribute to broader understanding of asset based approaches to improve public health.\ud \ud Trial registration\ud \ud ISRCTN 81942890, date of registration 12/09/2017.\ud \ud Keywords\ud Alcohol, Public health, Asset based community development, Brief intervention, Licensing, Dark logic, Community-based prevention

OBJECTIVES The surgical reduction of intra-articular olecranon fractures is judged primarily on the lateral elbow radiograph, as orthogonal imaging of the articular surface is not obtainable. We sought to determine surgeon accuracy in identifying intra-articular olecranon malreductions on the lateral elbow radiograph. METHODS Six human fresh-frozen cadaveric elbow specimens were sagittally sectioned in 5-mm increments after olecranon dissection, preservation of soft tissue envelope, and rigid fixation of the elbow in an external fixator. Three patterns of central intra-articular olecranon malreduction were created in each elbow using a ruler and bone saw. Perfect lateral elbow radiographs were taken of each malreduction, and these images were randomized along with x-rays of normal cadaveric olecranons. The image series was presented to 4 masked trauma-trained surgeons to determine whether the olecranon was malreduced or anatomic. Surgeons interpreted the same image series on 2 separate occasions separated by 6 weeks. Percent correct was recorded, and the interobserver and intraobserver reliability was calculated. RESULTS Orthopedic trauma surgeons correctly identified olecranon malreductions only 73% of the time on the lateral elbow radiograph. Interobserver agreement was moderate for the first review of images and fair for the second review, with respective Fleiss Kappa values of 0.43 and 0.28. Intrarater reliability revealed moderate agreement with Cohen's Kappa value ranging from 0.56 to 0.66. CONCLUSIONS Intra-articular olecranon malreductions are inconsistently recognized by trauma surgeons on the lateral elbow radiograph. Therefore, articular incongruity may still be present after surgical fixation of comminuted olecranon fractures. We must further define the radiographic anatomic representation of the articular olecranon to improve surgical reduction and clinical outcomes.

The optical and catalytic properties of metal nanoparticles have attracted significant attention for applications in a wide variety of fields, thus prompting interest in developing sustainable synthetic strategies that leverage the redox properties of natural compounds or extracts. Here, we investigate the surface chemistry of nanoparticles synthesized using coffee as a biogenic reductant. Building on our previously developed synthetic protocols for the preparation of silver and palladium nanoparticle/carbon composite microspheres, a combination of thermogravimetric and spectroscopic methods was used to characterize the carbon microsphere and nanoparticle surfaces. Infrared reflectance spectroscopy and single particle surface enhanced Raman spectroscopy were used to characterize Pd and Ag metal surfaces, respectively, following synthesis. Strongly adsorbed organic layers were found to be present at metal nanoparticle surfaces after synthesis. The catalytic activity of Pd nanoparticles in hydrogenation reactions was leveraged to study the availability of surface sites, and coffee-synthesized nanomaterials were compared to commercial Pd-based hydrogenation catalysts. Our results demonstrate that biogenic adsorbates block catalytic surface sites and affect nanoparticle functionality. These findings highlight the need for careful analysis of surface chemistry as it relates to the specific applications of nanomaterials produced using greener or more sustainable methods. (Figure Presented). Environmental Protection Agency Hewlett Mellon Fund for Faculty Development at Albion College (Michigan, USA)

There has been extensive discussion of the causes of short-term forgetting. Some accounts suggest that time plays an important role in the loss of representations, whereas other models reject this notion and explain all forgetting through interference processes. The present experiment used the recent-probes task to investigate whether residual visual information is lost over the passage of time. On each trial, three unusual target objects were displayed and followed by a probe stimulus. The task was to determine whether the probe matched any of the targets, and the next trial commenced after an intertrial interval lasting 300 ms, 3.3 s, or 8.3 s. Of critical interest were recent negative (RN) trials, on which the probe matched a target from the previous trial. These were contrasted against nonrecent negative (NRN) trials, in which the probe had not been seen in the recent past. RN trials damaged performance and slowed reaction times in comparison to NRN trials, highlighting interference. However, this interfering effect diminished as the intertrial interval was lengthened, suggesting that residual visual information is lost as time passes. This finding is difficult to reconcile with interference-based models and suggests that time plays some role in forgetting.

© 2017 Elsevier Ltd Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [

The Grassroots Archaeology Project is a home-grown community-based initiative aiming to combine professional expertise and local support to discover the story of a forgotten monument. The monument in question, a suspected medieval moated site, has been subsumed by the modern Seagrange housing estate where I grew up in suburban Dublin. Throughout the stages of the project, the Grassroots Team has worked to engage the public and to disseminate new knowledge in the hopes of contributing to the sense of identity and community for residents of this constructed suburban landscape. This paper places community archaeology within an Irish context, details the experience of community and the lessons learned during our first season, and examines the conflict arising between the role of the professional archaeologist and the local residents. This conflict was complicated by the simultaneous ‘professional’ and ‘local’ status of certain members of the project team, myself included.

In surgery, preoperative handover of surgical trauma patients is a process that must be made as safe as possible. We sought to determine vital clinical information to be transferred between patient care teams and to develop a standardized handover checklist.We conducted standardized small-group interviews about trauma patient handover. Based on this information, we created a questionnaire to gather perspectives from all Canadian Orthopaedic Association (COA) members about which topics they felt would be most important on a handover checklist. We analyzed the responses to develop a standardized handover checklist.Of the 1106 COA members, 247 responded to the questionnaire. The top 7 topics felt to be most important for achieving patient safety in the handover were comorbidities, diagnosis, readiness for the operating room, stability, associated injuries, history/mechanism of injury and outstanding issues. The expert recommendations were to have handover completed the same way every day, all appropriate radiographs available, adequate time, all appropriate laboratory work and more time to spend with patients with more severe illness.Our main recommendations for safe handover are to use standardized checklists specific to the patient and site needs. We provide an example of a standardized checklist that should be used for preoperative handovers. To our knowledge, this is the first checklist for handover developed by a group of experts in orthopedic surgery, which is both manageable in length and simple to use.En chirurgie, le transfert préopératoire des polytraumatisés nécessitant une chirurgie est un processus que l’on doit rendre aussi sécuritaire que possible. Nous avons voulu déterminer quels renseignements cliniques vitaux doivent être transmis aux équipes de soins et préparer une liste de vérification standardisée à cette fin.Nous avons réalisé des entrevues standardisées par petits groupes au sujet du transfert des polytraumatisés. À partir des renseignements recueillis, nous avons élaboré un questionnaire pour obtenir le point de vue de tous les membres de l’Association canadienne d’orthopédie (ACO) au sujet des éléments jugés les plus importants sur une liste de vérification en vue du transfert. Nous avons analysé les réponses pour dresser une liste de vérification standardisée.Sur les 1106 membres de l’ACO, 247 ont répondu au questionnaire. Les 7 éléments jugés les plus importants pour assurer la sécurité des patients lors du transfert ont été : comorbidités, diagnostic, état de préparation pour le bloc opératoire, stabilité, blessures connexes, histoire et mécanisme du traumatisme et questions en suspens. Les recommandations des experts ont été les suivantes : que les transferts s’effectuent de la même façon chaque jour, qu’on obtienne toutes les radiographies appropriées disponibles, qu’on dispose de temps suffisant, qu’on obtienne toute les analyses de laboratoire appropriées et qu’on aie plus de temps à consacrer aux patients plus grièvement blessés.Nos principales recommandations pour un transfert sécuritaire sont d’utiliser des listes de vérification standardisées spécifiques aux besoins des patients et des sites. Nous fournissons un modèle type de liste de vérification pour les transferts qui devrait être utilisée pour le transfert en chirurgie des polytraumatisés. À notre connaissance, il s'agit de la première liste de vérification rapide et simple mise au point à cette fin par un groupe d’experts en chirurgie orthopédique.

Der Graf von Ulster und der Albigenserkreuzzug. Verschiedene politische Bande verwickelten im 13. Jh. auf überraschende weise Irland in die Geschehnisse im fernen Languedoc. Inmitten dieser Verwicklungen findet sich der Graf von Ulster, Hugo II. von Lacy, der sich 13 Jahre lang auf dem Festland befand, nachdem er 1210 von Johann Ohneland aus seinen irischen Besitzungen vertrieben worden war und bevor er seine alten Besitztümer Meath und die Grafschaft Ulster wiedererobern konnte. Im Exil spielte er eine wichtige Rolle im Albigenserkreuzzug und wurde sogar Herr über Castelnaudary und Laurac. wie das Languedoc gehörte auch Irland zur globalen Machtstrategie der beiden Dynastien der Kapetinger und der Plantagenets. Die Annexion der benachbarten Regionen in Irland sowie im Languedoc weisen auf den Höhepunkt der Macht beider Familien hin, die in den darauffolgenden Jahrhunderten die westeuropäische Politik beherrschen sollten., The Count of Ulster and the Albigensian Crusade. In a rather surprizing way, 13th century Ireland was linked to events taking place in Languedoc through a network of political connections. At the center of these incidents was Hugh II de Lacy, Count of Ulster. After his expulsion from Ireland by John Lackland in 1210, Hugh II remained in exile on the Continent during 13 years before invading part of Meath and the County of Ulster that had once belonged to him. Through the analysis of the career of Hugh de Lacy during his years of exile, this article insists on the important rôle he played in the Albigensian Crusade, then on his nomination as Lord of Castelnaudary and Laurac. In this study, Ireland and Languedoc are seen within the global framework of the expansion of the power of the Houses of Capet and Plantagenêt. Annexation of the bordering territories of Ireland and Languedoc marks the beginning of the apogee of these two dynasties who were to dominate western European politics over the next centuries., De façon quelque peu surprenante, l’Irlande du XIIIe siècle fut liée aux événements survenus en Languedoc, à travers un réseau de connexions politiques. Au centre de ces péripéties figure Hugues II de Lacy, comte d’Ulster. À la suite de son expulsion d’Irlande par Jean sans Terre, en 1210, Hugues II demeura en exil sur le continent pendant treize ans avant d’envahir une partie de Meath et le comté d’Ulster autrefois sien. Grâce à l’analyse de la carrière d’Hugues de Lacy pendant ses années d’exil, cet article insiste sur son rôle capital dans la croisade contre les albigeois, puis sur sa nomination comme seigneur de Castelnaudary et Laurac. Au cours de cette étude, l’Irlande et le Languedoc sont envisagés dans le cadre global de l’expansion des pouvoirs des maisons capétienne et Plantagenêt. L’annexion des territoires frontaliers d’Irlande et du Languedoc marque le commencement de l’apogée de ces deux dynasties qui allaient dominer la politique de l’Europe occidentale au cours des siècles ultérieurs., El conde de Ulster y la Cruzada contra los Albigenses. Es algo sorprendente comprobar que la Irlanda del siglo XIII fue relacionada con lo que ocurría en Languedoc por medio de una red de conexiones políticas. En medio de esas peripecias destaca Hugues II de Lacy, conde de Ulster. Como consecuencia de su expulsión de Irlanda por mandato de Juan sin Tierra en 1210, Hugues II quedó durante trece años exiliado en el continente antes de invadir una parte de Meath y el condado de Ulster que antes era suyo. Apoyándose en el análisis de la carrera de Hugues de Lacy durante los años de exilio, este artículo subraya su papel crucial en la Cruzada contra los Albigenses y luego su nombramiento como señor de Castelnaudary et de Laurac. En este estudio, se considera a Irlanda y Languedoc en el marco global de la expansión de los poderes de las casas de los Capetos y de los Plantagenet. La anexión de los territorios colindantes de Irlanda y de Languedoc señala el inicio del apogeo de esas dinastías que dominarían la política de la Europa occidental durante los siglos posteriores., Duffy Paul. Le comte d’Ulster et la croisade contre les albigeois. In: Annales du Midi : revue archéologique, historique et philologique de la France méridionale, Tome 126, N°285, 2014. pp. 5-27.

Background: Concerns about prescribed methadone diversion are ongoing. This research investigated motivations for methadone diversion and continued use of street-sourced substances. Methods: Questionnaires completed with 886 past year users of methadone recruited in and out of prescribing agencies. Topics covered included current prescribing, obtaining/providing methadone, reasons for using illicit methadone and other substance use. Results: Missing appointments (prescription pick-up or reviews) were the most common reasons for use of diverted methadone but the most common course of action in these circumstances was to use other street-sourced substances. Topping up dosage levels was also a common reason for obtaining illicit methadone. The most common reason diverting methadone was to “help another substance user out”. Concurrent and simultaneous use of a variety of substances whilst prescribed methadone was common. Conclusion: Reasons for using diverted methadone are primarily related to service use and...

Composite materials are of interest because they can potentially combine the properties of their respective components in a manner that is useful for specific applications. Here, we report on the use of coffee as a low-cost, green reductant for the room temperature formation of catalytically active, supported metal nanoparticles. Specifically, we have leveraged the reduction potential of coffee in order to grow Pd and Ag nanoparticles at the surface of porous carbon microspheres synthesized via ultraspray pyrolysis. The metal nanoparticle-on-carbon microsphere composites were characterized using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD) and thermal gravimetric analysis (TGA). To demonstrate the catalytic activity of Pd/C and Ag/C materials, Suzuki coupling reactions and nitroaromatic reduction reactions were employed, respectively.

Aim: Methadone maintenance treatment (MMT) is a key treatment for opiate addiction; however, concerns about the diversion of methadone remain. Further empirical data on methadone diversion are required to inform clinical decisions. This study examined drug treatment practitioners’ perceptions of the illicit methadone market in Merseyside, England, and responses to it.Method: Semi-structured interviews with 120 practitioners directly involved in the delivery of MMT. Interview topics included: perceptions of the extent, nature and impact of diversion; protocols for prescribing and dispensing; and measures to prevent diversion. Local guidelines for prescribing and dispensing were obtained.Findings: Participants perceived methadone to be diverted in small amounts for monetary gain or shared among partners, friends and family. Illicit methadone was felt to be used to ‘top up’, replace prescriptions or self-medicate if not in treatment. Supervised consumption was thought to be the only effective way to prevent ...

With dental nurse salaries a hot topic, we hear from Paul Duffy on why he hopes his research study on job satisfaction may highlight the crux of the matter

We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced.

A group of Early Neolithic features probably relating to the cooking of food was excavated. Several of these features contained considerable amounts of carbonised botanical remains, providing a broader insight into the landscape where these features were found. Analysis of the remains suggests that there has been a short phase of occupation, radiocarbon dated to 3780-3650 cal BC.