Search

The aim of this review is to assess the efficacy and safety of using heat and cold therapy for adults with lymphoedema. A multi-database search was undertaken. Only studies which included adults with lymphoedema who were treated with heat or cold therapy reporting any outcome were included. Screening, data extraction, and assessment of bias were undertaken by a single reviewer and verified by a second. Due to the substantial heterogeneity, a descriptive synthesis was undertaken. Eighteen studies were included. All nine studies which assessed the effects of heat-therapy on changes in limb circumference reported a point estimate indicating some reduction from baseline to end of study. Similarly, the five studies evaluating the use of heat-therapy on limb volume demonstrated a reduction in limb volume from baseline to end-of-study. Only four studies reported adverse events of which all were deemed to be minor. Only two studies explored the effects of cold therapy on lymphoedema. Tentative evidence suggests heat-therapy may have some benefit in treating lymphoedema with minimal side effects. However, further high-quality randomised controlled trials are required, with a particular focus on moderating factors and assessment of adverse events. This review highlights the potential benefit that heat therapy may have on reducing limb circumference and volume for adults with lymphoedema. There was no evidence that controlled localised heat therapy was unsafe. The current evidence-base is at a point where no specific clinical recommendations can be made. The use of heat therapy should only be applied as part of a methodologically robust study to treat lymphoedema. [ABSTRACT FROM AUTHOR]

Despite the high diversity and endemism in the Mobile River Basin, analyses of molecular phylogeographic patterns of freshwater fishes in this system are lacking. Using cytochrome b (cyt b) and S7 ribosomal intron-1, this study compares the phylogeography and population structure of Etheostoma rupestre Rock Darter with a disjunct distribution throughout the Mobile River Basin. For cyt b, parsimony, Bayesian, and Species Delimitation analyses showed a split between the Tombigbee, Alabama, and Coosa/Tallapoosa Rivers, potentially representing previously undescribed species. In addition, there is evidence of limited gene flow between the lower Tombigbee/Sipsey River populations and other populations. Hierarchical comparison showed that there is genetic divergence between the major rivers of the Mobile River Basin. The lack of structure within the tributaries of the river system may indicate that Rock Darter is capable of further dispersal than typical for a darter species. The structure identified across the basin may be due to historic sea-level fluctuations and/or contemporary structure, but fine-scale, within-river analyses would be necessary to further unravel the phylogenetic relationships of the Rock Darter species complex. This study is relevant to establishing conservation guidelines for the biodiversity in the Mobile River Basin. [ABSTRACT FROM AUTHOR]

Background: Most deaths from injury occur in Low and Middle Income Countries (LMICs) with one third potentially avoidable with better health system access. This study aimed to establish consensus on the most important barriers, within a Three Delays framework, to accessing injury care in LMICs that should be considered when evaluating a health system.Methods: A three round electronic Delphi study was conducted with experts in LMIC health systems or injury care. In round one, participants proposed important barriers. These were synthesized into a three delays framework. In round 2 participants scored four components for each barrier. Components measured whether barriers were feasible to assess, likely to delay care for a significant proportion of injured persons, likely to cause avoidable death or disability, and potentially readily changed to improve care. In round 3 participants re-scored each barrier following review of feedback from round 2. Consensus was defined for each component as ≥70% agreement or disagreement.Results: There were 37 eligible responses in round 1, 30 in round 2, and 27 in round 3, with 21 countries represented in all rounds. Of the twenty conceptual barriers identified, consensus was reached on all four components for 11 barriers. This included 2 barriers to seeking care, 5 barriers to reaching care and 4 barriers to receiving care. The ability to modify a barrier most frequently failed to achieve consensus.Conclusion: 11 barriers were agreed to be feasible to assess, delay care for many, cause avoidable death or disability, and be readily modifiable. We recommend these barriers are considered in assessments of LMIC trauma systems. [ABSTRACT FROM AUTHOR]

We present the results of nuclear quadrupole resonance (NQR) measurements in crystalline and glassy As[sub 2]Se[sub 3] and As[sub 2]S[sub 3]. As a function of pulse separation, the decays of the NQR Hahn echoes following a 90°–180° pulse sequence exhibit damped oscillations superimposed on an exponential decay. These damped oscillations can be explained by an indirect coupling (J coupling) between two As nuclei through the polarized electrons on the chalcogen atom. Experimental values of the J couplings were obtained from the periods of the oscillations and calculations of the most probable transitions using second-order perturbation theory. The value estimated by this method for the [sup 2]J([sup 75]As–S–[sup 75]As) in crystalline As[sub 2]S[sub 3] compares well with empirical estimates, which are obtained using an existing value of [sup 2]J([sup 31]P–S–[sup 31]P) and known scalings with atomic number from the literature. Unfortunately, there is insufficient experimental data on [sup 2]J(X–Se–X) couplings to make any empirical estimate of [sup 2]J([sup 75]As–Se–[sup 75]As). © 2003 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the study drug OMS302 (Omidria [phenylephrine and ketorolac injection 1.0%/0.3%]) compared with a balanced salt solution (vehicle), ketorolac, and phenylephrine on pupil diameter during cataract surgery and early postoperative ocular pain. Setting Twenty-three centers in the United States. Design Randomized clinical trial. Methods Patients were randomized (1:1:1:1) to receive vehicle, phenylephrine, ketorolac, or the study drug containing phenylephrine and ketorolac administered intracamerally during surgery. Intraoperative pupil diameter was determined each minute by video capture. Postoperative ocular pain was evaluated for up to 12 hours. Results The study evaluated 223 patients. The study drug was significantly better than the vehicle and ketorolac in maintaining mydriasis (least-squares mean differences 0.9 ± 0.1 [SEM] and 0.7 ± 0.1 for the study drug versus vehicle and ketorolac, respectively; P < .0001 each). Ocular pain assessed using the Visual Analog Scale was significantly reduced for the study drug compared with the vehicle or phenylephrine (least-squares mean difference −4.6 ± 2.2 and P = .042 and 5.9 ± 2.2 and P = .009, respectively). Significantly fewer patients treated with the study drug (3 [6.1%]) had an intraoperative pupil diameter smaller than 6.0 mm compared with those treated with the vehicle (25 [47.2%]; P < .0001), ketorolac (18 [34.6%]; P = .0004), or phenylephrine (11 [22.4%]; P = .0216). Conclusions The study drug was safe and efficacious in maintaining mydriasis and reducing postoperative ocular pain. Both ketorolac and phenylephrine contributed to the therapeutic effects, with the combination showing superiority to either agent alone in maintaining an intraoperative pupil diameter of 6.0 mm or larger. [ABSTRACT FROM AUTHOR]

Until recently, only one species of baobab was thought to exist on mainland Africa, namely the tetraploid Adansonia digitata. However, a second, diploid species, Adansonia kilima, has recently been described and its presence has been confirmed in Tanzania, Kenya, Zambia, Namibia and South Africa. In this study, we use morphological analysis to confirm the presence of A. kilima in Zimbabwe. Leaves were collected from four different sites around Zimbabwe and the size and density of the stomata were measured. We found that the trees could be divided into two distinct groups, with the stomatal size and density in each group corresponding with those found previously. This suggests that both species do occur in Zimbabwe and their occurrence is sympatric. [ABSTRACT FROM AUTHOR]

This paper describes the 5E+I/A inquiry model and reports a case study of one curricular enactment by a US fifth-grade classroom. A literature review establishes the model's conceptual adequacy with respect to longstanding research related to both the 5E inquiry model and multiple, incremental innovations of it. As a collective line of research, the review highlights a common emphasis on formative assessment, at times coupled either with differentiated instruction strategies or with activities that target the generalization of learning. The 5E+I/A model contributes a multi-level assessment strategy that balances formative and summative functions of multiple forms of assessment in order to support classroom participation while still attending to individual achievement. The case report documents the enactment of a weeklong 5E+I/A curricular design as a preliminary account of the model's empirical adequacy. A descriptive and analytical narrative illustrates variable ways that multi-level assessment makes student thinking visible and pedagogical decision-making more powerful. In light of both, it also documents productive adaptations to a flexible curricular design and considers future research to advance this collective line of inquiry. [ABSTRACT FROM PUBLISHER]

We use GaP to generate terahertz pulses via optical rectification in a collinear phase-matched configuration relying on the dispersion of the refractive index. The GaP-based time-domain system operates up to 8 THz and is especially well suited at high frequencies, where it has high signal-to-noise ratio and power conversion efficiency ∼30 times greater than those of commercial photoconductive emitters. These characteristics are demonstrated in measurements of ZnTe in the reflection geometry. We also discuss the power output and describe theoretically the observed THz field generation by nonlinear mixing, the field's free space propagation, and its detection. [ABSTRACT FROM AUTHOR]

The article presents a study aimed at establishing incident reporting feedback experience and attitudes among medical personnel to understand the reasons behind findings of the British National Health Service (NHS) staff in a secondary care setting in Great Britain.

The introduction of Registration, Evaluation and Authorisation of Chemicals (REACH), requires companies to register and risk assess all substances produced or imported in volumes of >1 tonne per year. Extrapolation methods which use existing data for estimating the effects of chemicals are attractive to industry, and comparative data are therefore increasingly in demand. Data on natural toxic chemicals could be used for extrapolation methods such as read-across. To test this hypothesis, the toxicity of natural chemicals and their synthetic analogues were compared using standardised toxicity tests. Two chemical pairs: the napthoquinones, juglone (natural) and 1,4-naphthoquinone (synthetic); and anthraquinones, emodin (natural) and quinizarin (synthetic) were chosen, and their comparative effects on the survival and reproduction of collembolans, earthworms, enchytraeids and predatory mites were assessed. Differences in sensitivity between the species were observed with the predatory mite (Hypoaspis aculeifer) showing the least sensitivity. Within the chemical pairs, toxicity to lethal and sub-lethal endpoints was very similar for the four invertebrate species. The exception was earthworm reproduction, which showed differential sensitivity to the chemicals in both naphthoquinone and anthraquinone pairs. Differences in toxicity identified in the present study may be related to degree of exposure and/or subtle differences in the mode of toxic action for the chemicals and species tested. It may be possible to predict differences by identifying functional groups which infer increased or decreased toxicity in one or other chemical. The development of such techniques would enable the use of read-across from natural to synthetic chemicals for a wider group of compounds. [Copyright &y& Elsevier]

Background Coeliac disease affects about 1% of the population, with the majority being undetected. As a consequence, there have been calls for the introduction of screening. Before screening is given serious consideration, it is important to assess how acceptable early diagnoses and treatment would be. Aim To assess patients’ views as to the diagnosis and treatment of disease. Methods Coeliac disease patients who had taken a gluten-free diet for at least 12 months (mean 60 months) were mailed a questionnaire. Coeliac patients presenting with typical classical symptoms were compared with those diagnosed without such symptoms. Results Overall, 83% (147/177) of coeliac patients returned the questionnaires. Two-thirds (68%, 101/147) reported that their dietary restrictions reduced their enjoyment of food; 46% (68/147) believed their food cost them more and estimated this to be an extra £10 (€16) per week. Of those reporting greater cost, 31 (21%) said this was a problem for them. Half (54%, 80/147) reported doing things they enjoyed less often because of their diet, with the most common activity sacrificed being dining out ( n = 65). In spite of these findings, 81% (119/147) reported being pleased that they were diagnosed, with 66% (59/89) of cases with classical symptoms wishing they had been diagnosed earlier compared with 45% (23/51) of those without such symptoms (χ2 = 6.0, P < .05). In contrast, 27% (14/51) of coeliacs diagnosed without classical symptoms regretted being diagnosed with their condition compared with 10% (9/89) of those with classical symptoms (χ2 = 7.1, P < .01). Conclusions Even after several years of a gluten-free diet, many patients with coeliac disease regard it as a substantial burden, with a quarter of screen detected patients reporting regret at being diagnosed. Our findings question how acceptable screening for coeliac disease would be in people with minimal or no symptoms. [ABSTRACT FROM AUTHOR]

Objectives: To identify the risk of injury to young people participating in non-elite sport, and to establish whether the immediate 'on-field' medical care they receive is adequate. Methods: A literature search of electronic databases was initially undertaken, in addition to searches of governmental bodies' websites; papers obtained were then cross-referenced and appropriate articles ordered through interlibrary loans.Results: A total of 24 relevant papers were identified for review.Conclusions: The lack of standardised injury definitions and surveillance methods confounds the development of injury prevention strategies for young athletes. Future studies should be designed to measure injury exposure, so injury rates can be calculated which will make analysis and comparisons easier and more meaningful. Further studies investigating the extent of coaches', teachers' and therapists' first-aid knowledge and qualifications, and also the quality of the training they receive would also help to determine whether young athletes are receiving adequate 'on-field' care. [ABSTRACT FROM AUTHOR]

We report the observation of a metastable Staebler–Wronski effect in hydrogenated amorphous germanium (a-Ge:H) at room temperature. Both metastable and stable (irreversible) increases in the spin density were observed by electron spin resonance (ESR) after irradiation with 1.17 eV light. The inducing and annealing kinetics are compared to the well-studied behavior in hydrogenated amorphous silicon (a-Si:H). [Copyright &y& Elsevier]

Our first 100 patients and our second 100 patients who underwent a laparoscopic repair of incisional and ventral hernias were compared and evaluated. This analysis revealed that the second group was approximately 9 years older with more comorbid medical conditions. In all, 15% were incarcerated hernias, and 21% were recurrent. Seven operations were converted to the open repair because of adhesions in five patients and either a small or large bowel injury in two patients. There were no complications related to enterotomy. Older and more infirm patients in the second group did not significantly affect outcomes. The average size of the hernia defects was 111 cm2. The average size of the prosthesis was 257.5 cm2. Larger prostheses were used in the second group. With more experience, the recurrence rates have declined from 9% to 4%. The etiology of these recurrences differed in these two groups of patients. Removal of the prosthetic due to infection was a predictable recurrence in two patients. A new hernia below the original hernia has caused us to repair the entire incision that had the initial hernia. Only one technical failure was noted, due to fracture of the suture during transfascial placement and clamping of the suture. It is not recommended to grasp any suture that remains in the patient during this hernioplasty. Recurrences were reduced because of the use of an increased overlap of the biomaterial and the use of dual methods of fixation (tacks and transfascial sutures). [ABSTRACT FROM AUTHOR]

Summary • Phytochelatins (PCs) are required for arsenic (As) detoxification in nontolerant plants. In addition, a role for PCs in arsenate tolerance has recently been proven, with tolerant plants able to accumulate significantly higher concentrations of As–PC complexes at equivalent levels of stress than nontolerant plants. • The relationship between arsenate influx and PC production in tolerant and nontolerant Holcus lanatus plants was determined in this study, along with an investigation of the effect of inhibition of PC synthesis by buthionine sulfoximine (BSO) on arsenate tolerance. • A strong correlation between PC production and arsenate influx was demonstrated in arsenate-tolerant plants. In addition, inhibition of PC synthesis by BSO in tolerant plants increased arsenate sensitivity to that of the nontolerant clone. This dramatic reduction in tolerance proves that PC production is an essential component of the arsenate tolerance mechanism in H. lanatus . • This study proposes that while there is a single major gene for arsenate tolerance, hypostatic modifiers are also in operation, affecting the expression of the tolerance character. [ABSTRACT FROM AUTHOR]

Abstract The biochemical responses of Holcus lanatus L. to copper and arsenate exposure were investigated in arsenate-tolerant and -non-tolerant plants from uncontaminated and arsenic/copper-contaminated sites. Increases in lipid peroxidation, superoxide dismutase (SOD) activity and phytochelatin (PC) production were correlated with increasing copper and arsenate exposure. In addition, significant differences in biochemical responses were observed between arsenate-tolerant and -non-tolerant plants. Copper and arsenate exposure led to the production of reactive oxygen species, resulting in significant lipid peroxidation in non-tolerant plants. However, SOD activity was suppressed upon metal exposure, possibly due to interference with metallo-enzymes. It was concluded that in non-tolerant plants, rapid arsenate influx resulted in PC production, glutathione depletion and lipid peroxidation. This process would also occur in tolerant plants, but by decreasing the rate of influx, they were able to maintain their constitutive functions, detoxify the metals though PC production and quench reactive oxygen species by SOD activity. [ABSTRACT FROM AUTHOR]

Research evidence. reply to 'Research requirements for cct across the surgical specialties: why the difference? References 1 Farrell I, Duff S. Research requirements for CCT across the surgical specialties: why the difference? We have observed that to meet the General Medical Council (GMC) Generic Professional Capabilities Framework other evidence is accepted by different specialties.[2] Radiologists must undertake one research project during training which can be evidenced through a research evaluation form.[3] Gynaecology trainees can evidence guideline development, user involvement group attendance and eLearning.[4] Within palliative care, satisfactory academic portfolio evidence might include a completed guideline, protocol and an educational supervisor research project report.[5] Within acute medicine, research is considered a specialist skill where five publications are required. [Extracted from the article]

With advancing age, postoperative confusion is an increasingly important problem. Its aetiology is complex and multifactorial and includes surgical factors, anaesthetic factors, preexisting medical, psychiatric or psychological problems and postoperative complications. It often prolongs hospital stay and although mental function recovers in the majority of cases, it may be followed by permanent mental impairment. Postoperative confusion may interfere with the management of the original surgical problem and it occurs in a setting where interest and expertise in its management are low. There is scope for improved recognition, treatment and prevention of postoperative confusion. More work needs to be done to evaluate the effect of surgery and anaesthesia on mental function, especially in the very elderly. [ABSTRACT FROM AUTHOR]

Features a meeting that marks the close of the fiftieth anniversary of the Association of American Geographers. Implications of the high quality of papers and discussion for the growth of the field and of the society; Concern of the founders of the society; Impact of the association around a common purpose for the development of the field.

Focuses on the services of Almon Ernest Parkins in the field of geography. Personal background of Parkins; Career history; Achievements.

The article discusses issues and topics related to the destruction and conservation of natural resources. Concerns regarding the consequence of man's destruction of nature on himself; Disturbance on the harmony of plant and animal distribution and the exhaustion of mineral deposits; Treatment of the problem as a phase of the economic nationalism.

Picosecond bistable operation has been experimentally observed for the first time in a double-barrier resonant tunneling diode. A rise time of 2 ps was measured using the electro-optic sampling technique; this is the fastest switching event yet observed for an electronic device. This time domain measurement adds necessary information to the understanding of the transport mechanisms in the resonant tunneling diode and is consistent with switching time limitations computed for the device. It also demonstrates that appropriately designed double-barrier quantum well diodes have a response time comparable to that of the fastest all-optical logic elements, and that they may be very useful in high-speed logic applications. [ABSTRACT FROM AUTHOR]

The article discusses the advice guidelines from the British Hernia Society focusing on the health primary care management of inguinal hernias among medical personnels. It mentions the role of advancement of anesthetic and surgical techniques in patients undergoing hernia surgeries. It notes the role of hernia trusses in treating inguinal hernia for patients. It also emphasizes the society's retrospective study which reviews the therapeutic use of hernia trusses.

An interview with J. Patrick Whitaker of J. Sargeant Reynolds Community College in Richmond, Virginia is presented. When asked regarding the baby boom academic retirement, he says that the retirement of the said generation can benefit online programs. He states that online faculty may get their self involved with several excellent professional organizations which focuses on distance learning. He adds that scholarships is one of the services offered by retirement age faculty to distance programs.

Claw-only crab fisheries are often marketed as renewable because crabs are returned to the water after declawing to regenerate claws and re-enter the fishery. The challenge of managing a claw-only fishery for stone crabs ( Menippe spp.) is compounded by varying regulations throughout their range that include the number of claws harvested from a crab and use of a seasonal closure to protect spawning females. We conducted mark-recapture studies to examine crab responses to claw removal in the field and compared claw handedness and type (crusher, intermediate, pincer) in a wild population to commercial landings to examine compliance with fishery regulations in a one-claw fishery with no seasonal closure. Declawed crabs were recaptured less frequently than control crabs, particularly if claw removal created large wounds. Control crabs were more commonly recaptured within one month of tagging and declawed crabs recaptured one to three months after tagging, suggesting that declawed crabs were less mobile or less motivated to feed initially after claws were harvested and that, over time, intact crabs left the study area. Crabs with fishery-related, regenerated claws comprised 3% of crabs with legal claws. Claw type ratios in a limited assessment of the commercial catch most closely reflected expected ratios consistent with a two-claw fishery, indicating that voluntary adherence to current one-claw fishing regulations is not universal. In fisheries needing better protection of spawning stock, a seasonal closure on fishing could be instituted to ensure better protection of spawning. [ABSTRACT FROM AUTHOR]

An abstract is offered of the research paper "MDR Acinetobacter baumanni in the short term and long term acute care setting," by J. L. Whitaker, presented at the International Conference on Prevention & Infection Control (ICPIC 2011) held in Geneva, Switzerland on June 29-July 2, 2011.

Managing lymphoedema of the male genitals is challenging, distressing and potentially life-threatening if not managed appropriately. Consideration is made of the classification, clinical presentation, lymphatic anatomy and management of genital lymphoedema in clinical practice. The article addresses the issues raised when caring for patients suffering from this condition. A case history demonstrates the use of a novel innovation. The Whitaker Pouch, which can relieve and manage symptoms facilitating self-management and appropriate best practice. [ABSTRACT FROM AUTHOR]

Provides on overview of the contents of "The Proceedings of a Conference on Land Use in a Mediterranean Environment," first printed in 1947. Conference that grew out of a study of the Island's grazing problems; Interchange of views by officers of governmental departments concerned with land use, representatives of farmers' unions, and others, including visiting officials from Palestine.

Despite exhaustive literature describing drought stress effects on photosynthesis in Gossypium hirsutum, the sensitivity of photosynthetic electron flow to water deficit is heavily debated. To address this, G. hirsutum plants were grown at a field site near Camilla, GA under contrasting irrigation regimes, and pre-dawn water potential (Ψ PD), stomatal conductance (gs), net photosynthesis ( PN), actual quantum yield of photosystem II (Φ PSII) and electron transport rate ( ETR) were measured at multiple times during the 2012 growing season. Ψ PD values ranged from −0.3 to −1.1 MPa. Stomatal conductance exhibited a strong (r2 = 0.697), sigmoidal response to Ψ PD, where gs was ≤0.1 mol m−2 s−1 at Ψ PD values ≤ −0.86 MPa. Neither Φ PSII (r2 = 0.015) nor ETR (r2 = 0.010) was affected by Ψ PD, despite exceptionally low Ψ PD values (−1.1 MPa) causing a 71.7 % decline in PN relative to values predicted for well-watered G. hirsutum leaves at Ψ PD = −0.3 MPa. Further, PN was strongly influenced by gs, whereas ETR and Φ PSII were not. We conclude that photosynthetic electron flow through photosystem II is insensitive to water deficit in field-grown G. hirsutum. [ABSTRACT FROM AUTHOR]

A 31-year-old female with no risk factors for cardiac disease suffered a peri-operative myocardial infarction during an elective gynaecological procedure under spinal anaesthesia. The timing and nature of cardiac symptoms suggest that the myocardial infarction was caused by coronary artery vasospasm secondary to ephedrine and/or metaraminol, which were administered to treat spinal-induced hypotension. We review the recent literature and case reports on myocardial infarction attributed to sympathomimetic drugs, and recommend the use of sublingual or intravenous nitrates when signs or symptoms of coronary arterial vasospasm become evident during their use. [ABSTRACT FROM AUTHOR]

In this study the authors diagnose the sources for the contiguous U.S. seasonal forecast skill that are related to sea surface temperature (SST) variations using a combination of dynamical and empirical methods. The dynamical methods include ensemble simulations with four atmospheric general circulation models (AGCMs) forced by observed monthly global SSTs from 1950 to 1999, and ensemble AGCM experiments forced by idealized SST anomalies. The empirical methods involve a suite of reductions of the AGCM simulations. These include uni- and multivariate regression models that encapsulate the simultaneous and one-season lag linear connections between seasonal mean tropical SST anomalies and U.S. precipitation and surface air temperature. Nearly all of the AGCM skill in U.S. precipitation and surface air temperature, arising from global SST influences, can be explained by a single degree of freedom in the tropical SST field—that associated with the linear atmospheric signal of El Niño–Southern Oscillation (ENSO). The results support previous findings regarding the preeminence of ENSO as a U.S. skill source. The diagnostic methods used here exposed another skill source that appeared to be of non-ENSO origins. In late autumn, when the AGCM simulation skill of U.S. temperatures peaked in absolute value and in spatial coverage, the majority of that originated from SST variability in the subtropical west Pacific Ocean and the South China Sea. Hindcast experiments were performed for 1950–99 that revealed most of the simulation skill of the U.S. seasonal climate to be recoverable at one-season lag. The skill attributable to the AGCMs was shown to achieve parity with that attributable to empirical models derived purely from observational data. The diagnostics promote the interpretation that only limited advances in U.S. seasonal prediction skill should be expected from methods seeking to capitalize on sea surface predictors alone, and that advances that may occur in future decades could be readily masked by inherent multidecadal fluctuations in skill of coupled ocean–atmosphere systems. [ABSTRACT FROM AUTHOR]

Repair of parastomal represents a significant challenge for the hernia surgeon. Repair of these hernias is indicated because of an ill-fitting appliance, cosmetic deformity, inability to maintain proper hygiene and complications from the hernia itself such as incarceration or strangulation. Recent reports in the literature have shown that primary fascial repair can occur in 46% of patients and relocation of the stoma is associated with a 40% recurrence rate. For this reason, the use of polypropylene mesh has been applied to this repair. The recurrence rate with this open technique will still incur a failure rate of 20-29%. Additionally there are other complications such as obstruction, fistulization or mesh erosion with this biomaterial. The laparoscopic approach to this hernia may offer a new choice for this difficult problem. We have used ePTFE to repair 12 parastomal hernias with three different approaches. There have been eight colostomy, two ileostomy and two urostomy hernias. Follow-up ranges from 3-39 months (average 20 months). There has been one recurrence that required two repairs (8%). Other complications included enterotomy (one patient), ileus (one), seroma (one), and death from postoperative aspiration (one). The laparoscopic repair of parastomal hernias appears to be a promising technique for this complex dilemma. [ABSTRACT FROM AUTHOR]

Nuclear quadrupole resonance (NQR) studies on crystalline and glassy As–S/Se compounds reveal that the spin echo intensities as a function of pulse separation in the Hahn echo sequence exhibit oscillations superimposed on an exponential decay, given by the spin–spin relaxation time, T2. We have conducted systematic investigations of the nature of these T2 oscillations in glassy and crystalline As2S3 and As2Se3. T2 oscillations in c-As2S3 at 71.94 MHz are of the order of a kHz. T2 oscillations were also observed in glassy As2S3 and As2Se3. We will present calculations of indirect spin coupling between inequivalent As atoms to explain the nature of the T2 oscillations in glassy and crystalline As2S3 and As2Se3. [Copyright &y& Elsevier]

Maintaining adequate planter downforce is critical for achieving timely and uniform crop emergence across the field. On-farm research studies were conducted in different regions across South Georgia, USA to investigate the effect of planter downforce in varying soil textures. Six fields were planted in cotton with four different growers from 2017 to 2019. Soil electrical conductivity (EC) was mapped in each field to characterize areas of varying soil textures into low, medium and high soil EC zones. For each field, the downforce treatments consisted of a grower-preferred downforce along with a relatively lower and higher downforce dependent on prevalent field conditions and the downforce system available on the grower's planter. Results varied from field to field depending on soil texture variability or the type of downforce system. In three out of six fields, emergence was delayed and reduced in areas of high soil EC (heavy textured soils) whereas soil EC or downforce did not affect crop emergence in two fields. In one field, increasing planter downforce from the grower preferred value of 555 N to 1110 N improved crop emergence in heavy textured soils. In some cases, it was noted that even the highest downforce (1110 N) was not sufficient to place seeds at the desired seeding depth in the heavy textured soils. More on-farm studies are required to thoroughly understand planter downforce response in varying field conditions that exist during planting. Future studies should consider better quantification of in-field soil variability and changes in planter downforce during field operation. [ABSTRACT FROM AUTHOR]

The performance of a new historical reanalysis, the NOAA–CIRES–DOE Twentieth Century Reanalysis version 3 (20CRv3), is evaluated via comparisons with other reanalyses and independent observations. This dataset provides global, 3-hourly estimates of the atmosphere from 1806 to 2015 by assimilating only surface pressure observations and prescribing sea surface temperature, sea ice concentration, and radiative forcings. Comparisons with independent observations, other reanalyses, and satellite products suggest that 20CRv3 can reliably produce atmospheric estimates on scales ranging from weather events to long-term climatic trends. Not only does 20CRv3 recreate a "best estimate" of the weather, including extreme events, it also provides an estimate of its confidence through the use of an ensemble. Surface pressure statistics suggest that these confidence estimates are reliable. Comparisons with independent upper-air observations in the Northern Hemisphere demonstrate that 20CRv3 has skill throughout the twentieth century. Upper-air fields from 20CRv3 in the late twentieth century and early twenty-first century correlate well with full-input reanalyses, and the correlation is predicted by the confidence fields from 20CRv3. The skill of analyzed 500-hPa geopotential heights from 20CRv3 for 1979–2015 is comparable to that of modern operational 3–4-day forecasts. Finally, 20CRv3 performs well on climate time scales. Long time series and multidecadal averages of mass, circulation, and precipitation fields agree well with modern reanalyses and station- and satellite-based products. 20CRv3 is also able to capture trends in tropospheric-layer temperatures that correlate well with independent products in the twentieth century, placing recent trends in a longer historical context. [ABSTRACT FROM AUTHOR]

Background: The effects of placing a prosthesis directly on the internal inguinal ring and external iliac vessels in inguinal hernia repair are unknown. We compared tissue responses to five prostheses implanted in this position in uncastrated male pigs.Methods: Three types of polypropylene and two types of expanded polytetrafluoroethylene (ePTFE) mesh were implanted in 20 pigs (n = 8 for each prosthesis type). Specimens of the implants and surrounding tissue were obtained 30 and 90 days after implantation and assessed histologically.Results: The polypropylene implants had more adhesions, more surface area covered by adhesions, and more tenacious adhesions than did the ePTFE implants. Perivascular cuffing was observed in eight polypropylene and one ePTFE specimen; ossification, necrosis, and testicular venous congestion were seen in polypropylene specimens.Conclusions: Abnormal healing processes after implantation of polypropylene mesh may increase complications of the transabdominal preperitoneal and total extraperitoneal approaches in laparoscopic inguinal hernia repair, whereas the minimal response to ePTFE meshes may make them safer for use in the preperitoneal space. [ABSTRACT FROM AUTHOR]

Because the 157.74 μm [C ii ] line is the dominant coolant of star-forming regions, it is often used to infer the global star formation rates of galaxies. By characterizing the [C ii ] and far-infrared emission from nearby Galactic star-forming molecular clumps, it is possible to determine whether extragalactic [C ii ] emission arises from a large ensemble of such clumps, and whether [C ii ] is indeed a robust indicator of global star formation. We describe [C ii ] and far-infrared observations using the FIFI-LS instrument on the Stratospheric Observatory For Infrared Astronomy (SOFIA) airborne observatory toward four dense, high-mass, Milky Way clumps. Despite similar far-infrared luminosities, the [C ii ] to far-infrared luminosity ratio, /LFIR, varies by a factor of at least 140 among these four clumps. In particular, for AGAL313.576+0.324, no [C ii ] line emission is detected despite a FIR luminosity of 24,000. AGAL313.576+0.324 lies a factor of more than 100 below the empirical correlation curve between /LFIR and found for galaxies. AGAL313.576+0.324 may be in an early evolutionary "protostellar" phase with insufficient ultraviolet flux to ionize carbon, or in a deeply embedded "'hypercompact" region phase where dust attenuation of UV flux limits the region of ionized carbon to undetectably small volumes. Alternatively, its apparent lack of [C ii ] emission may arise from deep absorption of the [C ii ] line against the 158 μm continuum, or self-absorption of brighter line emission by foreground material, which might cancel or diminish any emission within the FIFI-LS instrument's broad spectral resolution element (km s−1). [ABSTRACT FROM AUTHOR]

We report the results of femtosecond optical transient absorption experiments performed on the superconducting compounds YBa2Cu3O7-x(x ∼ 0) and Bi2Sr2Ca2Cu3O10+δ(δ ∼ 0) and nonsuperconducting YBa2Cu3O6+y(y<0.4) for sample temperatures ranging from ∼7 K to room temperature. Nonequilibrium heating was found to occur on a subpicosecond time scale. A distinct, dramatic increase in the relaxation time was observed for the superconducting samples as the sample temperature was lowered below the critical temperatures of the respective films. Accompanying the increase in relaxation time was an increase in the peak fractional transmissivity change. No such changes were observed for the nonsuperconducting YBCO sample. We believe the above described behavior is electronic in origin and intimately related to the superconductivity of the compounds. [ABSTRACT FROM AUTHOR]

By around 2025, thorium-based fuel cycles are likely to be deployed internationally. States such as China and India are pursuing research, development, and deployment pathways toward a number of commercial-scale thorium fuel cycles, and they are already building test reactors and the associated fuel cycle infrastructure. In the future, the potential exists for these emerging programs to sell, export, and deploy thorium fuel cycle technology in other states. Without technically adequate international safeguards protocols and measures in place, any future potential clandestine misuse of these fuel cycles could go undetected, compromising the deterrent value of these protocols and measures. The development of safeguards approaches for thorium-based fuel cycles is therefore a matter of some urgency. Yet, the focus of the international safeguards community remains mainly on safeguarding conventional 235U- and 239Pu-based fuel cycles while the safeguards challenges of thorium-uranium fuel cycles remain largely uninvestigated. This raises the following question: Is the International Atomic Energy Agency and international safeguards system ready for thorium fuel cycles? Furthermore, is the safeguards technology of today sufficiently mature to meet the verification challenges posed by thorium-based fuel cycles? In defining these and other related research questions, the objectives of this paper are to identify key safeguards considerations for thorium-based fuel cycles and to call for an early dialogue between the international safeguards and the nuclear fuel cycle communities to prepare for the potential safeguards challenges associated with these fuel cycles. In this paper, it is concluded that directed research and development programs are required to meet the identified safeguards challenges and to take timely action in preparation for the international deployment of thorium fuel cycles. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the effect of OMS302 on intraoperative pupil diameter and early postoperative ocular pain when administered during intraocular lens replacement surgery. Methods: Four hundred and six patients (406 study eyes; 202 in the OMS302 group and 204 in the placebo group) were entered into this randomized, double-masked, placebo-controlled, multicenter Phase III study, which was conducted at 15 centers in the USA and the Netherlands. The patients received OMS302 (60.75 mM phenylephrine HC1 and 11.25 mM ketorolac tromethamine) or placebo in irrigation solution during intraocular lens replacement. No other changes in procedure were required. Coprimary endpoints were change in pupil diameter over time from surgical baseline to end of procedure and patient-reported ocular pain during the first 12 hours postoperatively. Secondary endpoints included additional measures of pupil diameter and postoperative pain. Results: OMS302 was superior to placebo in maintaining intraoperative mydriasis, preventing miosis, and reducing postoperative pain. The weighted mean (standard error) difference (OMS302 - placebo) in change in the area under the curve from baseline for pupil diameter was 0.590 ([0.049]; 95% confidence interval 0.494 to 0.686; P<0.0001). For ocular pain scores, the weighted mean (standard error) difference was -4.580 ([1.192]; 95% confidence interval-6.917 to 2.244; P=0.0002). All secondary efficacy results favored OMS302. Specifically, analyses supporting prevention of miosis (patients with ≥6 mm pupil diameter at completion of cortical clean-up and those with <6 mm diameter at any time during surgery) were significant for OMS302 (95.9% versus 77.0% and 9.2% versus 38.0%, respectively; P<0.0001 for each end-point). OMS302 was well tolerated and not associated with any unexpected adverse events. Conclusion: OMS302 maintained mydriasis, prevented miosis, and reduced early postoperative pain when administered in irrigation solution during intraocular lens replacement, with a safety profile similar to that of placebo. OMS302 is preservative-free and bisulfite-free, and its administration does not require any modification to the surgical procedure. [ABSTRACT FROM AUTHOR]