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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jenvman.2010.06.023 Byline: A. Vandenbohede (a), L. Lebbe (a), R. Adams (b), E. Cosyns (c), P. Durinck (d), A. Zwaenepoel (c) Abstract: In dune slacks a close coupling exists between changes in the hydrology and changes in species composition and vegetation structure. Consequently, there is a need to underpin nature restoration projects not only with ecologically relevant knowledge but also with scientifically sound hydrogeological data. In this paper, this necessity is illustrated through a study of the Flemish Nature Reserve 'The Zwindunes and Zwinpolders' (Belgian coastal plain) as an example. The management plan for the nature reserve suggests rewetting part of it to enhance its ecological value. The groundwater aspect was studied by means of field observations and mathematical modelling. First, fresh water head observation showed a mean groundwater flow from the nature reserve to the adjacent polder. Secondly, groundwater quality was studied with borehole measurements and water samples, resulting in a map of the fresh-salt water distribution and of water types. All available information was then put together in a density dependent groundwater flow model. The aim of this model was the description of current flow and fresh-salt water distribution and to simulate the impact of three possible rewetting scenarios. Rewetting will be accomplished by the infiltration of water in a depression, different lay-outs for which are considered. A zoomed in flow model based on a regional model was used to incorporate both local scale, which is of importance to ecology, and the larger scale, which determines general groundwater flow and fresh-salt water distribution. This modelling indicated differences between scenarios and was used to decide on the best rewetting strategy. Author Affiliation: (a) Research Unit Groundwater Modelling, Department of Geology and Soil Science, Ghent University, Krijgslaan 281 (S8), 9000 Gent, Belgium (b) International Marine and Dredging Consultants(IMDC), Coveliersstraat 15, 2600 Antwerpen, Belgium (c) West-Vlaamse Intercommunale(WVI), Baron Ruzettelaan 35, 8310 Brugge, Belgium (d) Grontmij, Meersstraat 138A, 9000 Gent, Belgium Article History: Received 17 July 2009; Revised 31 May 2010; Accepted 29 June 2010

Abstract We have performed extensive testing and qualification of different commercial fast neutron scintillator screens in camera-based imaging detectors. These include organic scintillators and a ZnS:Cu scintillator mixed in a polypropylene (PP) matrix. Furthermore, we have developed simple and inexpensive in-house ZnS-based fast neutron imaging screens and their performance has been tested and compared to the aforementioned commercial ones. Furthermore, ZnS:Ag was mixed with high viscosity glycerol to create suspension type imaging screen. The ZnS concentration and the screen thickness have been optimized experimentally using sample screen pieces. The screens have been tested in spallation and fission spectra. The plastic scintillator performed the worst mainly due to its low light output, while the PP/ZnS screen the best. The in-house ZnS–epoxy screens produced about 60% of light intensity of its commercial counterpart, which is mainly due to the lower hydrogen density of the optical epoxy compared to polypropylene. A simple model of the converter/ZnS screen type was developed to help understand its properties and to optimize its performance. Some fast neutron radiographic images are shown to illustrate the capabilities of the screens. Highlights • Commercial and in-house fast neutron imaging screens were tested in different spectra. • A commercial ZnS/PP scintillator screen shows the highest efficiency in both spectra. • Plastic scintillator slab screen has the lowest efficiency. • A simple analytical model of the screen behavior has been setup. • The model explains the qualitative experimental findings and helps optimizing screen performance. • TRIM simulations show that grain size distribution of ZnS can influence the light yield. [ABSTRACT FROM AUTHOR]

Simple and inexpensive ZnS-based fast neutron imaging screens have been developed and their performance has been tested and compared to a commercially available one using the RAD beamline of the 10 MW research reactor of the Budapest Neutron Centre (BNC), Hungary. ZnS(Ag) and ZnS(Cu) powders have been mixed with optical epoxy, deaerated and casted into sheet form using an aluminum frame. The ZnS concentration and the screen thickness have been optimised using sample screen pieces. The in-house screens have been tested in camera-based neutron imaging detectors in a reactor beamline and compared with a commercially available polypropylene/ZnS(Cu) fast neutron imaging screen and with a BC400 plastic scintillator slab screen. It has been found that the in-house screen produces only about 60 % of light intensity of the commercial polypropylene/ZnS screen, which is mainly due to the lower hydrogen density of the optical epoxy compared to polypropylene by the same amount. The BC400 performs inferior compared to any ZnS-based scintillator tested here. Fast neutron tomography has been performed with both the commercial and the in-house screens on the reactor beamline. A spatial resolution of around 1.6 mm has been achieved. Typically 10–15 min exposures were needed to obtain good quality radiographic images, whereas several hours of acquisition were needed to obtain the full tomographic set images. High quality imaging results have been obtained on large (150 mm in diameter) and dense objects (hydraulic couplings) proving the feasibility and utility of fast neutron imaging for such samples. [ABSTRACT FROM AUTHOR]

• Memory-for-when judgments indicate when in a list an item first appeared and measure a kind of explicit temporal context memory. • Correct memory-for-when during study of items' second occurrence predicted items' final free recall on a later test. • Memory-for-when advantage was mainly driven by superior memory-for-when for items in the primacy region; other items showed no such benefit. • Explicit temporal context information probably doesn't cause the benefits of spaced repetition (though implicit context information or distinctiveness might) A number of temporal context-based theories of the spacing effect assume that temporal context is retrieved during repetitions, allowing better memory on a later test. Since associations in memory are often bidirectional, if we can use temporal context to recall an item, perhaps we can also use the item to explicitly recall its temporal context. If so, explicit memory-for-when during study would be a good predictor of later recall for repeated items. Experiment 1 appeared to be consistent with our predictions; items with memory-for-when during List 2 showed superior recall accuracy on a final free recall test. However, the effect was primarily driven by better memory-for-when in the primacy region. Experiment 2 used an incidental learning procedure during List 1 to reduce this confound since the primacy region is greatly attenuated in incidental learning. While the benefits of having memory-for-when persisted in Experiment 2, they were again attributable solely to the first few items on the list. The results suggest that explicit temporal context information is unlikely to underlie the benefits of spaced repetition. Either temporal context information is strengthened implicitly, our measures of context failed to capture the type of context used in spacing, or other mechanisms entirely produce the benefits of repetition. [ABSTRACT FROM AUTHOR]

Fast neutron imaging was performed using a beamline of the 10 MW research reactor of the Budapest Neutron Centre, Hungary. A simple, low-cost 2D area detector has been used featuring a 8 mm thick BC400 plastic scintillator converter screen and a CCD camera. A spatial resolution of around 1.3 mm has been achieved. Typically 10 min long exposures were needed to obtain reasonable quality radiographic images. For tomographic imaging typically several hours of acquisition were needed to obtain reasonable quality on non-symmetric and larger (e.g. 10 × 10 × 10 cm 3 ) objects. Due to the presence of a significant gamma background at the experimental position, massive (30 cm thick) lead shielding and filtering was applied to the beam. The gamma contribution was mostly baseline independent of the object imaged and therefore could be subtracted, whereas the direct gamma contribution from the beam to the imaging detector signal is estimated to be less than 1%. [ABSTRACT FROM AUTHOR]

Background. In pulmonary lobectomy, video-assisted thoracoscopic surgery (VATS) offers advantages compared with open thoracotomy. However, various issues have limited its adoption, especially in community settings. Single surgeon studies suggest that completely portal robotic lobectomy (CPRL) may address such limitations. This multicenter study evaluates early CPRL experience in 6 community cardiothoracic surgeons' practices. Methods. Perioperative data from each surgeon's initial 20, consecutive and unselected cases of CPRL were retrospectively gathered (total n = 120) and compared with the 2009 and 2010 Society of Thoracic Surgeons database for VATS (n = 4,612) and open (n = 5,913) lobectomy. The χ² and t test procedures were used and significance was defined at the 95% confidence level (p < 0.05). Results. One hundred sixteen lobectomies (96.7%) were completed robotically with a conversion rate of 3.3%. Preoperative patient characteristics were comparable across the CPRL, VATS, and open groups. The CPRL was equivalent to VATS on all intraoperative and postoperative outcomes, and resulted in significantly lower postoperative blood transfusion rates (0.9% vs 7.8%; p = 0.002), air leaks greater than 5 days (5.2% vs 10.8%; p = 0.05), chest tube duration (3.2 days vs 4.8 days; p < 0.001), and length of stay (4.7 days vs 7.3 days; p < 0.001) when compared with open. For these outcomes, results trended favorably for CPRL over VATS. Conclusions. This early CPRL experience reveals a minimally invasive lobectomy technique that is safe and reproducible in varied practice settings. Outcomes were equivalent between CPRL and VATS, trending in favor of robotics. The CPRL was superior in several measures compared with open. The absence of patient selection and low conversion rates suggest a broad applicability of this technique. [ABSTRACT FROM AUTHOR]

Patients in Intensive Care Unit (ICU) often require sedatives which commonly include midazolam and the more recently developed α2-receptor agonist, dexmedetomidine. It was our aim to compare the sedative and clinical effectiveness of dexmedetomidine vs midazolam in adults admitted to ICU, using an objective appraisal of randomized control trials. Medline, Embase, SCOPUS, Web of Knowledge, Cinhal, the United States National Library of Medicine, and the Cochrane Database of Systematic Reviews were searched using keywords: ‘dexmedetomidine’, ‘midazolam’, and ‘intensive care’. These were limited to human studies and adults (>18 yr old). Six randomized controlled trials were found and were critically appraised using a standardized appraisal method. Two papers described the time spent by each intervention group within a specified target sedation range and both found no statistically significant difference between midazolam and dexmedetomidine (P=0.18 and P=0.15). A third paper found no statistically significant difference in the length of time that patients were sedated within a target zone (P=0.445). Two additional pilot studies did not report P values as they were insufficiently statistically powered. A final paper found that, of the eight occasions measured, patients on dexmedetomidine were more often within the target sedation range than patients on midazolam. The sedative benefits of dexmedetomidine vs midazolam remain inconclusive. While some secondary outcomes showed clinical effectiveness of dexmedetomidine, more research is needed to validate the findings of these studies. [ABSTRACT FROM PUBLISHER]

Abstract: The end-of-life (EOL) tests recently performed at the Phenix reactor present a unique opportunity to validate computational tools used for Sodium-cooled Fast Reactor (SFR) static and transient analysis. In the first part of the current study, PSI’s FAST code system – which includes ERANOS and TRACE/PARCS – has been used to analyze test data from the control-rod-shift (CRS) experiments. The second part of the study, presented in a separate paper, is devoted to an analysis of the unprotected phase of the Natural Convection (NC) Test. Both tests have been studied in the framework of international benchmark exercises organized by the IAEA. A static model of the Phenix core was first developed with ERANOS. This was used (i) for direct comparison with the CRS test data and (ii) to prepare the macroscopic reference cross-sections and their derivatives for use in the 3D neutron kinetics PARCS model. A coupled TRACE/PARCS static model was then developed and verified against ERANOS results. The power deformations resulting from the different control rod (CR) positions calculated with both models have been found to agree very well with the experimental data, showing that the control rods were accurately modeled. This analysis has thus provided valuable additional validation of the SFR modeling capabilities of ERANOS and TRACE/PARCS as implemented within the FAST code system. [Copyright &y& Elsevier]

OBJECTIVE: To examine the population distribution of different types of relationships between people with chronic conditions and their doctors that influence decisions being made from a shared-decision making perspective. METHODS: A survey questionnaire based on recurring themes about the doctor/patient relationship identified from qualitative in-depth interviews with people with chronic conditions and doctors was administered to a national population sample (n=999) of people with chronic conditions. RESULTS: Three factors explained the doctor/patient relationship. Factor 1 identified a positive partnership characteristic of involvement and shared decision-making; Factor 2 doctor-controlled relationship; Factor 3 relationship with negative dimensions. Cluster analysis identified four population groups. Cluster 1 doctor is in control (9.7% of the population); Cluster 2 ambivalent (27.6%); Cluster 3 positive long-term relationship (58.6%); Cluster 4 unhappy relationship (4.4%). The proportion of 18-34 year olds is significantly higher than expected in Cluster 4. The proportion of 65+ year olds is significantly higher than expected in Cluster 1, and significantly lower than expected in Cluster 4. CONCLUSION: This study adds to shared decision-making literature in that it shows in a representative sample of people with chronic illnesses how their perceptions of their experiences of the doctor-patient relationship are distributed across the population. PRACTICE IMPLICATIONS: Consideration needs to be given as to whether it is better to help doctors to alter their styles of interactions to suit the preferences of different patients or if it is feasible to match patients with doctors by style of decision-making and patient preference. [ABSTRACT FROM AUTHOR]

We recently characterized Winnie mice carrying a missense mutation in Muc2, leading to severe endoplasmic reticulum stress in intestinal goblet cells and spontaneous colitis. In this study, we characterized the immune responses due to this intestinal epithelial dysfunction. In Winnie, there was a fourfold increase in activated dendritic cells (DCs; CD11c+ major histocompatibility complex (MHC) class IIhi) in the colonic lamina propria accompanied by decreased colonic secretion of an inhibitor of DC activation, thymic stromal lymphopoietin (TSLP). Winnie also displayed a significant increase in mRNA expression of the mucosal TH17 signature genes Il17a, IL17f, Tgfb, and Ccr6, particularly in the distal colon. Winnie mesenteric lymph node leukocytes secreted multiple TH1, TH2, and TH17 cytokines on activation, with a large increase in interleukin-17A (IL-17A) progressively with age. A major source of mucosal IL-17A in Winnie was CD4+ T lymphocytes. Loss of T and B lymphocytes in Rag1-/- × Winnie (RaW) crosses did not prevent spontaneous inflammation but did prevent progression with age in the colon but not the cecum. Adoptive transfer of naive T cells into RaW mice caused more rapid and severe colitis than in Rag1-/-, indicating that the epithelial defect results in an intestinal microenvironment conducive to T-cell activation. Thus, the Winnie primary epithelial defect results in complex multicytokine-mediated colitis involving both innate and adaptive immune components with a prominent IL-23/TH17 response, similar to that of human ulcerative colitis. [ABSTRACT FROM AUTHOR]

UCB Selected Lymphocyte Antibody Method (SLAM) is a rapid and efficient process for the generation of high-quality monoclonal antibodies, in which variable region gene sequences are recovered directly from specific, single B cells. Monoclonal antibody generation has been limited in the past by the relatively low efficiency of the hybridoma process. UCB SLAM process is well suited to high-throughput screening and has been extensively automated at UCB. If necessary, in excess of 1×109 B cells can be screened in a campaign, to discover a rare therapeutic antibody candidate, which meets the stringent selection criteria. Primary screening for antigen binders, on purified or cell expressed antigen, is performed using a homogeneous fluorescence assay format. Supernatants from positive wells are consolidated to allow further secondary screening and selection of antibodies with desired characteristics. Individual, specific B cells are identified using a fluorescence based method and isolated using a micromanipulator. The antibody variable region genes are cloned from DNA extracted from the single B cell. The genes are sequenced then prepared for transient expression to confirm activity. Antibodies with affinities (KD) in the sub 10 pM range against a range of therapeutic targets are routinely recovered using this process. [ABSTRACT FROM AUTHOR]

Abstract: Interleukin-13 (IL-13) sequentially binds to IL-13Rα1 and IL-4Rα forming a high affinity signalling complex. This receptor complex is expressed on multiple cell types in the airway and signals through signal transducer and activator of transcription factor-6 (STAT-6) to stimulate the production of chemokines, cytokines and mucus. Antibodies have been generated, using the UCB Selected Lymphocyte Antibody Method (UCB SLAM), that block either binding of murine IL-13 (mIL-13) to mIL-13Rα1 and mIL-13Rα2, or block recruitment of mIL-4Rα to the mIL-13/mIL-13Rα1 complex. Monoclonal antibody (mAb) A was shown to bind to mIL-13 with high affinity (K D 11 pM) and prevent binding of mIL-13 to mIL-13Rα1. MAb B, that also bound mIL-13 with high affinity (K D 8 pM), was shown to prevent recruitment of mIL-4Rα to the mIL-13/mIL-13Rα1 complex. In vitro, mAbs A and B similarly neutralised mIL-13-stimulated STAT-6 activation and TF-1 cell proliferation. In vivo, mAbs A and B demonstrated equipotent, dose-dependent inhibition of eotaxin generation in mice stimulated by intraperitoneal administration of recombinant mIL-13. In an allergic lung inflammation model in mice, mAbs A and B equipotently inhibited muc5ac mucin mRNA upregulation in lung tissue measured two days after intranasal allergen challenge. These data support the design of therapeutics for the treatment of allergic airway disease that inhibits assembly of the high affinity IL-13 receptor signalling complex, by blocking the binding of IL-13 to IL-13Rα1 and IL-13Rα2, or the subsequent recruitment of IL-4Rα. [Copyright &y& Elsevier]

In this article, we study the Cauchy Problem associated to the generalized cubic–quintic Schrödinger equation which has been used for the description of propagation pulses in optical fibers. Using gauge transforms and a derivation process, we prove under some regularity assumptions, the local well-posedness. Additionally, a global H 1 bound is established for the solution. [ABSTRACT FROM AUTHOR]

Summary: Aim of the study: Early cooling of resuscitated patients improves neurological outcome. Out-of hospital initiation of cooling is uncommon however for mainly practical reasons. Using burn dressings in the out-of-hospital care could initiate brain cooling in an early stage and therefore be of value; the method is easily adaptable by ambulance crews. The influence of burn dressings on brain temperature is however unknown. We determined tympanic temperature changes as proxy for brain temperature in healthy volunteers after the application of cooling dressings to face and neck as a proof of concept study. Method: In 10 healthy human volunteers tympanic temperatures were measured in 30s intervals before, during and after the application of burn-dressings, special trauma burn-care dressings that are designed for the acute treatment of skin burns (Burnshield® emergency burn care sterile trauma burn dressings, Burnshield Ltd., Wadefield, South Africa) for the duration of 20min for each episode. Results: In all study subjects the tympanic temperature was significantly lowered after 20min of the application of the burnshields. The mean difference between baseline and 2nd half of the exposure period was 0.43°C (p <0.0001), ranging from 0.10 to 1.18°C. Conclusion: Burn dressings could be of value in the early initiation of brain cooling in resuscitated patients. This study warrants further research to the effect of burnshield dressings on neurological activity and the effect on outcome after resuscitation. [Copyright &y& Elsevier]

Recent international consensus guidelines propose that cystic pancreatic tumors less than 3 cm in size in asymptomatic patients with no radiographic features concerning for malignancy are safe to observe; however, there is little published data to support this recommendation. The purpose of this study was to determine the prevalence of malignancy in this group of patients using pancreatic resection databases from five high-volume pancreatic centers to assess the appropriateness of these guidelines. All pancreatic resections performed for cystic neoplasms < or =3 cm in size were evaluated over the time period of 1998-2006. One hundred sixty-six cases were identified, and the clinical, radiographic, and pathological data were reviewed. The correlation with age, gender, and symptoms (abdominal pain, nausea and vomiting, jaundice, presence of pancreatitis, unexplained weight loss, and anorexia), radiographic features suggestive of malignancy by either computed tomography, magnetic resonance imaging, or endoscopic ultrasound (presence of solid component, lymphadenopathy, or dilated main pancreatic duct or common bile duct), and the presence of malignancy was assessed using univariate and multivariate analysis. Among the 166 pancreatic resections for cystic pancreatic tumors < or =3 cm, 135 cases were benign [38 serous cystadenomas, 35 mucinous cystic neoplasms, 60 intraductal papillary mucinous neoplasms (IPMN), 1 cystic papillary tumor, and 1 cystic islet cell tumor], whereas 31 cases were malignant (14 mucinous cystic adenocarcinomas and 13 invasive carcinomas and 4 in situ carcinomas arising in the setting of IPMN). A greater incidence of cystic neoplasms was seen in female patients (99/166, 60%). Gender was a predictor of malignant pathology, with male patients having a higher incidence of malignancy (19/67, 28%) compared to female patients (12/99, 12%; p < 0.02). Older age was associated with malignancy (mean age 67 years in patients with malignant disease vs 62 years in patients with benign lesions (p < 0.05). A majority of the patients with malignancy were symptomatic (28/31, 90%). Symptoms that correlated with malignancy included jaundice (p < 0.001), weight loss (p < 0.003), and anorexia (p < 0.05). Radiographic features that correlated with malignancy were presence of a solid component (p < 0.0001), main pancreatic duct dilation (p = 0.002), common bile duct dilation (p < 0.001), and lymphadenopathy (p < 0.002). Twenty-seven of 31(87%) patients with malignant lesions had at least one radiographic feature concerning for malignancy. Forty-five patients (27%) were identified as having asymptomatic cystic neoplasms. All but three (6.6%) of the patients in this group had benign disease. Of the patients that had no symptoms and no radiographic features, 1 out of 30 (3.3%) had malignancy (carcinoma in situ arising in a side branch IPMN). Malignancy in cystic neoplasms < or =3 cm in size was associated with older age, male gender, presence of symptoms (jaundice, weight loss, and anorexia), and presence of concerning radiographic features (solid component, main pancreatic duct dilation, common bile duct dilation, and lymphadenopathy). Among asymptomatic patients that displayed no discernable radiographic features suggestive of malignancy who underwent resection, the incidence of occult malignancy was 3.3%. This study suggests that a group of patients with small cystic pancreatic neoplasms who have low risk of malignancy can be identified, and selective resection of these lesions may be appropriate. [ABSTRACT FROM AUTHOR]

Abstract: The authors have previously developed a novel joint that consists of two adhesives, one better at low temperatures (−55°C) and the other for high temperatures (200°C). They have shown that this technique enables the design of a joint with a higher load capacity than a joint with only one adhesive, especially for dissimilar adherends. They studied the case of a double-lap joint where the outer adherends were titanium and the inner adherend was a carbon fibre-reinforced bismaleimide. However, they found that at low temperatures, the joint strength was low because the composite failed first and did not allow the adhesive to develop its full shear strength capacity. This paper presents techniques that were investigated to decrease the transverse stresses in the composite and so to increase the joint strength, particularly at low temperatures, thus making the use of a mixed adhesive joint more justifiable. Experimental tests and a finite-element analysis of double-lap joints have shown that it is more advantageous to have the composite as the outer adherend than having the composite as the inner adherend in conjunction with an internal taper in the external metallic adherends and an adhesive fillet. [Copyright &y& Elsevier]

Abstract: Aims: Combined modality therapy (with chemotherapy±radiotherapy) has become a standard treatment for locally advanced oesophageal cancer. However, there appears to be no compelling evidence for one treatment type or combination to suit all and at this time the clinical multi-disciplinary team (MDT) forms an important role in selecting optimal therapies for the individual. This prospective comparison in one cancer network, looks at the outcomes of this decision making process. Methods: Over a five year period 1998–2003, data were prospectively collected on all 330 consecutive patients, referred to a tertiary specialised MDT for whom curative treatment was the planned intent. Patients were managed according to an agreed local protocol and allocated to receive one of 5 treatments: surgery alone (S), pre-operative chemotherapy (C+S), pre-operative chemo-radiotherapy (CRT+S), definitive chemo-radiotherapy (CRT) and radiotherapy alone (RT). Results: The 2 and 5year survival for all patients receiving potentially curative treatment were 49% and 26% respectively. With 2 and 5year survival for S, CRT+S, C+S, CRT and RT being 53,21; 57,40; 37,27; 50,27; 23,0months respectively. Of the surgical therapies, mortality was highest in the CRT+S group, versus C+S and S; 12.5%, 1.6%, 4.5% respectively (p =0.025). Non-surgical based therapies had more than double the incidence of local relapses compared to surgical based therapies; however the CRT group had an overall survival comparable with S alone. The commonest sites of distant relapse were liver (56%), lung (38%), bone (32%) and non-regional lymph nodes (24%). Conclusion: The results suggest that in patients who are deemed unfit for surgical intervention, definitive chemoradiotherapy remains a viable alternative; they also lend further support to selected case triple modality therapy. These areas should be further examined in the context of randomised controlled phase III trials. [Copyright &y& Elsevier]