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Background: Adnexal torsion (AT), a serious gynaecological emergency, often presents with non‐specific symptoms leading to delayed diagnosis. Objective: To compare the test accuracy of ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose AT. Search strategy: We searched EMBASE, MEDLINE and Cochrane CENTRAL until December 2019. Selection criteria: Studies reporting on the accuracy of any imaging modality (Index Test) in female patients (paediatric and adult) suspected of AT compared with surgical diagnosis and/or standard clinical/radiological follow‐up period until resolution of symptoms (Reference Standard). Data collection and analysis: We assessed study quality using QUADAS‐2. We conducted test accuracy meta‐analysis using a univariate model or a hierarchical model. Main results: We screened 3836 citations, included 18 studies (1654 women, 665 cases), and included 15 in the meta‐analyses. Ultrasound pooled sensitivity (n = 12, 1187 women) was 0.79 (95% CI 0.63–0.92) and specificity was 0.76 (95% CI 0.54–0.93), with negative and positive likelihood ratios of 0.29 (95% CI 0.13–0.66) and 4.35 (95% CI 2.03–9.32), respectively. Using Doppler with ultrasound (n = 7, 845 women) yielded similar sensitivity (0.80, 95% CI 0.67–0.93) and specificity (0.88, 95% CI 0.72–1.00). For MRI (n = 3, 99 women), the pooled sensitivity was 0.81 (95% CI 0.63–0.91) and specificity was 0.91 (95% CI 0.80–0.96). A meta‐analysis for CT was not possible with two case‐control studies and one cohort study (n = 3, 232 women). Its sensitivity range was 0.74–0.95 and specificity was 0.80–0.90. Conclusions: Ultrasound has good performance as a first‐line diagnostic test for suspected AT. Magnetic resonance imaging could offer improved specificity to investigate complex ovarian morphology, but more evidence is needed. To investigate adnexal torsion, ultrasound is a good first‐line diagnostic test with a pooled sensitivity of 0.79 and specificity of 0.76. To investigate adnexal torsion, ultrasound is a good first‐line diagnostic test with a pooled sensitivity of 0.79 and specificity of 0.76. [ABSTRACT FROM AUTHOR]

Chloride ( Cl) ions diffuse into iron objects during burial and drive corrosion after excavation. Located under corrosion layers, Cl is inaccessible to many analytical techniques. Neutron analysis offers non-destructive avenues for determining Cl content and distribution in objects. A pilot study used prompt gamma activation analysis ( PGAA) and prompt gamma activation imaging ( PGAI) to analyse the bulk concentration and longitudinal distribution of Cl in archaeological iron objects. This correlated with the object corrosion rate measured by oxygen consumption, and compared well with Cl measurement using a specific ion meter. High- Cl areas were linked with visible damage to the corrosion layers and attack of the iron core. Neutron techniques have significant advantages in the analysis of archaeological metals, including penetration depth and low detection limits. [ABSTRACT FROM AUTHOR]

We use a CGE model to simulate the effects of a one-year US border closure. Relative to previously used input-output modeling, CGE modeling offers a flexible framework for capturing bottleneck and labor-market effects. Our analysis suggests that the costs of a prolonged closure could be much greater than indicated by input-output studies. We find that cutting all imports by 95% in an environment of sticky real wages would reduce GDP by 48%. However, if bottleneck imports (mainly oil) were exempt and workers accepted real wage cuts then the GDP reduction would be only 11%. [ABSTRACT FROM AUTHOR]

Larval and juvenile barramundi, Lates calcarifer (Bloch), were reared intensively on test diets comprising nutritionally supplemented and unsupplemented rotifers, Brachionus plicatilis Muller, and brine shrimp, Artemia salina L. Both growth and survival of barramundi larvae fed on nutritionally supplemented brine shrimp were superior to those of larvae fed on untreated brine shrimp. Barramundi larvae fed diets incorporating untreated brine shrimp exhibited a mortality syndrome which commenced from 20 to 30 days after hatching and resulted in almost total mortality within the next 10 days. Analyses of the proximate, fatty acid and amino acid composition of the live food organisms used in the test diets, and reference samples comprising barramundi egg yolk and extensively reared juvenile barramundi, suggest that this mortality syndrome was primarily associated with the fatty acid composition of the food organisms, particularly the relative amount of 20:5n-3 in the brine shrimp fed to the larvae. These results, and the work of other authors, indicate that there are two mortality syndromes which affect intensively cultured L. calcarifer larvae. [ABSTRACT FROM AUTHOR]

The endangered Australian freshwater fish trout cod, Maccullochella macquariensis (Cuvier), was the subject of a captive breeding programme to produce fry for reintroduction into the wild. Trout cod broodfish were maintained in earthen ponds for up to 5 years and underwent gonadal maturation each spring but did not spawn in the ponds. Infestations of the protozoan parasite Chilodonella hexasticha caused the death of at least 21 broodfish. Mature fish, removed from ponds when water temperatures had reached or exceeded 16°C, had a higher proportion of atretic oocytes and fewer fish spawned successfully compared to fish removed at lower temperatures. Ovulation was induced by a single injection of 1000-3000 iu/kg HCG. Between 1188 and 11338 eggs ranging from 2.5 to 3.6 mm in diameter were stripped from individual fish. Hatching commenced on days 5-9 and continued for up to 10 days (at 15.5-23°C). Larvae commenced feeding on days 21-25. Trout cod larvae were grown out to fry (36.3-48.6mm total length [TL]) in fertilized fry rearing ponds then released. Between 1986 and 1989, 8420 trout cod fry were released into several sites in the upper Murray River and upper Murrumbidgee River, and reports indicate that released fish are surviving. [ABSTRACT FROM AUTHOR]

It is accepted that care must be taken in initiating testosterone replacement in hypogonadal individuals with historically low androgen levels. However less is reported about the influence of restoration of normal endogenous testosterone production on behaviour. Here we report how the adverse sequelae of successful treatment of hypogonadism secondary to hyperprolactinaemia, manifesting as irritability and low threshold to aggression, were managed through a joint approach between psychiatrist and physician. [ABSTRACT FROM AUTHOR]

In this prospective, randomized study we assessed the use of cold therapy after arthroscopic anterior cruciate ligament reconstruction. Seventy-one patients were randomly allocated, without the knowledge of the single surgeon, to one of three groups: Group I had an ice water-filled CryoCuff fitted in the operating theater after surgery, Group II had room temperature water in the CryoCuff, and Group III patients had no CryoCuff. Patients were well matched for age, sex, and associated surgery. An independent observer measured blood loss, analgesic use, range of motion, and visual analog pain scores postoperatively. There were no differences between any of the three groups regarding the variables measured. The use of cold therapy devices as an adjunct to the postoperative management of these patients must be questioned. [ABSTRACT FROM AUTHOR]

Presents an article about the Mental Health Act 1983. Discussion on the right to appeal against detention; Details on the issue of capacity in relation to hospital admission and treatment; Vulnerability of incapacitated patients.