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Severe obesity is increasingly common in youth and young adults, but outcomes following bariatric surgery remain largely unknown. The purpose of this study was to examine the trends, clinical characteristics, and postoperative outcomes of youth who underwent bariatric surgery. This retrospective cohort study was conducted using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data registry from 2015 to 2018 inclusive. All youth and young adults aged 15–24 who underwent elective sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) were included. Bivariate analysis of trends, clinical characteristics, and postoperative outcomes was performed using Chi-squared tests for categorical variables and independent two sample t test for continuous variables. Multivariable logistic regression modeling was used to determine patient and operative factors predictive of serious complications. A total of 21,592 youth and young adults underwent bariatric surgery during the study time frame, representing 3.7% of total cases (n = 583,567) within the MBSAQIP. The cohort had a mean age of 21.5 ± 2.0 years and a mean BMI of 47.2 ± 8.0 kg/m2 and were predominantly female (84%). A relatively constant number of youth and young adult cases per hospital were observed over time (7.4 cases/center in 2015 vs. 6.7 cases/center in 2018). Overall

TP53 mutations are implicated in the progression of mucinous borderline tumors (MBOT) to mucinous ovarian carcinomas (MOC). Optimized immunohistochemistry (IHC) for TP53 has been established as a proxy for the TP53 mutation status in other ovarian tumor types. We aimed to confirm the ability of TP53 IHC to predict TP53 mutation status in ovarian mucinous tumors and to evaluate the association of TP53 mutation status with survival among patients with MBOT and MOC. Tumor tissue from an initial cohort of 113 women with MBOT/MOC was stained with optimized IHC for TP53 using tissue microarrays (75.2%) or full sections (24.8%) and interpreted using established criteria as normal or abnormal (overexpression, complete absence, or cytoplasmic). Cases were considered concordant if abnormal IHC staining predicted deleterious TP53 mutations. Discordant tissue microarray cases were re-evaluated on full sections and interpretational criteria were refined. The initial cohort was expanded to a total of 165 MBOT and 424 MOC for the examination of the association of survival with TP53 mutation status, assessed either by TP53 IHC and/or sequencing. Initially, 82/113 (72.6%) cases were concordant using the established criteria. Refined criteria for overexpression to account for intratumoral heterogeneity and terminal differentiation improved concordance to 93.8% (106/113). In the expanded cohort, 19.4% (32/165) of MBOT showed evidence for TP53 mutation and this was associated with a higher risk of recurrence, disease-specific death, and all-cause mortality (overall survival: HR = 4.6, 95% CI 1.5-14.3, p = 0.0087). Within MOC, 61.1% (259/424) harbored a TP53 mutation, but this was not associated with survival (overall survival, p = 0.77). TP53 IHC is an accurate proxy for TP53 mutation status with refined interpretation criteria accounting for intratumoral heterogeneity and terminal differentiation in ovarian mucinous tumors. TP53 mutation status is an important biomarker to identify MBOT with a higher risk of mortality.

In pursuit of socioeconomic development, many countries are expanding oil and mineral extraction into tropical forests. These activities seed access to remote, biologically rich areas, thereby endangering global biodiversity. Here we demonstrate that conservation solutions that effectively balance the protection of biodiversity and economic revenues are possible in biologically valuable regions. Using spatial data on oil profits and predicted species and ecosystem extents, we optimise the protection of 741 terrestrial species and 20 ecosystems of the Ecuadorian Amazon, across a range of opportunity costs (i.e. sacrifices of extractive profit). For such an optimisation, giving up 5% of a year's oil profits (US$ 221 million) allows for a protected area network that retains of an average of 65% of the extent of each species/ecosystem. This performance far exceeds that of the network produced by simple land area optimisation which requires a sacrifice of approximately 40% of annual oil profits (US$ 1.7 billion), and uses only marginally less land, to achieve equivalent levels of ecological protection. Applying spatial statistics to remotely sensed, historic deforestation data, we further focus the optimisation to areas most threatened by imminent forest loss. We identify Emergency Conservation Targets: areas that are essential to a cost-effective conservation reserve network and at imminent risk of destruction, thus requiring urgent and effective protection. Governments should employ the methods presented here when considering extractive led development options, to responsibly manage the associated ecological-economic trade-offs and protect natural capital. Article Impact Statement: Governments controlling resource extraction from tropical forests can arrange production and conservation to retain biodiversity and profits. This article is protected by copyright. All rights reserved.

Background Intraoperative assessment of the extent and location of Crohn’s disease is not standardised and relies on a mixture of surgeons’ experience, tactile feedback and macroscopic appearance. To overcome this variability, we developed a protocol for full intraoperative ultrasound scan of the small bowel and we here report the results of “Assessing the Feasibility and Safety of Using Intraoperative Ultrasound in Ileocolic Crohn’s Disease—The IUSS CROHN Study”. Methods This is a prospective single centre observational study with enrolment of all patients undergoing elective surgery for terminal ileal Crohn’s disease from January 2019 to March 2020. Patients underwent laparoscopic ileocolic resection, according to a standardised technique. Ultrasound intraoperative quantitative assessment was performed according to the METRIC (MREnterography or ulTRasound in Crohn’s disease) scoring guide. Results Intraoperative ultrasound was successfully performed in 6 patients from the ileocaecal valve to the proximal jejunum. The median time required was 23.5 min (range 17–37 min) as compared to 6.5 min (5–12 min) required for the macroscopic evaluation performed by the surgeon. In 3 patients, intraoperative ultrasound identified more disease than surgical evaluation. Conclusions This feasibility study demonstrated the safety of intraoperative ultrasound and allowed the development of a standardised protocol for intraoperative ultrasound and the data collection required to inform a randomised multicentre study.

Measurement of the psoas muscle area has been applied to estimate lean muscle mass as a surrogate marker of sarcopenia, but there is a paucity of evidence regarding the influence of sarcopenia on clinical outcomes following inflammatory bowel disease surgery. The aim of this study was to evaluate the association between MRI enterography defined sarcopenia and postoperative complications in patients undergoing elective ileocaecal resection for Crohn’s disease. To obtain cross sectional area measurement of the psoas muscle, the freehand area tool was used to trace the margin of each psoas muscle at the level of L4, with the sum recorded as Total Psoas Area (TPA). The total cross sectional muscle area of the abdominal wall was recorded as Skeletal Muscle Area (SMA), while myosteatosis was measured by normalising the psoas muscle intensity with the mean intensity of the cerebrospinal fluid. The primary outcome was the incidence of 30-day postoperative complications in patients in the lowest quartile of TPA and SMA. 31 patients were included and ten patients (32.25%) developed postoperative complications within 30 days of surgery. The cut-off values for the lowest quartile for TPA were 11.93 cm2 in men and 9.77 cm2 in women, including a total of 8 patients (25.8%) with 5 patients in this group (62.5%) developing postoperative complications and 3 patients (37.5%) Clavien-Dindo class ≥ 3 complications. The cut-off values for the lowest quartile for SMA were 73.49 cm2 in men and 65.85 cm2 in women, with 4 patients out of 8 (50%) developing postoperative complications. Psoas muscle cross sectional area and skeletal mass area can be estimated on Magnetic Resonance Enterography as surrogate markers of sarcopenia with high inter-observer agreement.

Background Although beta‐blockers are recommended following myocardial infarction (MI), the benefits of long‐term treatment have not been established. The study's aim was to evaluate beta‐blocker efficacy by dose in 1‐year post‐MI survivors. Methods and Results The OBTAIN (Outcomes of Beta‐Blocker Therapy After Myocardial Infarction) registry included 7057 patients with acute MI, with 6077 one‐year survivors. For this landmark analysis, beta‐blocker dose status was available in 3004 patients and analyzed by use (binary) and dose at 1 year after MI. Doses were classified as no beta‐blocker and >0% to 12.5%, >12.5% to 25%, >25% to 50%, and >50% of target doses used in randomized clinical trials. Age was 63 to 64 years, and approximately two thirds were men. Median follow‐up duration was 1.05 years (interquartile range, 0.98–1.22). When analyzed dichotomously, beta‐blocker therapy was not associated with improved survival. When analyzed by dose, propensity score analysis showed significantly increased mortality in the no–beta‐blocker group (hazard ratio,1.997; 95% CI, 1.118–3.568; P 0% to 12.5% group (hazard ratio, 1.817; 95% CI, 1.094–3.016; P 25% to 50% group (hazard ratio, 1.764; 95% CI, 1.105–2.815; P 12.5% to 25% dose group. The mortality in the full‐dose group was not significantly higher (hazard ratio, 1.196; 95% CI, 0.687–2.083). In subgroup analyses, only history of congestive heart failure demonstrated significant interaction with beta‐blocker effects on survival. Conclusions This analysis suggests that patients treated with >12.5% to 25% of the target dose used in prior randomized clinical trials beyond 1 year after MI may have enhanced survival compared with no beta‐blocker and other beta‐blocker doses. A new paradigm for post‐MI beta‐blocker therapy is needed that addresses which patients should be treated, for how long, and at what dose.

The rate of change in the relative size of SOC pools (sensitivity) due to land management may vary depending on their level of chemical and/or physical protection from decomposition, but has rarely been directly measured. The availability of archived (1975) soils from an abandoned long term tillage treatment experiment provided a unique opportunity to assess the sensitivity of SOC pools with different levels of stability to uniform land management after divergent tillage treatments. There were four initial treatments (1968–1991): 1) deep plough then no till, 2) shallow plough, 3) reduced till then rotary cultivation and 4) no till. The treatments were followed by uniform long-term grassland management (17 years) and subsequent short-term arable (two years). The sensitivity of SOC to land management was assessed by fractionation and direct comparison of archived soils and soils sampled in 2014 from this site. Both reductions and increases in SOC stocks were observed over time in comparable treatments but the overall effect was a trend towards an equilibration of SOC stocks across all plots. The labile fractions (particulate and dissolved organic matter) were sensitive to land management regardless of initial tillage treatment, but were more sensitive in the reduced till + rotary cultivation and no till treatments (2.3–5.3 times more sensitive than the whole soil) than the deep plough + no till and shallow plough treatments (1.12.2 times more sensitive than the whole soil). The chemically resistant fraction of the soils was surprisingly sensitive to land management (0.9–1.3 times more sensitive than the whole soil). This study shows that the degree of sensitivity of SOC fractions to land management can vary significantly depending on previous tillage management practices.

Purpose: Soft tissue sarcomas (STS) represent a heterogeneous group of diseases, and selection of individualized treatments remains a challenge. The goal of this study was to determine whether radiomic features extracted from magnetic resonance (MR) images are independently associated with overall survival (OS) in STS. Methods and Materials: This study analyzed 2 independent cohorts of adult patients with stage II-III STS treated at center 1 (N=165) and center 2 (N=61). Thirty radiomic features were extracted from pretreatment T1-weighted contrast-enhanced MR images. Prognostic models for OS were derived on the center 1 cohort and validated on the center 2 cohort. Clinical-only (C), radiomics-only (R), and clinical and radiomics (C+R) penalized Cox models were constructed. Model performance was assessed using Harrell's concordance index. Results: In the R model, tumor volume (hazard ratio [HR], 1.5) and 4 texture features (HR, 1.1-1.5) were selected. In the C+R model, both age (HR, 1.4) and grade (HR, 1.7) were selected along with 5 radiomic features. The adjusted c-indices of the 3 models ranged from 0.68 (C) to 0.74 (C+R) in the derivation cohort and 0.68 (R) to 0.78 (C+R) in the validation cohort. The radiomic features were independently associated with OS in the validation cohort after accounting for age and grade (HR, 2.4; P=.009). Conclusions: This study found that radiomic features extracted from MR images are independently associated with OS when accounting for age and tumor grade. The overall predictive performance of 3-year OS using a model based on clinical and radiomic features was replicated in an independent cohort. Optimal models using clinical and radiomic features could improve personalized selection of therapy in patients with STS.

AimsPatients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality.Method and resultsWe used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existent heart disease and in-hospital mortality. 16,511 patients with COVID-19 were included (21.1% aged 66 – 75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male and often had other comorbid conditions when compared to those without. Mortality was higher in patients with cardiac disease (29.7%; n=1545 versus 15.9%; n=1797). However, following multivariable adjustment this difference was not significant (adjusted risk ratio (aRR) 1.08 [95% CI 1.02 – 1.15; p-value 0.12 (corrected for multiple testing)]). Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure aRR (1.19 [1.10 – 1.30]; p-value ConclusionConsiderable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare.

With the EV market set to grow rapidly over the coming years, the industry faces a challenging ramp-up of volume and material performance demands. From the current trend towards high-energy high-nickel cathode materials, driven in-part by consumer range anxiety, to the emergence of solid-state and beyond lithium ion technologies, herein we review the changing requirements for active materials in automotive lithium ion battery applications, and how science and industry is set to respond.

Low bone mineral density (BMD) is a significant comorbidity in Alzheimer's disease (AD) and may reflect systemic regulatory pathway dysfunction. Low BMD has been identified in several AD mouse models selective for amyloid-β or tau pathology, but these deficits were attributed to diverse mechanisms. In this study, we identified common pathophysiological mechanisms accounting for bone loss and neurodegeneration in the htau mouse, a tauopathy model with an early low BMD phenotype. We investigated the Wnt/β-catenin pathway—a cellular signaling cascade linked to both bone loss and neuropathology. We showed that low BMD persisted in male htau mice aged from 6 to 14 months, remaining significantly lower than tau-null and C57BL/6J controls. Osteogenic gene expression in female and male htau mice was markedly reduced from controls, indicating impaired bone remodeling. In both the bone and brain, htau mice showed alterations in Wnt/β-catenin signaling genes suggestive of increased inhibition of this pathway. These findings implicate dysfunctional Wnt signaling as a potential target for addressing bone loss in AD.

Objective: To evaluate myeloid differentiation primary response gene 88 (MyD88) and Toll-like receptor 4 (TLR4) expression in relation to clinical features of epithelial ovarian cancer, histologic subtypes, and overall survival. Patients and Methods: We conducted centralized immunohistochemical staining, semi-quantitative scoring, and survival analysis in 5263 patients participating in the Ovarian Tumor Tissue Analysis consortium. Patients were diagnosed between January 1, 1978, and December 31, 2014, including 2865 high-grade serous ovarian carcinomas (HGSOCs), with more than 12,000 person-years of follow-up time. Tissue microarrays were stained for MyD88 and TLR4, and staining intensity was classified using a 2-tiered system for each marker (weak vs strong). Results: Expression of MyD88 and TLR4 was similar in all histotypes except clear cell ovarian cancer, which showed reduced expression compared with other histotypes (P

Globally soil quality and food security continue to decrease indicating that agriculture and the food system need to adapt. Improving connection to the soil by knowledge exchange can help achieve this. We propose a framework of three types of connections that allow the targeting of appropriate messages to different groups of people. Direct connection by, for example, handling soil develops soil awareness for management that can be fostered by farmers joining groups on soil-focused farming such as organic farming or no-till. Indirect connections between soil, food and ecosystem services can inform food choices and environmental awareness in the public and can be promoted by, for example, gardening, education and art. Temporal connection revealed from past usage of soil helps to bring awareness to policy workers of the need for the long-term preservation of soil quality for environmental conservation. The understanding of indirect and temporal connections can be helped by comparing them with the operations of the networks of soil organisms and porosity that sustain soil fertility and soil functions.

A systematic and structured ultrasound scan (USS) evaluation of the entire small bowel is feasible intraoperatively during ileocolic Crohn’s disease (CD) surgery as we have previously reported [1]. Our video demonstrates the ultrasound assessment performed via a 4 cm midline laparotomy used for specimen extraction, extracorporeal control of the mesentery and fashioning of the anastomosis. The right colon and terminal ileum have been fully mobilised laparoscopically with a medial approach and the main steps of the laparoscopic procedure are also demonstrated in the video, with focus on anatomical landmarks and take down of the hepatic flexure.

Background: Obesity is a major world-wide epidemic which has led to a surge of various weight loss-inducing medical or surgical treatments. Orlistat is a gastrointestinal lipase inhibitor used as an adjunct treatment of obesity and type 2 diabetes mellitus to induce clinically significant weight loss via fat malabsorption. Case Presentation: We describe a case of a 76-year-old female with past medical history of chronic kidney disease (baseline serum creatinine was 1.5-2.5 mg/dL), hypertension, gout and psoriatic arthritis, who was admitted for evaluation of elevated creatinine, peaking at 5.40 mg/dL. She was started on orlistat 120 mg three times a day six weeks earlier. Initial serologic work-up remained unremarkable. Percutaneous kidney biopsy revealed massive calcium oxalate crystal depositions with acute tubular necrosis and interstitial inflammation. Serum oxalate level returned elevated at 45 mm/l (normal

SUMMARYIncreasing recognition of the extent to which nitrous oxide (N2O) contributes to climate change has resulted in greater demand to improve quantification of N2O emissions, identify emission sources and suggest mitigation options. Agriculture is by far the largest source and grasslands, occupying c. 0·22 of European agricultural land, are a major land-use within this sector. The application of mineral fertilizers to optimize pasture yields is a major source of N2O and with increasing pressure to increase agricultural productivity, options to quantify and reduce emissions whilst maintaining sufficient grassland for a given intensity of production are required. Identification of the source and extent of emissions will help to improve reporting in national inventories, with the most common approach using the IPCC emission factor (EF) default, where 0·01 of added nitrogen fertilizer is assumed to be emitted directly as N2O. The current experiment aimed to establish the suitability of applying this EF to fertilized Scottish grasslands and to identify variation in the EF depending on the application rate of ammonium nitrate (AN). Mitigation options to reduce N2O emissions were also investigated, including the use of urea fertilizer in place of AN, addition of a nitrification inhibitor dicyandiamide (DCD) and application of AN in smaller, more frequent doses. Nitrous oxide emissions were measured from a cut grassland in south-west Scotland from March 2011 to March 2012. Grass yield was also measured to establish the impact of mitigation options on grass production, along with soil and environmental variables to improve understanding of the controls on N2O emissions. A monotonic increase in annual cumulative N2O emissions was observed with increasing AN application rate. Emission factors ranging from 1·06–1·34% were measured for AN application rates between 80 and 320 kg N/ha, with a mean of 1·19%. A lack of any significant difference between these EFs indicates that use of a uniform EF is suitable over these application rates. The mean EF of 1·19% exceeds the IPCC default 1%, suggesting that use of the default value may underestimate emissions of AN-fertilizer-induced N2O loss from Scottish grasslands. The increase in emissions beyond an application rate of 320 kg N/ha produced an EF of 1·74%, significantly different to that from lower application rates and much greater than the 1% default. An EF of 0·89% for urea fertilizer and 0·59% for urea with DCD suggests that N2O quantification using the IPCC default EF will overestimate emissions for grasslands where these fertilizers are applied. Large rainfall shortly after fertilizer application appears to be the main trigger for N2O emissions, thus applicability of the 1% EF could vary and depend on the weather conditions at the time of fertilizer application.

The SPectrometer for Internal Conversion Electrons (SPICE) has been commissioned for use in conjunction with the TIGRESS $\gamma$-ray spectrometer at TRIUMF's ISAC-II facility. SPICE features a permanent rare-earth magnetic lens to collect and direct internal conversion electrons emitted from nuclear reactions to a thick, highly segmented, lithium-drifted silicon detector. This arrangement, combined with TIGRESS, enables in-beam $\gamma$-ray and internal conversion electron spectroscopy to be performed with stable and radioactive ion beams. Technical aspects of the device, capabilities, and initial performance are presented.

A new type of gaseous micropattern particle detector based on a closed-cell microcavity plasma panel sensor is reported. The first device was fabricated with 1 x 1 x 2 mm cells. It has shown very clean signals of 0.6 to 2.5 volt amplitude, fast rise time of approximately 2 ns and FWHM of about 2 ns with very uniform signal shapes across all pixels. From initial measurements with beta particles from a radioactive source, a maximum pixel efficiency of greater than 95% is calculated, for operation of the detector over a 100V wide span of high voltages (HV). Over this same HV range, the background rate per pixel was measured to be 3 to 4 orders of magnitude lower than the rate with the cell illuminated by the beta source. Pixel-to-pixel count rate uniformity is within 3% and stable within 3% for many days. The time resolution is 2.4 ns, and a very low cell-to-cell crosstalk has been measured between cells separated by 2 mm., Comment: Submitted to NIM

Summary Dual Use Research of Concern (DURC) deals with the unintended consequences of research and development and is particularly acute in the area of drug development. The United States National Science Advisory Board for Biosecurity (NSABB) has defined DURC as "research that, based on current understanding, can be reasonably anticipated to provide knowledge, products, or technologies that could be directly misapplied by others to pose a threat to public health, agriculture, plants, animals, the environment, or materiel” (1). One particular receptor antagonist and glycolate anticholinergic compound (BZ, QNB or 3 -quinuclidinyl benzilate) was stockpiled by the United States as a non-lethal chemical weapon that incapacitates and severely degrades the capability of exposed individuals (2). Given time and medical treatment, combatants and non-combatants exposed to such incapacitating agents could recover without any long-term effects. The purpose of this review is to identify potential new and more potent incapacitating agents based on the structures of BZ or atropine using peer reviewed publications of new pharmaceutical agents. A number of peer reviewed studies have reported on compounds with effects observed at lower concentrations than or comparable to BZ suggesting that these compounds could also be developed as potential chemical incapacitating chemical warfare agents and represent good examples of the principal of Dual Use Research of Concern.

Electromagnetic transition rate measurements play an important role in characterizing the evolution of nuclear structure with increasing proton-neutron asymmetry. At TRIUMF, the TIGRESS Integrated Plunger device and its suite of ancillary detector systems have been implemented for charged-particle tagging and light-ion identification in coincidence with gamma-ray spectroscopy for Doppler-shift lifetime studies and low-energy Coulomb excitation measurements. Digital pulse-shape analysis of signals from these ancillary detectors for particle identification improves the signal-to-noise ratio of gamma-ray energy spectra. Here, we illustrate the reaction-channel selectivity achieved by utilizing digital rise-time discrimination of waveforms from alpha particles and carbon ions detected with silicon PIN diodes, thereby enhancing gamma-ray line-shape signatures for precision lifetime studies.

Civic engagement has long been a pedagogical and societal goal for communication scholars (Arnett & Arneson, 1999; Bennett, Wells, & Freelon, 2011). Kidd and Parry-Giles (2013) point out that belie...

The Gamma-Ray Infrastructure For Fundamental Investigations of Nuclei, GRIFFIN, is a new experimental facility for radioactive decay studies at the TRIUMF-ISAC laboratory. The performance of the 16 high-purity germanium (HPGe) clover detectors that will make up the GRIFFIN spectrometer is reported. The energy resolution, efficiency, timing resolution, crosstalk and preamplifier properties of each crystal were measured using a combination of analog and digital data acquisition techniques. The absolute efficiency and add-back factors are determined for the energy range of 80–3450 keV. The detectors show excellent performance with an average over all 64 crystals of a FWHM energy resolution of 1.89(6) keV and relative efficiency with respect to a 3 in . × 3 in . NaI detector of 41(1)% at 1.3 MeV.

AIM: To evaluate major/minor discrepancy rates for provisional (initial) and addendum (supplementary senior review) emergency computed tomography (CT) reports in patients presenting with non-traumatic abdominal pain. MATERIALS AND METHODS: Ethical approval for this type of study is not required in the UK. All radiology departments with an approved lead for audit registered with the Royal College of Radiologists were invited to participate in this retrospective audit. The first 50 consecutive patients (25 surgical, 25 non-surgical) who underwent emergency abdominal CT for non-traumatic abdominal pain in 2013 were included. Statistical analyses were performed to identify organisational and report/patient-related variables that might be associated with major discrepancy. RESULTS: One hundred and nine (58%) of 188 departments supplied data to the study with a total of 4,931 patients (2,568 surgical, 2,363 non-surgical). The audit standard for provisional report major discrepancy was achieved for registrars (target

This article reports on the development and experimental results of commercial plasma display panels adapted for their potential use as micropattern gas radiation detectors. The plasma panel sensors (PPS) design an materials include glass substrates, metal electrodes and inert gas mixtures which provide a physically robust, hermetically-sealed device. Plasma display panels used as detectors were tested with cosmic ray muons, beta rays and gamma rays, protons and thermal neutrons. The results demonstrated rise times and time resolution of a few nanoseconds, as well as sub-millimeter spatial resolution compatible with the pixel pitch., Submitted to NIM

The SPICE spectrometer is a new in-beam electron spectrometer designed to operate in conjunction with the TIGRESS HPGe Clover array at TRIUMF-ISAC. The spectrometer consists of a large area, annular, segmented lithium-drifted silicon electron detector shielded from the target by a photon shield. A permanent magnetic lens directs electrons around the photon shield to the detector. Experiments will be performed utilising Coulomb excitation, inelastic-scattering, transfer and fusion–evaporation reactions using stable and radioactive ion beams with suitable heavy-ion detection. Good detection efficiency can be achieved in a large energy range up to 3500 keV electron energy using several magnetic lens designs which are quickly interchangeable. COMSOL and Geant4 simulations have been used to maximise the detection efficiency. In addition, the simulations have guided the design of components to minimise the contributions from various sources of backgrounds.

The TIGRESS Integrated Plunger device is a new experimental tool for nuclear structure investigations via gamma-ray spectroscopy with post-accelerated beams from the ISAC-II facility at TRIUMF. Several ancillary detection systems integral to the device׳s capabilities for charged-particle tagging and light-ion identification following a variety of nuclear reaction mechanisms have been constructed and characterized. In particular, a silicon PIN diode wall, an annular silicon segmented detector, and a CsI(Tl) scintillator wall have together enabled particle-gamma correlations for reaction channel selectivity and precision kinematic reconstruction in recent measurements. We highlight the construction, characteristics, and implementation of the device׳s ancillary detectors as they enable a rich set of electromagnetic transition rate measurements via Doppler-shift lifetime techniques and low-energy Coulomb excitation.

Soil management practices shown to increase carbon sequestration include reduced tillage, amendments of carbon and mixed rotations. As a means to mitigate greenhouse gases, however, the success of these practices will be strongly influenced by nitrous oxide (N 2 O) emissions that vary with soil wetness. Few seasonal data are available on N 2 O under different soil managements so we measured seasonal N 2 O emission in three field experiments between 2006 and 2009 in eastern Scotland. The experimental treatments at the three sites were (1) tillage: no-tillage, minimum tillage, ploughing to 20 cm with or without compaction and deep ploughing to 40 cm, (2) organic residue amendment: application of municipal green-waste compost or cattle slurry and (3) rotations: stocked and stockless (without manure) organic arable farming rotations. Most seasons were wetter than average with 2009 the wettest, receiving 20–40% more rainfall than average. Nitrous oxide emissions were measured using static closed chambers. There was no statistical evidence, albeit with low statistical power, that reduced tillage affected N 2 O emissions compared to normal depth ploughing. With organic residue amendments, only in the wet season in 2008 were emissions significantly increased by high rates of green-waste compost (4.5 kg N 2 O-N ha −1 ) and cattle slurry (5.2 kg N 2 O-N ha −1 ) compared to the control (1.9 kg N 2 O-N ha −1 ). In the organic rotations, N 2 O emissions were greatest after incorporation of the grass/clover treatments, especially during conversion of a stocked rotation to stockless. Emissions from the organic arable crops (1.9 kg N 2 O-N ha −1 in 2006, 3.0 kg N 2 O-N ha −1 in 2007) generally exceeded those from the organic grass/clover (0.8 kg N 2 O-N ha −1 in 2006, 1.1 kg N 2 O-N ha −1 in 2007) except in 2008 when the wet weather delayed manure applications and increased emissions from the grass/clover (2.8 kg N 2 O-N ha −1 ). Nevertheless, organic grassland was the land use providing the most effective overall mitigation. Although the magnitude of fluxes did not relate particularly well to rainfall differences between seasons, greater rainfall received during some growing seasons increased the differences between tillage, organic residue and crop rotation phase treatments, negating any possible mitigation by timing management operations in dry periods. This was partly attributed to applying tillage and manures late and/or in wet conditions. Of benefit would be different sampling strategies including closed chambers or eddy covariance with standardised methodology. Controlled soil management experiments with a wide geographic spread to specify land management for mitigation also important.

As we move into the fourth decade of the HIV epidemic, this illness, once considered nearly always fatal, is now viewed as a chronic disease in most industrialized nations, due to advances in treatment. Patients with HIV are growing older and the number of infected patients over the age of 50 years is growing steadily. With this shift in demographics, the medical field is turning its attention toward the need to both care for older patients whose disease is long-standing, and identify newly infected older patients. It is increasingly apparent that older HIV-infected patients are vulnerable to a variety of non-AIDS-related conditions and the interplay of aging and HIV occurs in multiple ways. Identifying older patients at risk, the importance of getting patients into care and the impact of aging on the course of the infection are discussed as are common comorbidities such as cardiovascular disease, chronic kidney disease and neurocognitive decline. Recommendations for the evaluation of an older HIV-infecte...

The assessment of areas at risk from various soil threats is a key task within the proposed EU Soil Framework Directive. Such assessment is, however, hampered by the complex nature of the soil threats, which result from the sometimes poorly understood interaction of various soil physical properties, climatic factors and land management practices. Methodologies for risk assessment of soil threats are needed to protect the soil quality for future generations and to target resources to the areas at greatest risk. We present here a generic risk framework for the development of Bayesian Belief Networks (BBNs) to estimate the risk from soil threats. The generic BBN structure follows a standard risk assessment approach, where the risk is quantified by combining assessments of vulnerability and exposure. The soil's vulnerability to a given threat is determined from inherent soil and site characteristics as well as from climatic factors influencing soil characteristics, while the exposure estimate is based on an evaluation of the stresses inflicted by land management and climate. The generic framework is demonstrated by taking soil compaction as an example. Soil compaction is a major threat to soil function particularly in highly managed agricultural systems and is known to have many adverse effects on farming systems including decreased crop yield and soil productivity, increased management costs, increased emissions of greenhouse gases, and decreased water infiltration into the soil leading to accelerated run-off and risk of soil erosion. Existing modelling approaches to predict soil compaction risk either require data on soil mechanical behaviour that are difficult and expensive to collect, or are expert-based systems that are highly subjective and sometimes cannot accommodate the myriad of processes underlying compaction risk. Using the generic framework, a detailed BBN for assessing the risk of soil compaction is developed. The BBN allows for combining available data from standard soil surveys and land use databases with qualitative expert knowledge and explicitly accounts for uncertainties in the assessment of the risk. The BBN is applied to identify the distribution of the compaction risk across Scotland using data from the National Soils Inventory of Scotland.

Summary Over the past 20 years, research has focused on the writing processes of college students, however, despite recent support for writing as a tool of reflection in nursing education, little is known about how it is that nursing students go about writing papers and assignments as part of their professional education. In order to determine the writing processes of nursing students, the Inventory of Processes in College Composition, a self-response questionnaire, was administered to 169 nursing students. Results support the independence of the writing approaches that nursing students use and similarity to the writing approaches of a general college student population.

The plasma panel sensor (PPS) is a gaseous micropattern radiation detector under current development. It has many operational and fabrication principles common to plasma display panels. It comprises a dense matrix of small, gas plasma discharge cells within a hermetically sealed panel. As in plasma display panels, it uses nonreactive, intrinsically radiation-hard materials such as glass substrates, refractory metal electrodes, and mostly inert gas mixtures. We are developing these devices primarily as thin, low-mass detectors with gas gaps from a few hundred microns to a few millimeters. The PPS is a high gain, inherently digital device with the potential for fast response times, fine position resolution (

With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network – patients and providers – with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is considerable expertise in assessing, combining and exploiting information. Social networking is providing a new landscape for patients to assemble health information, relatively free from the constraints of traditional health care. However, health information from social networks currently complements traditional sources rather than substituting for them. Networking among health care provider organisations is enabling greater exploitation of health information for health care planning. The platforms of interaction are also changing. Patient-doctor encounters are now more permeable to influence from social networks and professional networks. Diffuse and temporary platforms of interaction enable discourse between patients and professionals, and include platforms controlled by patients. We argue that social networking has the potential to change patterns of health inequalities and access to health care, alter the stability of health care provision and lead to a reformulation of the role of health professionals. Further research is needed to understand how network structure combined with its dynamics will affect the flow of information and potentially the allocation of health care resources.

Anomalies in pulmonary vasculature are rare; however, the knowledge of the anomal and potential physiological implications for a patient undergoing a thoracic surgery must be understood. We report a case of a 64-year-old female who had a robotic left upper lobectomy for an incidental pulmonary nodule and was found to have a partial anomalous pulmonary vein. We discuss the incidence of pulmonary vein anomalies, associated conditions, and surgical management in patients requiring thoracic surgery.

AISC 358 provides steel connections that are prequalified for use in special and intermediate moment frames (SMF and IMF). Implicit in this standard is that the beam and column are orthogonal to each other in the elevation of the frame. To evaluate the effects of a sloped connection considering an angle of deviation from orthogonal of 28°, two reduced beam section (RBS) moment connections with W36×231 beam and W36×302 column were cyclically tested. Although both specimens met the acceptance criteria of AISC 341, brittle fracture of top flange weld soon followed, a failure mode not typical of an RBS connection. Finite-element analysis demonstrated that the strain demand was not symmetric between two flanges. The strain demand at the heel location was higher than that at the opposite flange and increased with the angle of the slope. The AISC 341 welding requirement for steel backing removal, back-gouging, and fillet reinforcing should be linked to the heel and toe locations, not the top and bottom f...

Patient: Male, 77 Final Diagnosis: Femoral artery pseudoaneurysm Symptoms: None Medication: — Clinical Procedure: Cardiac catheterization and coronary stenting with Starclose vascular closure Specialty: Interventional Cardiology Objective: Educational Purpose (only if useful for a systematic review or synthesis) Background: Vascular closure devices (VCDs) are frequently used for hemostasis with endovascular procedures by employing sutures or plug devices (using collagen or hydrogel) or through the use of a metal clip made of nickel and titanium, such as the StarClose SE device. In comparison to manual compression (MC), VCDs are associated with earlier time to discharge and ambulation, improved patient comfort, and better cost-effectiveness. Case Report: A 77-year-old man with history of ischemic cardiomyopathy with non-ST segment elevation myocardial infarction (NSTEMI) underwent diagnostic cardiac catheterization with deployment of a StarClose SE vascular closure device for hemostasis. Upon repeat access 4 days later for coronary intervention, retrograde sheath angiography revealed a pseudo-aneurysm emanating from the center of the StarClose clip. Conclusions: A review of the literature shows VCDs to be non-inferior to MC, with an overall high success rate. Major and minor complications rates are comparable to those with MC, and pseudo-aneurysm is an infrequent complication.

Water plays a central role in plant biology and the efficiency of water transport throughout the plant affects both photosynthetic rate and growth, an influence that scales up deterministically to the productivity of terrestrial ecosystems. Moreover, hydraulic traits mediate the ways in which plants interact with their abiotic and biotic environment. At landscape to global scale, plant hydraulic traits are important in describing the function of ecological communities and ecosystems. Plant hydraulics is increasingly recognized as a central hub within a network by which plant biology is connected to palaeobiology, agronomy, climatology, forestry, community and ecosystem ecology and earth-system science. Such grand challenges as anticipating and mitigating the impacts of climate change, and improving the security and sustainability of our food supply rely on our fundamental knowledge of how water behaves in the cells, tissues, organs, bodies and diverse communities of plants. A workshop, 'Emerging Frontiers in Plant Hydraulics' supported by the National Science Foundation, was held in Washington DC, 2015 to promote open discussion of new ideas, controversies regarding measurements and analyses, and especially, the potential for expansion of up-scaled and down-scaled inter-disciplinary research, and the strengthening of connections between plant hydraulic research, allied fields and global modelling efforts.

This paper provides information about a novel approach of rating agricultural soil quality (SQ) and crop yield potentials consistently over a range of spatial scales. The Muencheberg Soil Quality Rating is an indicator-based straightforward overall assessment method of agricultural SQ. It is a framework covering aspects of soil texture, structure, topography and climate which is based on 8 basic indicators and more than 12 hazard indicators. Ratings are performed by visual methods of soil evaluation. A field manual is then used to provide ratings from tables based on indicator thresholds. Finally, overall rating scores are given, ranging from 0 (worst) to 100 (best) to characterise crop yield potentials. The current approach is valid for grassland and cropland. Field tests in several countries confirmed the practicability and reliability of the method. At field scale, soil structure is a crucial, management induced criterion of agricultural SQ. At the global scale, climate controlled hazard indicators of ...

Mead’s milkweed Asclepias meadii, a long-lived perennial herb of tallgrass prairie and glade communities of the central United States, is a species designated as threatened under the U.S. Endangered Species Act. Challenges to its successful management include the facts that much about its life history is unknown, its age at reproductive maturity is very advanced, certain life stages are practically unobservable, its productivity is responsive to unpredictable environmental events, and most of the known populations occur on private lands unprotected by any legal conservation instrument. One critical source of biological uncertainty is the degree to which fire promotes growth and reproductive response in the plant. To aid in its management, we developed a prototype population-level state-dependent decision-making framework that explicitly accounts for this uncertainty and for uncertainties related to stochastic environmental effects and vital rates. To parameterize the decision model, we used estimates found in the literature, and we analyzed data from a long-term monitoring program where fates of individual plants were observed through time. We demonstrate that different optimal courses of action are followed according to how one believes that fire influences reproductive response, and we show that the action taken for certain population states is informative for resolving uncertainty about competing beliefs regarding the effect of fire. We advocate the use of a model-predictive approach for the management of rare populations, particularly when management uncertainty is profound. Over time, an adaptive management approach should reduce uncertainty and improve management performance as predictions of management outcome generated under competing models are continually informed and updated by monitoring data.

SUMMARY The architectural expressions for many modern buildings require creative and unconventional structural solutions. Columns must be taller, beams must span further, the structure must be more slender, elements must be curved, structural framing must be sloped and connections must deviate from conventional orthogonal fit-up. Although the technology exists to analyze and design responsive structural systems, prescriptive code requirements oftentimes hinder the implementation of those technologies. Although not a ‘tall building’ by traditional definition, the Tom Bradley International Terminal (TBIT) Modernization Program at Los Angeles International Airport (LAX) provides an appropriate case study in the implementation of unconventional structural geometry subject to code requirements that prescribe contrasting conventional geometry, which is a familiar challenge for many tall buildings. The architectural expression for the LAX TBIT Modernization Program required the use of long-span steel Special Moment Frames with non-orthogonal moment connections between the beams and columns. The beams were sloped, some were sloped and curved and some of the columns were sloped. The reduced beam section (RBS) moment connection was selected for the project. ANSI/AISC 358, Prequalified Connections for Special and Intermediate Steel Moment Frames for Seismic Applications, provides prequalification limits for using an RBS connection. Those limits do not address non-orthogonal moment connections. ANSI/AISC 358 implicitly limits connections to orthogonal geometry; hence, non-orthogonal moment connections are not prequalified for use in seismic applications. This paper describes the structure and the cyclic testing program that was implemented to qualify the proposed non-orthogonal RBS connections in accordance with ANSI/AISC 341, Seismic Provisions for Structural Steel Buildings, Appendix S for use on the LAX TBIT Modernization Project. Copyright © 2011 John Wiley & Sons, Ltd.

A radiation detector technology based on plasma display panels (PDPs), the underlying engine of panel plasma television displays, is being investigated. Emerging from this well-established television technology is the Plasma Panel Sensor (PPS), a novel variant of the micro-pattern radiation detector. The PPS is fundamentally a fast, high-resolution detector comprised of an array of plasma discharge cells, operating in a hermetically sealed gas mixture. We report on the PPS development effort, including proof-of-principle results of laboratory signal observations.