Search

Abstract We report multi-differential measurements of strange hadron production ranging from mid- to target-rapidity in Au+Au collisions at a center-of-momentum energy per nucleon pair of s NN $$ \sqrt{s_{\textrm{NN}}} $$ = 3 GeV with the STAR experiment at RHIC. K S 0 $$ {K}_S^0 $$ meson and Λ hyperon yields are measured via their weak decay channels. Collision centrality and rapidity dependences of the transverse momentum spectra and particle ratios are presented. Particle mass and centrality dependence of the average transverse momenta of Λ and K S 0 $$ {K}_S^0 $$ are compared with other strange particles, providing evidence of the development of hadronic rescattering in such collisions. The 4π yields of each of these strange hadrons show a consistent centrality dependence. Discussions on radial flow, the strange hadron production mechanism, and properties of the medium created in such collisions are presented together with results from hadronic transport and thermal model calculations.

The chiral magnetic effect (CME) is a phenomenon that arises from the QCD anomaly in the presence of an external magnetic field. The experimental search for its evidence has been one of the key goals of the physics program of the Relativistic Heavy-Ion Collider. The STAR Collaboration has previously presented the results of a blind analysis of isobar collisions (_{44}^{96}Ru+_{44}^{96}Ru, _{40}^{96}Zr+_{40}^{96}Zr) in the search for the CME. The isobar ratio (Y) of CME-sensitive observable, charge separation scaled by elliptic anisotropy, is close to but systematically larger than the inverse multiplicity ratio, the naive background baseline. This indicates the potential existence of a CME signal and the presence of remaining nonflow background due to two- and three-particle correlations, which are different between the isobars. In this postblind analysis, we estimate the contributions from those nonflow correlations as a background baseline to Y, utilizing the isobar data as well as Heavy Ion Jet Interaction Generator simulations. This baseline is found consistent with the isobar ratio measurement, and an upper limit of 10% at 95% confidence level is extracted for the CME fraction in the charge separation measurement in isobar collisions at sqrt[s_{NN}]=200 GeV.

Abstract We report a new measurement of the production of electrons from open heavy-flavor hadron decays (HFEs) at mid-rapidity (|y| < 0.7) in Au+Au collisions at s NN $$ \sqrt{s_{\textrm{NN}}} $$ = 200 GeV. Invariant yields of HFEs are measured for the transverse momentum range of 3.5 < p T < 9 GeV/c in various configurations of the collision geometry. The HFE yields in head-on Au+Au collisions are suppressed by approximately a factor of 2 compared to that in p + p collisions scaled by the average number of binary collisions, indicating strong interactions between heavy quarks and the hot and dense medium created in heavy-ion collisions. Comparison of these results with models provides additional tests of theoretical calculations of heavy quark energy loss in the quark-gluon plasma.

Abstract Partons traversing the strongly interacting medium produced in heavy-ion collisions are expected to lose energy depending on their color charge and mass. We measure the nuclear modification factors for charm- and bottom-decay electrons, defined as the ratio of yields, divided by the number of binary nucleon–nucleon collisions, in $$\sqrt{s_{\textrm{NN}}}=200$$ s NN = 200 GeV Au+Au collisions to p+p collisions ( $$R_{\textrm{AA}}$$ R AA ), or in central to peripheral Au+Au collisions ( $$R_{\textrm{CP}}$$ R CP ). We find the bottom-decay electron $$R_{\textrm{AA}}$$ R AA and $$R_{\textrm{CP}}$$ R CP to be significantly higher than those of charm-decay electrons. Model calculations including mass-dependent parton energy loss in a strongly coupled medium are consistent with the measured data. These observations provide evidence of mass ordering of charm and bottom quark energy loss when traversing through the strongly coupled medium created in heavy-ion collisions.

The deconfined quark-gluon plasma (QGP) created in relativistic heavy-ion collisions enables the exploration of the fundamental properties of matter under extreme conditions. Noncentral collisions can produce strong magnetic fields on the order of 10^{18} G, which offers a probe into the electrical conductivity of the QGP. In particular, quarks and antiquarks carry opposite charges and receive contrary electromagnetic forces that alter their momenta. This phenomenon can be manifested in the collective motion of final-state particles, specifically in the rapidity-odd directed flow, denoted as v_{1}(y). Here, we present the charge-dependent measurements of dv_{1}/dy near midrapidities for π^{±}, K^{±}, and p(p[over ¯]) in Au+Au and isobar (_{44}^{96}Ru+_{44}^{96}Ru and _{40}^{96}Zr+_{40}^{96}Zr) collisions at sqrt[s_{NN}]=200 GeV, and in Au+Au collisions at 27 GeV, recorded by the STAR detector at the Relativistic Heavy Ion Collider. The combined dependence of the v_{1} signal on collision system, particle species, and collision centrality can be qualitatively and semiquantitatively understood as several effects on constituent quarks. While the results in central events can be explained by the u and d quarks transported from initial-state nuclei, those in peripheral events reveal the impacts of the electromagnetic field on the QGP. Our data put valuable constraints on the electrical conductivity of the QGP in theoretical calculations.

Abstract We report on the measurement of the Central Exclusive Production of charged particle pairs h + h − (h = π, K, p) with the STAR detector at RHIC in proton-proton collisions at s $$ \sqrt{s} $$ = 200 GeV. The charged particle pairs produced in the reaction pp → p′ + h + h − + p′ are reconstructed from the tracks in the central detector and identified using the specific energy loss and the time of flight method, while the forward-scattered protons are measured in the Roman Pot system. Exclusivity of the event is guaranteed by requiring the transverse momentum balance of all four final-state particles. Differential cross sections are measured as functions of observables related to the central hadronic final state and to the forward-scattered protons. They are measured in a fiducial region corresponding to the acceptance of the STAR detector and determined by the central particles’ transverse momenta and pseudorapidities as well as by the forward-scattered protons’ momenta. This fiducial region roughly corresponds to the square of the four-momentum transfers at the proton vertices in the range 0.04 GeV2 < −t 1 , −t 2 < 0.2 GeV2, invariant masses of the charged particle pairs up to a few GeV and pseudorapidities of the centrally-produced hadrons in the range |η| < 0.7. The measured cross sections are compared to phenomenological predictions based on the Double Pomeron Exchange (DPE) model. Structures observed in the mass spectra of π + π − and K + K − pairs are consistent with the DPE model, while angular distributions of pions suggest a dominant spin-0 contribution to π + π − production. For π + π − production, the fiducial cross section is extrapolated to the Lorentz-invariant region, which allows decomposition of the invariant mass spectrum into continuum and resonant contributions. The extrapolated cross section is well described by the continuum production and at least three resonances, the f 0(980), f 2(1270) and f 0(1500), with a possible small contribution from the f 0(1370). Fits to the extrapolated differential cross section as a function of t 1 and t 2 enable extraction of the exponential slope parameters in several bins of the invariant mass of π + π − pairs. These parameters are sensitive to the size of the interaction region.

A Nationwide Nitrogen Deposition Monitoring Network (NNDMN) containing 43 monitoring sites was established in China to measure gaseous NH3, NO2, and HNO3 and particulate NH4+ and NO3− in air and/or precipitation from 2010 to 2014. Wet/bulk deposition fluxes of Nr species were collected by precipitation gauge method and measured by continuous-flow analyzer; dry deposition fluxes were estimated using airborne concentration measurements and inferential models. Our observations reveal large spatial variations of atmospheric Nr concentrations and dry and wet/bulk Nr deposition. On a national basis, the annual average concentrations (1.3–47.0 μg N m−3) and dry plus wet/bulk deposition fluxes (2.9–83.3 kg N ha−1 yr−1) of inorganic Nr species are ranked by land use as urban > rural > background sites and by regions as north China > southeast China > southwest China > northeast China > northwest China > Tibetan Plateau, reflecting the impact of anthropogenic Nr emission. Average dry and wet/bulk N deposition fluxes were 20.6 ± 11.2 (mean ± standard deviation) and 19.3 ± 9.2 kg N ha−1 yr−1 across China, with reduced N deposition dominating both dry and wet/bulk deposition. Our results suggest atmospheric dry N deposition is equally important to wet/bulk N deposition at the national scale. Therefore, both deposition forms should be included when considering the impacts of N deposition on environment and ecosystem health.

Abstract Background The established recommendations and guidelines regarding ideal measurements for an attractive face are mostly based on data gathered among Caucasian population. The aim of this study was to examine the relationship between perception of 3-dimensional facial attractiveness and golden ratio, neoclassical canons, ‘ideal’ ratios and ‘ideal’ angles in Hong Kong Chinese. Methods Thirty 3-D photographs (15 males and 15 females) were shown to 101 laypersons and 60 patients seeking orthognathic treatment. The photographs were rated based on a 100 mm visual analogue scale (VAS) from 0 (very unattractive) to 100 (very attractive). Results More than half of the measurements (42/77) in females and thirty-two measurements in males were found to be significantly different from the ideal target value (p

Extracting the seismic deformation field and analyzing the surface deformation after an earthquake occurs are of great significance for explaining earthquake mechanism and earthquake relief. Through the dual polarization mode of the two-pass method D-InSAR technology, this paper extracted the coseismic deformation fields based on two Sentinel-1A SAR images covering the Yulin earthquake area, and analyzed the surface deformation. The results show that the subsidence area obtained by VV and VH polarization modes are consistent. The uplift center areas are located in Tongxin Village in Rong County and Mapo Town in Luchuan County, and the subsidence center area is located in Fuxin Town of Beiliu City in the northeast. In the earthquake area, the maximum uplift derived by the VV mode SAR data is 12.1 cm, and the maximum subsidence is 5.8 cm. the maximum uplift obtained by the VH mode SAR data is 11.2 cm, and the maximum subsidence is 9 cm. The results obtained by the two polarization modes are consistent. D-InSAR technology can accurately obtain the coseismic deformation field, which provides data guarantee for the follow-up study of the inversion of seismic source parameters in the region.

To analyse the response and recovery characteristics of forest to forest fire, this paper selected the forest fire in the Greater Khingan Mountains (GKM) in China in 1987 and the forest fire in the Yellowstone National Park (YSP) in the United States in 1988. We first used Landsat-5 TM images before and after the fire to extract the burned area and calculate burn severity based on the Differential Normalized Burn Ratio (dNBR). Next, we analysed the response of forest vegetation to forest fire with different burn severity using the anomaly value of Leaf area index (LAI) derived from Global Land Surface Satellite (GLASS) products. And the recovery of forest vegetation after forest fire were revealed using time – series LAI data and MODIS Land cover data. The results showed that the LAI decreased rapidly after the forest fire, and the greater the burn severity, the higher the decreasing amplitude of LAI. The maximum decreasing amplitude of LAI in the burned areas with high burn severity were 1.3–3.8 times higher than that in low burn severity areas. The recovery time of LAI is affected by burn severity and manual interference. The recovery time of LAI in burned areas in the GKM is about 5–10 years, which in the burned areas with high burn severity is 2 times than that with low burn severity. The recovery time of LAI in the burned areas with low burn severity in the YSP is at least 20 years, while that with high burn severity will take longer time to recovery. And the manual interference accelerated the recovery of LAI in the GKM. Our research on the response and recovery of vegetation is helpful for formulating and implementing adaptation and mitigation strategies in response to forest fire.

The GaoFen-7 (GF-7) satellite is successfully launched on November 3, 2019, and its laser altimeter system is officially and firstly employed as the main payload for earth observations in China, which includes two sets of laser altimeters and laser footprint cameras. The Laser Footprint Image (LFI) is used to capture laser spots on the ground. In order to make up for the shortcomings of high cost field work for the traditional laser altimeter ground detector-based calibration method, this paper proposes a novel laser altimeter calibration method based on LFI. Firstly, the spaceborne laser calibration model and the Laser Footprint Camera (LFC) geolocation model are established. Secondly, the image coordinates of laser spot centroid are extracted from LFI, and the ground location of is obtained by ray intersecting with the reference Digital Surface Model (DSM). Finally, the centroid of laser spot is considered as Ground Control Point (GCP), and the pointing bias of GF-7 laser altimeter is calibrated by the Least Squares Estimation (LSE). The ALOS Global Digital Surface Model “ALOS World 3D-30m” (AW3D30) is used to evaluate the elevation accuracy of GF-7 laser altimeter before and after the calibration. The results indicate that elevation accuracy of the GF-7 laser altimeter is improved significantly after calibration. The proposed method can be effectively applied for high-frequency geometric calibration of GF-7 laser altimeter.

Abstract Background Post stroke cognitive difficulties are common but generally prioritised below other impairments. In the UK, clinical guidelines recommend a holistic review at six-months post-stroke including an assessment of cognitive function. In order to assist clinicians to provide better care for patients with post-stroke cognitive deficits and assist with service planning, our aim was to establish professional consensus on key actions at the six-month review. Methods An electronic Delphi survey was developed with ten potential actions for clinicians to prioritise across five different clinical scenarios describing patients with cognitive difficulties. Scenarios varied in terms of age of the stroke-survivor, stroke severity and use of dementia risk assessment. A panel of professional volunteers was obtained through the British Association of Stroke Physicians and the UK National Stroke Nursing Forum. Results Forty-five stroke clinicians completed round one, with 21 participants completing round two. Priorities consistently supported by professionals included access to psychological services, screening for a mood disorder and ensuring multi-professional input. Direct access to specialist memory services was not generally supported unless a dementia risk assessment tool indicated that the individual was at high risk of dementia. Conclusions Assessment of post-stroke cognitive deficits needs to be routinely considered during the six-month review. A formal risk assessment tool could be a way to streamline direct access to memory clinic services to ensure that individuals at-risk of dementia receive ongoing care.

Recovering from major earthquakes is a challenge, especially in mountainous environments where postearthquake hazards may cause substantial impacts for prolonged periods of time. Although such impacts were reported in the 1923 Great Kantō earthquake and the 1999 Chi-Chi earthquake, careless reconstruction in hazard-prone areas and consequently huge losses were witnessed following the 2008 Wenchuan earthquake in the Sichuan province of China, as several reconstructed settlements were severely damaged by mass movements and floods. In order to summarize experiences and identify problems in the reconstruction planning, a monitoring of one of the settlements, the town of Longchi, was carried out by image interpretation and field investigation. Seven inventories containing buildings, farmlands, roads and mitigation measures were made to study the dynamics of elements at risk and exposure over a period of 11 years. It was found that the total economic value of the newly reconstructed buildings was several times more than in the preearthquake situation in 2007, because of enormous governmental investment. Postseismic hazards were not sufficiently taken into consideration in the recovery planning before the catastrophic debris flow disaster in 2010. As a result, the direct economic loss from postseismic disasters was slightly more than the loss caused by the Wenchuan earthquake itself. The society showed an impact-adapt pattern, experiencing losses from disasters and then gaining resistance by abandoning buildings in hazard-prone areas and installing mitigation measures. The locations potentially exposed to postearthquake hazards were summarized, and a possible timetable for reconstruction was proposed. Problems might be encountered in hazard assessment, and possible solutions were discussed.

The Tibetan Plateau (TP) is the largest alpine plateau on Earth and plays an important role in global climate dynamics. On the TP, climate change is happening particularly fast, with an increase in air temperature twice the global average. The particular sensitivity of this high mountain environment allows observation and tracking of abiotic and biotic feedback mechanisms. Closed lake systems, such as Nam Co on the central TP, represent important natural laboratories for tracking past and recent climatic changes, as well as geobiological processes and interactions within their respective catchments. This review gives an interdisciplinary overview of past and modern environmental changes using Nam Co as a case study. In the catchment area, ongoing rise in air temperature forces glaciers to melt, contributing to a rise in lake level and changes in water chemistry. Some studies base their conclusions on inconsistent glacier inventories, but an ever-increasing deglaciation and thus higher water availability have persisted over the last few decades. Increasing water availability causes translocation of sediments, nutrients and dissolved organic matter to the lake, as well as higher carbon emissions to the atmosphere. The intensity of grazing has an additional and significant effect on CO2 fluxes, with moderate grazing enhancing belowground allocation of carbon while adversely affecting the C sink potential through reduction of above-surface and subsurface biomass at higher grazing intensities. Furthermore, increasing pressure from human activities and livestock grazing are enhancing grassland degradation processes, thus shaping biodiversity patterns in the lake and catchment. The environmental signal provided by taxon-specific analysis (e.g., diatoms and ostracods) in Nam Co revealed profound climatic fluctuations between warmer–cooler and wetter–drier periods since the late Pleistocene and an increasing input of freshwater and nutrients from the catchment in recent years. Based on the reviewed literature, we outline perspectives to further understand the effects of global warming on geodiversity and biodiversity and their interplay at Nam Co, which acts as a case study for potentially TP-level or even worldwide processes that are currently shaping high mountain areas.

Aiming at the problem that the fitting parameters of the least squares support vector machine fitting method are difficult to select, a method of introducing the artificial bee colony algorithm into the least squares support vector machine to establish a high-precision region fitting model is proposed. The artificial bee colony algorithm can perform global tracking search on the parameters in the least squares support vector machine, imitate the honey collecting process of the bees, and use the primary value of the parameters as the honey source, and the average square error predicted by the least squares support vector machine as the target. The function value is determined by iterative update within a certain range to determine the optimal parameters, and finally a GPS height fitting model with higher precision is established. Experimental analysis, compared with the conventional least squares support vector machine fitting method, the accuracy of the fitting model constructed by the ABC-LSSVM combination method is improved by 45.4%. At the same time, the combined method is better than the particle swarm optimization fitting method and BP neural network. The legal convergence effect is higher and the stability is better. The effective feasibility of the ABC-LSSVM combination method in the construction of GPS height fitting model is proved, which provides a certain reference value for the establishment of GPS height fitting model.

IntroductionCervical cancer is the leading cause of cancer death among women in Malawi. Low awareness of cervical cancer and negative perceptions of screening can prevent women from participating in preventative strategies. We sought to explore perceptions and motivations for screening among women who participated in a cervical cancer screen-and-treat pilot study in rural Malawi.Materials and methodsWe conducted a qualitative sub-study of a community-based cervical cancer screen-and-treat pilot study in rural Lilongwe between July-August 2017. From October 2017-February 2018, 17 women who underwent screening using visual inspection with acetic acid (VIA) and same-day thermal ablation treatment were recruited at their 12-week follow-up visit post treatment to participate in this qualitative sub-study. Semi-structured interview guides that explored baseline knowledge of cervical cancer, perceptions, and motivation for screening were used for in-depth interviews (IDIs). IDIs were conducted in the local language, Chichewa, translated and transcribed to English. Data was analyzed using NVivo® V12.0.ResultsFindings included fatalistic views on cancer, but limited knowledge specific to cervical cancer. Misconceptions of cervical cancer screening were common; however, there was a unique understanding of screening as prevention (i.e., finding and treating early disease to prevent progression to worsening disease). This understanding appeared to stem from HIV prevention concepts known to the community. Motivations for screening included desire to know one's health status, convenience of community-based screening, and peer encouragement.ConclusionDespite limited knowledge of cervical cancer and misconceptions of screening, the concept of screening for prevention, desire to know one's health status, convenient access, and peers' influence were motivators for participation in screening. Cervical cancer screen-and-treat programs in high HIV prevalence areas should consider utilizing language that parallels HIV prevention language to communicate the need for cervical cancer screening and treatment and utilize prevention concepts that may already be familiar to women living there.

IntroductionLong-term care engagement of women on antiretroviral therapy (ART) is essential to effective HIV public health measures. We sought to explore factors associated with a history of HIV treatment interruption among pregnant women living with HIV presenting to an antenatal clinic in Lilongwe, Malawi.MethodsWe performed a cross-sectional study of pregnant women living with HIV who had a history of ART interruption presenting for antenatal care. Women were categorized as either retained in HIV treatment or reinitiating care after loss-to-follow up (LTFU). To understand factors associated with treatment interruption, we surveyed socio-demographic and partner relationship characteristics. Crude and adjusted prevalence ratios (aPR) for factors associated with ART interruption were estimated using modified Poisson regression with robust variance. We additionally present patients' reasons for ART interruption.ResultsWe enrolled 541 pregnant women living with HIV (391 retained and 150 reinitiating). The median age was 30 years (interquartile range (IQR): 25-34). Factors associated with a history of LTFU were age ConclusionsInterventions that simplify the ART clinic transfer process, facilitate partner disclosure, and provide counseling about the importance of lifelong ART beyond pregnancy and breastfeeding should be further evaluated for improving retention in ART treatment of women living with HIV in Malawi.

Background In stable coronary artery disease, medications are used for 2 purposes: cardiovascular risk reduction and symptom improvement. In clinical trials and clinical practice, medication use is often not optimal. The ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) trial was the first placebo‐controlled trial of percutaneous coronary intervention. A key component of the ORBITA trial design was the inclusion of a medical optimization phase, aimed at ensuring that all patients were treated with guideline‐directed truly optimal medical therapy. In this study, we report the medical therapy that was achieved. Methods and Results After enrollment into the ORBITA trial, all 200 patients entered a 6‐week period of intensive medical therapy optimization, with initiation and uptitration of risk reduction and antianginal therapy. At the prerandomization stage, the median number of antianginals established was 3 (interquartile range, 2–4). A total of 195 patients (97.5%) reached the prespecified target of ≥2 antianginals; 136 (68.0%) did not stop any antianginals because of adverse effects, and the median number of antianginals stopped for adverse effects per patient was 0 (interquartile range, 0–1). Amlodipine and bisoprolol were well tolerated (stopped for adverse effects in 4/175 [2.3%] and 9/167 [5.4%], respectively). Ranolazine and ivabradine were also well tolerated (stopped for adverse effects in 1/20 [5.0%] and 1/18 [5.6%], respectively). Isosorbide mononitrate and nicorandil were stopped for adverse effects in 36 of 172 (20.9%) and 32 of 141 (22.7%) of patients, respectively. Statins were well tolerated and taken by 191 of 200 (95.5%) patients. Conclusions In the 12‐week ORBITA trial period, medical therapy was successfully optimized and well tolerated, with few drug adverse effects leading to therapy cessation. Truly optimal medical therapy can be achieved in clinical trials, and translating this into longer‐term clinical practice should be a focus of future study. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02062593.

Vitreous biopsy is essential for establishing a definitive diagnosis and guiding potential therapy in patients with refractory vitritis and posterior uveitis, among other indications. Especially in cases where one must rule out intraocular lymphoma, obtaining a significant amount of undiluted vitreous increases diagnostic yield. We demonstrate our technique for obtaining a significant amount of undiluted vitreous using pars plana vitrectomy with air infusion.

Purpose: To profile vitreous protein expression of intermediate uveitis (IU) patients. Observations: We identified a mean of 363 ± 41 unique proteins (mean ± SD) in IU vitreous and 393 ± 69 unique proteins in control samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis of liquid vitreous biopsies collected during pars plana vitrectomy. A total of 233 proteins were differentially expressed among control and IU samples, suggesting a protein signature that could distinguish the two groups. Pathway analysis identified 22 inflammatory mediators of the interleukin-12 (IL-12) signaling pathway in IU vitreous. Upstream regulator analysis identified downstream mediators of IL-23 and myeloid differentiation primary response protein (MYD88), both of which are involved in the recruitment and differentiation of myeloid cells. Taken together, our results suggest the recruitment of myeloid cells as an upstream pathway in the pathogenesis of IU. Conclusions: This study provides insights into proteins that will serve as biomarkers and therapeutic targets for IU. These biomarkers will help design future clinical trials using rational molecular therapeutics.

Purpose: The primary goal of this study was to identify characteristic features of peripheral degenerative retinoschisis (RS), schisis detachment (SD) and retinal detachment (RD) on both fundus autofluorescence (FAF) and infrared (IR) imaging, using spectral domain optical coherence tomography (SD-OCT) imaging of the peripheral retina as the confirmatory imaging tool. Methods: This is a descriptive case series study. A total of 27 eyes of 22 patients were included. Thirteen eyes of 10 patients diagnosed with RS, 4 eyes of 3 patients diagnosed with SD, and 10 eyes of 9 patients diagnosed with RD were included. Patients with images of poor quality were excluded. Heidelberg Spectralis HRA + OCT machine (Heidelberg Engineering, Heidelberg, Germany) were used to acquire the images. Results: All conditions appeared as areas of hypo-AF on FAF and hypo-reflectance on IR imaging. Accentuated vasculature of the lesion was noted with IR imaging due to elevation of the RS and RD, which was less frequently observed with FAF. On FAF, a hyper-AF leading edge around the RS lesion indicated the presence of intraretinal or subretinal fluid and an extension of the RS. Retinal breaks/holes were best visualized with IR imaging. SD-OCT confirmed the diagnosis in all performed cases. Conclusions: We were unable to differentiate between RS and RD based solely on findings from FAF and IR imaging. However, the combination of them with SD-OCT can assist in the diagnosis of RS from RD and in the evaluation of RS progression. OCT remains the main modality imaging to differentiate these conditions.

Background This study aimed to investigate longitudinal physiological changes in the recanalized coronary chronic total occlusion (CTO) vessel and its dependent myocardium after successful percutaneous coronary intervention (PCI). Methods and Results In this pilot study, 25 patients scheduled for elective CTO PCI with viable myocardium and angiographically visible collaterals were included. Absolute coronary blood flow and absolute microvascular resistance were measured invasively using continuous thermodilution. Measurements were performed immediately after successful CTO PCI and at short‐term follow‐up. In a subgroup of patients, physiological measurements were performed at the predominant donor vessel before CTO PCI, immediately afterwards, and at follow‐up. Absolute coronary blood flow in the recanalized CTO artery increased from 148±53 mL/min immediately after PCI to 221±77 mL/min at follow‐up (P

Objectives: Cervical cancer can often be cured by surgery alone, if diagnosed and treated early. However, of the cancer patients who live in the world's poorest countries less that 5% have access to safe, effective and timely cancer surgery. We designed a novel, competency-based curriculum to rapidly build surgical capacity for the treatment of cervical cancer. Here we report experiences and early outcomes of its implementation in Malawi. Methods: Curriculum implementation consisted of preoperative evaluation of patients and surgical video review, discussion of surgical instruments and suture material, deconstruction of the surgical procedure into critical subcomponents including trainees walking through the steps of the procedure with the master trainers, high-volume surgical repetition over a short time interval, intra-operative mentoring, post-operative case review, and mental narration. This was preceded by self-directed learning and followed by clinical mentorship through electronic communication and quarterly on-site visits. Results: Between June 2015–June 2017, 28 patients underwent radical abdominal hysterectomy with bilateral pelvic lymphadenectomy. The first 8 surgeries were performed over 5 days. After the 7th case the trainee could perform the procedure alone. During and between quarterly mentoring-visits the trainee independently performed the procedure on 20 additional patients. Major surgical complications were rare. Conclusions: Life-saving surgical treatment for cervical cancer is now available for the first time, as a routine clinical service, in Central/Northern, Malawi. Keywords: Cervical cancer, Radical hysterectomy, Pelvic lymphadenectomy, Competency-based surgical training

Abstract Background Perinatal mortality is unacceptably high in low-income countries, including Malawi. Use of family planning to encourage birth spacing may optimize outcomes for subsequent pregnancies. However, the reproductive desires and family planning knowledge of women who have experienced a stillbirth or neonatal death in resource-poor settings are not well understood. Methods We examined family planning knowledge, contraceptive practices and barrier to contraceptive use among women who had experienced a poor obstetric outcome at Bwaila Hospital in Lilongwe, Malawi. We performed individual in-depth interviews or through focus group discussion with women who had experienced a stillbirth or early neonatal death, 4–8 weeks after their delivery. NVivo software was used to analyze data for recurrent patterns and themes, and central ideas were extracted to identify the data’s core meanings. Results We interviewed 46 women who had experienced a poor obstetric outcome. Overall, women were aware of both modern and traditional family planning methods, and the majority were in favour of modern versus traditional methods. They also had knowledge about risks for future complications if they have a short inter-pregnancy interval. However, they faced conflict about whether to use family planning methods for their health, as suggested by their relatives and friends, or to have another child to fulfil their husband’s desire, especially among those with no living child. Some had fear about side effects, while others were concerned that use of family planning methods without involving the husband could bring misunderstandings within the family. A number of women had misconceptions about family planning methods, which also served as a barrier to their use. Conclusion Although women with a poor obstetric outcome are aware of modern family planning and its health benefits after their delivery, their decision to use a method is complicated by their own desire to protect their own health and the husband’s desire for a child, particularly among those women with no living children coupled with fear of side effects and misconceptions. These findings suggest the importance of counselling both the affected woman and her husband about the benefits of family planning use, even after a poor obstetric outcome, to jointly choose the method they feel comfortable to use and dispel any misconceptions. Trial registration Clinicaltrials.gov NCT02674542.

In the recent decade, the demand for water resources has been increasing with the economic development. The reservoirs of cascade hydropower stations in Hongshuihe basin, which are constructed with a main purpose of power generation, are facing more integrated water resources utilization problem. The conflict between power generation of cascade reservoirs and flood control, shipping, environmental protection and water supply has become increasingly prominent. This paper introduces the general situation and integrated water demand of cascade reservoirs in Hongshuihe basin, and it analyses the impact of various types of integrated water demand on power generation and supply. It establishes mathematic models, constrained by various types of integrated water demand, to guide the operation and water resources utilization management of cascade reservoirs in Hongshuihe basin. Integrated water coordination mechanism of Hongshuihe basin is also introduced. It provides a technical and management guide and demonstration for cascade reservoirs operation and integrated water management at home and abroad.