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PurposeThe purpose of this paper is to explore the impact of a particular firm’s stakeholder orientation, particularly employee orientation, on corporate communications with stakeholders concerning financial irregularities.Design/methodology/approachThis study explores the impact of a particular firm’s stakeholder orientation, particularly employee orientation, on corporate communications with stakeholders concerning financial irregularities. Using a sample of 762 firm restatements, the authors separate their observations by disclosure transparency (high or low transparency of disclosure) and use logit regressions to examine whether companies with stronger employee orientation make more or less transparent restatement disclosures.FindingsThe findings show that higher levels of investment in employee orientation are associated with less transparent restatement disclosures. Further, examining a subsample of restatements in which managers may have greater discretion over how a restatement is disclosed confirms this finding. However, supplemental tests show that increased external monitoring may mitigate these effects.Practical implicationsThe findings provide support that other stakeholders, such as shareholders, should weigh the potential pros/cons of management investments in corporate social responsibility (CSR). These concerns are more important now as firms continue to embrace a stakeholder-focused model of management which allocates resources to numerous stakeholder groups.Originality/valueThis paper extends the growing body of research that assesses the impact of CSR on firm outcomes (Kimet al., 2012; Guoet al., 2016; Hmaittaneet al., 2019). Further, this paper contributes to the disclosure transparency literature by finding an association between CSR investment levels and the manner in which a firm discloses a restatement.

Despite legislation affirming the rights of people with intellectual disabilities to take equal part in society, marginalization persists. Accessibility needs can impact this group’s ability to engage in the digital society and in aspects of daily living, such as employment and socializing. The Digi-ID PLUS study was established with a team of seven people with an intellectual disability. Team members were hired as a diverse group to give insight into their lived experiences in reviewing and validating research findings. Their insights were key to every aspect of Digi-ID PLUS. It has been recognized that user-centered design enhances technology development and accessibility; therefore, the aim of establishing a Citizen Advisory Panel (CAP) in our program design and delivery is to include the critical role of users by experience to review, validate and test our solution to enhance the accessibility of all aspects of the program. Working with Digi-ID PLUS, the CAP spoke of the impact being paid team members had on their lives. Analysis of insights shared indicated that being a part of the team had a positive impact on their self-image confidence and digital skills acquisition CAP members discussed the importance of supporting each other and the value of being paid for their insights.

There is much controversy regarding enhanced recovery for recipients of liver transplants from deceased and living donors. The objectives of this Review were to summarise current knowledge on individual enhanced recovery elements on short-term outcomes, identify key components for comprehensive pathways, and create internationally accepted guidelines on enhanced recovery for liver-transplant recipients. The ERAS4OLT.org collaborative partnered by the International Liver Transplantation Society performed systematic literature reviews on the effect of 32 relevant enhanced perioperative recovery elements on short-term outcomes, and global specialists prepared expert statements on deceased and living donor liver transplantation. The Grading Recommendations, Assessment, Development and Evaluations approach was used for rating of quality of evidence and grading of recommendations. A virtual international consensus conference was held in January, 2022, in which results were presented, voted on by the audience, and discussed by an independent international jury of eight members, applying the Danish model of consensus. 273 liver transplantation specialists from 30 countries prepared expert statements on elements of enhanced recovery for liver transplantation based on the systematic literature reviews. The consensus conference yielded 80 final recommendations, covering aspects of enhanced recovery for preoperative assessment and optimisation, intraoperative surgical and anaesthetic conduct, and postoperative management for the recipients of liver transplants from both deceased and living donors, and for the living donor. The recommendations represent a comprehensive overview of the relevant elements and areas of enhanced recovery for liver transplantation. These internationally established guidelines could direct the development of enhanced recovery programmes worldwide, allowing adjustments according to local resources and practices.

Introduction\ud \ud Evidence based guidelines for the optimal management of breast cancer locoregional recurrence (LRR) are limited, with potential for variation in clinical practice. This national practice questionnaire (NPQ) was designed to establish the current practice of UK breast multidisciplinary teams (MDTs) regarding LRR management.\ud \ud \ud \ud Methods\ud \ud UK breast units were invited to take part in the MARECA study MDT NPQ. Scenario-based questions were used to elicit preference in pre-operative staging investigations, surgical management, and adjuvant therapy.\ud \ud \ud \ud Results\ud \ud 822 MDT members across 42 breast units (out of 144; 29%) participated in the NPQ (February–August 2021). Most units (95%) routinely performed staging CT scan, but bone scan was selectively performed (31%).\ud \ud \ud \ud For patients previously treated with breast conserving surgery (BCS) and radiotherapy, few units (7%) always/usually offered repeat BCS. However, in the absence of radiotherapy, most units (90%) always/usually offered repeat BCS. For patients presenting with isolated local recurrence following previous BCS and SLNB (sentinel lymph node biopsy), most units (95%) advocated repeat SLNB. Where SLNs could not be identified, 86% proceeded to a four-node axillary sampling procedure.\ud \ud \ud \ud For ER positive, HER2 negative, node negative local recurrence, 10% of units always/usually offered chemotherapy. For ER positive, HER2 negative, node positive local recurrence, this recommendation increased to 64%. For triple negative breast cancer local recurrence, 90% of units always/usually offered chemotherapy.\ud \ud \ud \ud Conclusion\ud \ud This survey has highlighted where consistencies and variations exist in the multidisciplinary management of breast cancer LRR. However, further research is required to determine how these management patterns influence patient outcomes, which will further refine optimal treatment pathways.

The decision-making around transjugular intrahepatic portosystemic shunt (TIPSS) placement in the management of patients with chronic liver disease and portal hypertension (PH) is a regular challenge for hepatologists. In the UK, access has improved, with more than 35 hospitals now offering this service. However, its role in acute variceal bleeding, refractory ascites and other complications of PH continues to be redefined and expanded. In particular, the role of pre-emptive TIPSS has become more established and requires re-evaluation of pathways to enable equitable access for patients. Here, we summarise the key recommendations from the recently published British Society of Gastroenterology guidelines and expand on the challenges posed.

OBJECTIVES: To determine the positive predictive value (PPV) of disc haemorrhages (DHs) for the diagnosis of open angle glaucoma (OAG). METHODS: A retrospective review of 618 consecutive new referrals by community optometrists to a hospital glaucoma service, including 54 patients with DHs. All patients had a comprehensive eye examination. The primary outcome was whether the patient was diagnosed with OAG in either eye, with a secondary outcome of whether they were discharged at the first visit (first visit discharge rate, FVDR). RESULTS: 54 of 618 patients (8.7%) had a DH noted at the time of referral, including 21 referred with DH alone. 29 patients with DHs were diagnosed with OAG for a PPV of 54% (95% CI 40–67%), falling to 24% (95% CI 8–47%) in those with DH alone. The overall FVDR was 35%, increasing to 57% in those referred due to DH alone. The FVDR for those referred with DH alone was significantly higher than the FDVR of 25% among the 564 patients referred with suspected glaucoma without a DH (P = 0.001). The FVDR decreased to 35% for patients with a DH plus one other feature of glaucoma and to 0% for patients with a DH and at least two other features suggestive of glaucoma. CONCLUSIONS: Almost 60% of patients referred due to isolated DHs were discharged at the first visit to the glaucoma clinic, however almost one in four was diagnosed with OAG. Patients with DH and other features suggestive of glaucoma had a higher probability of glaucoma diagnosis.

AIM To examine the accuracy of referrals by community optometrists for suspected primary angle closure, including primary angle closure suspects, primary angle closure and primary angle closure glaucoma. METHODS A retrospective review of 769 consecutive patients referred by community optometrists to the glaucoma clinic at a university hospital in Scotland. Ninety-five of 715 eligible subjects (13%) were referred due to suspected angle closure. All subjects had a comprehensive eye examination in the glaucoma clinic, including gonioscopy, with angle closure defined according to the International Society of Geographical and Epidemiological Ophthalmology classification as iridotrabecular contact over at least 270 degrees. RESULTS Fifty-nine of 95 subjects referred due to suspected angle closure were confirmed to have an occludable angle, while 36 of 95 (38%) had open angles (positive predictive value = 62%). Of 620 patients referred to the glaucoma clinic for reasons other than narrow angles, 601 (97%) had open angles on gonioscopy and 19 (3%) had narrow angles. Using the 620 patients referred with 'open angles' as a control group, sensitivity was estimated as 76% and specificity 94%. Eleven of 95 (12%) patients referred for possible angle closure were discharged at the first visit compared to 156 of 620 (25%) referred to the glaucoma clinic for other reasons (p = 0.003). In a multivariable model, suspect angle closure detected by the optometrist (OR = 56.0, 95% CI 35.2-89.2, p

This study assessed the efficacy of selected silicon-rich soil amendments in terms of their ability to provide dissolved silicon (Si) to soil solutions during a 15-month experiment. Four inorganic amendments (peat ash, coal ash, rice husk ash and ground granulated blast furnace slag (GGBS)) and one organic amendment (rice husks) were mixed with a natural field soil. An un-amended control and two liquid-based Si-positive controls (sodium metasilicate and a commercial Si fertiliser (Pro-Tekt)) were also included. Soil-filled 4-l pots (n = 5 per treatment) were placed outdoors, over funnels to collect soil leachates, while soil solution samplers were installed in the pots to collect in situ soil solutions. Plant available Si concentrations were measured in the soil solutions and leachates using colourimetric heteropoly blue method. Rice husks were found to be most effective soil amendment as they provided the highest release of dissolved Si into the soil solutions (22.3 to 47.9 mg Si l−1) and leachates (10.9 to 31.0 mg Si l−1). Si release from rice husks was found to be greater than rice husk ash and either of the two liquid-based amendments. Si release from the peat ash, coal ash and GGBS amendments was found to be very low for both soil solutions (0 to 1.8 mg Si l−1) and leachates (0 to 2.0 mg Si l−1), suggesting that these are poor choices for Si soil amendments. Release of dissolved, plant available Si from rice husks and rice husk ash was found to be consistently high for the duration of the experiment, making them the most attractive candidates for slow release Si-rich fertilisers for crop production. By contrast, despite being used previously as a soil amendment, coal ash and GGBS were found to be less suitable as they released little soluble Si. Evaluation of the release rates of soluble Si from any proposed soil amendments prior to their application to soils is therefore essential.

Alternative methods of protection are required against feeding by the large pine weevil (Hylobius abietis) on the bark of conifer seedlings. Silicon (Si) has been shown to enhance the resistance of...

Reacting to the criticism that companies routinely mislead investors by emphasizing non-GAAP or pro forma numbers, the SEC promulgated Regulation G in 2003, which requires firms to provide a reconciliation of the pro forma and GAAP numbers. In this study, we conduct an experiment to examine how investors' GAAP and non-GAAP earnings performance assessments affect their financial evaluations and investment decisions based on the presentation format of the reconciliation (presenting a full non-GAAP income statement, referred to as the full NGIS format, versus presenting only the items that caused the difference between GAAP and non-GAAP measures, referred to as the summary NGIS format). We find that even though a summary NGIS format for the reconciliation of pro forma earnings does not increase the perceived non-GAAP earnings performance, it does increase the weight given to non-GAAP earnings performance when making investment-related judgments and decisions, relative to a full NGIS format. These findings regarding the evaluation and weighting of non-GAAP earnings performance extend prior studies and suggest that non-GAAP earnings information may be processed differently based upon the format of the reconciliation. Further, our finding regarding the weighting of non-GAAP earnings performance is inconsistent with the concern expressed by the SEC that the full NGIS format may give greater prominence to non-GAAP information. Finally, the implications of these findings for regulators, investors, and future research are discussed. Data Availability: Contact the authors.

Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety and short-term outcomes of TM and mastectomy with or without IBR.The subgroup of patients in the TeaM study who underwent TM to avoid mastectomy were identified, and data on demographics, complications, oncology and adjuvant treatment were compared with those of patients undergoing mastectomy with or without IBR in the iBRA-2 study. The primary outcome was the percentage of successful breast-conserving procedures in the TM group. Secondary outcomes included postoperative complications and time to adjuvant therapy.A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21·0 per cent; mastectomy: 570, 37·2 per cent; mastectomy and IBR: 359, 35·6 per cent; P 0·001). Breast conservation was possible in 87·0 per cent of patients who had TM, and TM did not delay adjuvant treatment.TM may allow high-risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient-reported and cosmetic outcomes of the different approaches, and to establish long-term oncological safety.La mamoplastia terapéutica (therapeutic mammaplasty, TM) puede ser una alternativa a la mastectomía, pero hay pocos estudios bien diseñados que hayan evaluado el éxito de esta estrategia o hayan comparado los resultados a corto plazo de la TM con la mastectomía con o sin (+/-) reconstrucción mamaria inmediata (immediate breast reconstruction, IBR). Para comparar la seguridad y los resultados a corto plazo de la TM y la mastectomía +/- IBR se combinaron los datos de los estudios nacionales iBRA-2 y TeaM. MÉTODOS: En el estudio TeaM se identificó el subgrupo de pacientes al que se realizó una TM para evitar la mastectomía y se compararon los datos demográficos, las complicaciones, los resultados oncológicos y el tratamiento adyuvante con las pacientes sometidas a mastectomía +/- IBR del estudio iBRA-2. La variable principal fue el porcentaje de éxito de la cirugía conservadora de mama en el grupo TM. Las variables secundarias fueron las complicaciones postoperatorias y el intervalo de tiempo hasta el inicio del tratamiento adyuvante.Se incluyeron en el análisis 2.916 pacientes (TM n = 376; mastectomía n = 1.532; IBR n = 1.008). La TM era más frecuente en pacientes obesas o en las sometidas a cirugía bilateral en comparación con las pacientes con IBR. Sin embargo, las pacientes sometidas a una mastectomía +/- IBR tenían más probabilidades de desarrollar complicaciones que las del grupo TM (TM n = 79, 21,0%; mastectomía n = 570, 37,2%; mastectomía y IBR n = 359, 35,6%; P 0,001). La conservación de la mama fue posible en el 87% de las pacientes con TM y el procedimiento no retrasó el inicio del tratamiento adyuvante. CONCLUSIÓN: La TM puede permitir que pacientes de alto riesgo que no serían candidatas a IBR eviten la mastectomía de una forma segura. Se necesitan más trabajos para comparar los resultados percibidos por las pacientes y los estéticos de las diferentes estrategias terapéuticas y establecer la seguridad oncológica a largo plazo.

Optical sensing has shown great potential for both quantitative and qualitative analysis of compounds. In particular sensors which are capable of detecting changes in refractive index at a surface as well as in bulk material have received much attention. Much of the recent research has focused on developing technologies that enable such sensors to be deployed in an integrated photonic device. In this work we demonstrate experimentally, using a sub-wavelength grating the detection of ethanol in aqueous solution by interrogating its large absorption band at 9.54 μm. Theoretical investigation of the operating principle of our grating sensor shows that in general, as the total field interacting with the analyte is increased, the corresponding absorption is also increased. We also theoretically demonstrate how sub-wavelength gratings can detect changes in the real part of the refractive index, similar to conventional refractive index (RI) sensors.

SYNOPSIS Restatement disclosures have evolved into two basic categories: reissuances (Big “R”) and revisions (little “r”). A reissuance restatement requires an 8-K filing, whereas a revision restatement can be disclosed in less transparent ways. The high-transparency of a reissuance restatement disclosure (8-K) results in a greater likelihood of negative effects on companies, executives, and auditors (e.g., Plumlee and Yohn 2008; Burks 2010). Determining whether an 8-K filing is required involves judgment regarding materiality of the restatement, thus creating ambiguity as to the correct disclosure method. Such judgment also introduces the potential to opportunistically choose the method of disclosure. We study the restatement disclosure choices of companies to examine whether executive pay structure is associated with disclosure transparency. Using a sample of 1,178 restatements from the years 2004 through 2013, our results show that as the equity proportion of executive pay increases, the likelihood of a high-transparency disclosure decreases. However, as the difference in pay structure between the CEO and CFO increases, the likelihood of a high-transparency disclosure increases. Overall, our results suggest that executive pay structure influences disclosure choice and that pay structure differences between the CEO and CFO may mitigate such influence. Data Availability: All data are available from public sources identified in the paper.

PURPOSE: Corneal central thickness (CCT) is an important risk factor for glaucoma, which also influences intraocular pressure (IOP) measurements. Recently, all community optometrists in Scotland were provided with pachymeters. This study examined the accuracy of CCT measured by community optometrists compared to measurements in the glaucoma clinic. METHODS: A retrospective analysis of consecutive patients referred to the glaucoma clinic at a university hospital between June and November 2016. 142 of 715 (19.9%) patients had CCT measurements included in the referral, all of whom had repeat measurements in the glaucoma clinic. CCT was measured using the PachPen (Accutome Inc) which generates a CCT reading by automatically taking the average of up to 9 measurements. Measurements were compared using Bland-Altman analysis. RESULTS: CCT measured by community optometrists was slightly thicker than CCT in the glaucoma clinic (558.3 ± 41.5 vs. 552.6 ± 58.8 µm, P 20 µm, 40 (14.1%) by >30 µm and 17 (6.0%) by >50 µm. There was no significant relationship between difference in CCT and IOP (−0.02, 95% CI −0.05 to 0.002, P = 0.077), gender (0.00, 95%CI −0.01 to 0.01, P = 0.805), or age (−0.01, 95% CI −0.08 to 0.06, P = 0.791). CONCLUSIONS: There was good overall agreement between CCT measured by community optometrists and measurements obtained in the glaucoma clinic. The tendency for thicker CCT measurements by community optometrists may be due to more peripheral or non-perpendicular positioning of the pachymeter relative to the cornea.

Purpose – The purpose of this paper is to determine the association between auditor-provided tax services (APTS) and long-term corporate tax rates. Design/methodology/approach – The paper uses empirical data and multivariate regression models to explore the relationship between a firm’s use of APTS and their long-term effective tax rate. Findings – An economically and statistically significant long-term negative relationship was found between firm levels of APTS and taxes paid. Further, a portion of this benefit is lost for some firms when returning to their auditor for tax services even after a short break. Originality/value – This paper contributes to the debate regarding the value of APTS by providing evidence of the apparent long-term negative consequences to firms who reduce their reliance on APTS, perhaps even through the engagement of separate accounting firms for their audit and tax functions, although these consequences may be mitigated upon return with a significant increase in APTS. However, this is the first study, to our knowledge, to explore, in a long-term setting, the consequences of a firm’s return to their auditors for a non-audit service previously reduced or terminated. Additionally, further incremental contributions are made to other studies that look at APTS and tax avoidance by studying the long-term relationship which allows firms to consider the cumulative cost/benefit relationship between independence and knowledge spillover.

A new material pairing is presented for the realisation of sub-wavelength graings in this work and has been used to realise high contrast gratings which operate at wavelengths of 10 μm and greater. The chosen material pairing overcomes the absorption issue which prevents the popular Si/SiO2 pairing from being useful at wavelengths above 6 μm. The obstacles that exist with the currently used grating materials for this wavelength range are described and it is outlined how the chosen materials overcome these issues. It is numerically demonstrated that gratings utilising these materials are capable of wideband high reflectivity. The gratings were fabricated using standard optical photolithography only and it is shown experimentally that the spectral response of gratings which were fabricated show good agreement with theoretically predicted performance

Slugs are a serious pest of cereal crops, and recent emphasis in slug pest management has shifted from solely chemical towards integrated approaches. The objective of the present research was to test if boosted silicon (Si) and calcium (Ca) levels in wheat seedlings can reduce slug grazing. Laboratory experiments were conducted in which wheat seedlings were grown firstly, with soluble Si and Ca (with and without additional mineral N) or secondly, with six levels of soluble Si, and consumption of leave sections by the field slug (Deroceras reticulatum) was measured. Boosted foliar Si concentrations reduced consumption significantly (P

Advances in the field of groin pain in athletes have long been hampered by the use of inconsistent and confusing nomenclature. This reflects a lack of clarity on whether pathology is clinically relevant and on differentiating between often multiple painful structures. In a systematic review of 72 studies, 33 different diagnostic terms were used1 to describe patient cohorts, often with similar clinical presentations. A thorough patient and injury history and standardised complete physical examination remain the cornerstone for diagnosing athletes with groin pain. The Doha agreement defined four clinical entities (pubic, adductor, iliopsoas and inguinal-related groin) while also highlighting the hip and other possible causes of groin pain.2 This agreement aimed to simplify the terminology used to classify/diagnose athletes with groin pain and to provide a standardised approach to physical examination. This approach uses the patient's ‘known’ pain to identify the specific involved clinical entity. However, not all papers published since have adopted the terminology recommended in the Doha agreement. There remains a lack of histopathological evidence to support the multiple pathological conditions implicated in groin pain. A single study examined …

We present a new material pairing that can be used to realize high-contrast gratings at wavelengths of 10 μm and greater. Using only optical lithography, the material pair solves the absorption issue limiting the popular Si/SiO2 pairing from operation above 6 μm. We describe the obstacles that exist with the currently used grating materials for this wavelength range and outline why our chosen materials overcome this obstacle. We numerically demonstrate that gratings utilizing these materials are capable of wideband high reflectivity. We experimentally show that the spectral response of gratings that are fabricated using such a process show good agreement with theoretically predicted performance.

The funeral xylophone tradition of the Birifor people of Northwest Ghana is renowned across the West African hinterland for its musical artistry, cultural histories, surrogated song texts, and symbolic meaning. The Northwest as a whole has a historically high incidence of blindness, motivating a range of interpretations of visual impairment as disability. In rural Birifor communities, the music, bodies, and ability of blind xylophonists are filtered through a cultural ideology of ability that hijacks social conceptions of disability as biological deviance, and manufactures disability as spiritual deviance. This reveals a spiritual model of disability, which together with the mystical aspects of musicianship in Birifor culture, leads to a compound form of subordination for blind musicians. Against this culturally pervasive ableism, blind Birifor xylophonists compose and perform “enemy music” as an act of resistance, contestation, and catharsis that recasts disability as a lived reality and reframes the true locations of disability.

We conduct a quasi-experiment to determine whether the value placed on a taxpayer's opinion by an elected representative (valued or not valued) has an impact on the taxpayer's procedural and outcome fairness perceptions. We also examine how the taxpayer's intensity of support for the tax legislation interacts with both the value the elected representative placed on the taxpayer's voiced opinion and whether the taxpayer's preferred policy outcome is ultimately passed in a representative democracy. We recruited 92 participants from graduate accounting classes and assigned them to four experimental groups based on whether the elected officials valued their opinion, and whether their desired legislation was passed. As predicted, perceptions of fairness are more positively associated with receiving a desired outcome as intensity of support for an issue increases. Further, we find that taxpayers who do not have a strong intensity of support for a particular legislative position react favorably to having their voice valued by legislators. However, for those taxpayers who feel most passionate about a legislative issue, having their voice valued may provide limited benefits, if any at all. Data Availability: Data are available from the authors on request.

The knowledge of yields and properties of soot from combustion of hydrocarbon fuels is crucial for accurate evaluation of the impacts of primary aerosols on air quality and climate. This study presents measurements of soot generated from combustion of propane in a shock tube, using independently adjustable fuel equivalence ratio (φ), temperature, and pressure. The characterization of soot yields inside the shock tube by in situ laser extinction is complemented with a set of comprehensive measurements of soot transferred into a fluoropolymer chamber, including particle size distributions, elemental carbon (EC) mass fraction, effective density, mass fractal dimension (Dfm), dynamic shape factor (χ), and optical properties. The properties of soot particles and the soot yield are sensitive to combustion conditions and the duration of the combustion experiment. High-temperature combustion with φ = 2.5 produces small fractal (Dfm = 2) soot particles composed mainly of EC (up to 90%), at a low mass yield. Partic...

Objective: Postoperative wound complications after excisional surgery for primary breast cancer can result in patients requiring additional treatments and delay adjuvant therapy and are associated with worse prognoses. We investigated factors that might predispose patients to wound complications. Background: A number of patient characteristics have been associated with wound complications, but there is currently no quantitative measure of the risk of their occurrence. Our hypothesis was that wound complications are related, in part, to the immune status of patients. Methods: We recruited patients undergoing surgery for primary breast cancer and determined their circulating levels of various immune cells shortly before and after surgery as a measure of immune status. Results: One hundred seventeen patients were recruited; 16 (13.7%) developed wound complications. The following patient and tumor characteristics were associated with higher wound complication rates: diabetes (P = 0.02); larger tumors (T2/3 vs T1; P = 0.02); metastatic axillary nodes (P = 0.006). With respect to immune status, no significant differences in preoperative levels of circulating immune cells were detected between patients who developed wound complications and those who did not. However, patients who developed complications showed greater reductions in lymphocyte levels 4 hours postoperatively than those who did not (P < 0.001). Multivariate analyses demonstrated that falls in lymphocyte levels of greater than 20% or 50% 4 hours postoperatively acted as a significant and independent predictor of wound complications (P < 0.005 and P < 0.0001, respectively). Conclusions: Perioperative changes in lymphocyte levels could provide a practical predictive marker for wound complications on which selective antibiotic prophylaxis could be based.

Sub-wavelength gratings (SWG) have shown much promise for applications such as lightweight high bandwidth reflectors, polarising filters and focusing lenses. Unfortunately, grating performance may be rapidly degraded through variability in grating dimensions. We demonstrate, in particular, how an error in depth of etch can be detrimental to the performance of zero contrast grating reflectors. We mitigate the impact of this fabrication error through the introduction of an etch stop layer and in so doing we experimentally realise a high bandwidth reflector based on this modified structure. Another common fabrication error is variation in the duty-cycle of fabricated gratings. This duty-cycle variation can weaken grating performance, however we demonstrate that grating designs that exhibit tolerance to duty-cycle fluctuation can be identified through simulation. Finally, we discuss the impact of lateral etching and the resulting sidewall concavity. We present our approach for numerically predicting the spectral response from such a grating and also for convenience we outline an approach for quickly approximating grating performance. Good agreement is observed between these numerical predictions and measurements made on a HCG with concave sidewalls. (C) 2018 Optical Society of America under the terms of the OSA Open Access Publishing Agreement

Involvement of an intramammary lymph node with metastatic breast cancer is an uncommon clinical or radiological presentation. Previously reported series of patients are small in number and the clinical advice is unclear. We identified 100 patients on our pathology database with intramammary lymph nodes in association with a primary breast cancer. Ten were identified pre-operatively on breast imaging and 90 were first discovered on pathological assessment of excised breast tissue. Twenty one contained metastasis. Factors that predicted for intramammary node metastasis were increasing age (p=0.017), lymphovascular invasion (p=0.002) and grade of tumour (p=0.012). The presence of metastasis within the intramammary lymph node was associated with a poorer disease free survival (p=0.007) and reduced overall survival (p=0.035). Sixty seven percent of patients with intramammary node metastasis had further axillary metastases. One patient had an intramammary node metastasis but uninvolved axillary sentinel node. She presented 19 months later with an axillary nodal recurrence. The presence of intramammary lymph node metastasis is associated with poorer outcome in breast cancer patients. Pre-operative detection of intramammary lymph node metastasis is helpful to guide breast and axillary surgeries. Intramammary lymph node metastasis predicts strongly for axillary metastatic disease and axillary node clearance is recommended.

To identify the prevalence of hip disorders in elite level academy rugby union players using clinical and radiological investigation comparing findings to active controls.Cross-sectional, controlled study.Participants were assessed clinically using validated questionnaire (HAGOS) and physical testing procedures. Active ROM of all hip movements were measured using a goniometer and hip-specific clinical tests including the FABER and the Thomas test examined functional hip motion. Physical tests were compared to age, gender and activity matched controls. The rugby-playing participants underwent dedicated non-arthrographic 3T MRI imaging of the hip in axial oblique, sagittal and coronal planes to assess anatomical abnormality.The rugby cohort had significantly reduced ROM of internal/external rotation, extension and FABER scores compared to the controls. Symptoms were reported by 65% of rugby players (HAGOS symptom score89.3) versus 15% in controls. There was a 95% prevalence of abnormality on MRI (19 of 20 players); 80% of the elite rugby players had labral pathology, 55% had a cam deformity (45% left sided 30% right-sided) and 25% had either unilateral or bilateral chondral wear.The prevalence of abnormality on MRI of the hip is high in rugby players at 95% of study participants. The percentage reporting symptoms was lower at 65% of the cohort although this was significantly higher than (non-rugby) matched controls at 15% of participants. Rugby players demonstrated significantly reduced ROM of the hip compared to controls. Further prospective research is required to investigate the long term sequelae of these findings.

Carbonaceous particles produced from combustion of fossil fuels have strong impacts on air quality and climate, yet quantitative relationships between particle characteristics and combustion conditions remain inadequately understood. We have used a shock tube to study the formation and properties of diesel combustion soot, including particle size distributions, effective density, elemental carbon (EC) mass fraction, mass-mobility scaling exponent, hygroscopicity, and light absorption and scattering. These properties are found to be strongly dependent on the combustion temperature and fuel equivalence ratio. Whereas combustion at higher temperatures (∼2000 K) yields fractal particles of a larger size and high EC content (90 wt %), at lower temperatures (∼1400 K) smaller particles of a higher organic content (up to 65 wt %) are produced. Single scattering albedo of soot particles depends largely on their organic content, increasing drastically from 0.3 to 0.8 when the particle EC mass fraction decreases from 0.9 to 0.3. The mass absorption cross-section of diesel soot increases with combustion temperature, being the highest for particles with a higher EC content. Our results reveal that combustion conditions, especially the temperature, may have significant impacts on the direct and indirect climate forcing of atmospheric soot aerosols.

Extra-cellular microRNAs have been identified within blood and their profiles reflect various pathologies; therefore they have potential as disease biomarkers. Our aim was to investigate how circulating microRNA profiles change during cancer treatment. Our hypothesis was that tumour-related profiles are lost after tumour resection and therefore that comparison of profiles before and after surgery would allow identification of biomarker microRNAs. We aimed to examine whether these microRNAs were directly derived from tumours, and whether longitudinal expression monitoring could provide recurrence diagnoses.Plasma was obtained from ten breast cancer patients before and at two time-points after resection. Tumour tissue was also obtained. Quantitative PCR were used to determine levels of 367 miRNAs. Relative expressions were determined after normalisation to miR-16, as is typical in the field, or to the mean microRNA level.210 microRNAs were detected in at least one plasma sample. Using miR-16 normalisation, we found few consistent changes in circulating microRNAs after resection, and statistical analyses indicated that this normalisation was not justifiable. However, using data normalised to mean microRNA expression we found a significant bias for levels of individual circulating microRNAs to be reduced after resection. Potential biomarker microRNAs were identified, including let-7b, let-7g and miR-18b, with higher levels associated with tumours. These microRNAs were over-represented within the more highly expressed microRNAs in matched tumours, suggesting that circulating populations are tumour-derived in part. Longitudinal monitoring did not allow early recurrence detection.We concluded that specific circulating microRNAs may act as breast cancer biomarkers but methodological issues are critical.

Soot as a byproduct of hydrocarbon combustion has been studied extensively because of its contribution to pollution, on the order of 12-24 Teragrams annually[1]. The composition and morphology of highly agglomerated soot particles is very much dependent on the combustion conditions and may change significantly during atmospheric aging, which occurs through condensation of low-volatile gaseous species (e.g. sulfuric acid and organics), coagulation with existing aerosols, and oxidation by OH and O3[2]. Therefore, better understanding of soot’s fundamental characteristics and formation pathways is critical to minimizing its adverse impact on the environment and human health. An experimental technique has been established for analyzing soot generated in a shock tube using a suite of instruments with particular emphasis on soot yield, particle composition, morphology, optical properties and mass fraction of elemental carbon (EC). The shock tube is useful for creating precise and repeatable temperature and pressure conditions for combusting test mixtures. This precise and individual control over the test conditions allows for studying the effects small temperature and pressure changes have on fundamental soot properties. In the present study, soot is examined from its initiation, through its growth, and at various time increments. The following describes the equipment and techniques used to produce and analyze soot from the combustion of high-equivalence ratio propane and oxygen mixtures, and the results of the analysis are presented.