A Geometric Approach Towards Momentum Conservation

In this work, a geometric discretization of the Navier-Stokes equations is sought by treating momentum as a covector-valued volume-form. The novelty of this approach is that we treat conservation of momentum as a tensor equation and describe a higher order approximation to this tensor equation. The resulting scheme satisfies mass and momentum conservation laws exactly, and resembles a staggered-mesh finite-volume method. Numerical test-cases to which the discretization scheme is applied are the Kovasznay flow, and lid-driven cavity flow

Survival of Escherichia coli on onion during field curing and packout.

The Food and Drug administration has expressed concern that Onions (Allium cepa) irrigated with water contaminated with high rates of Escherichia coli could harbor E. coli on their surface or interior. On the other hand, since onions contain antimicrobial compounds and field conditions may not be conducive to E. coli survival, the E. coli population on the surface of onions might become negligible through the course of field curing. Further, the relationship between the E. coli in the irrigation water to the E. coli on onion bulbs after field curing, harvest, and packout has not been studied. To determine if E. coli should be of concern in onion production, we sought to measure the die-off of E. coli on onions between the last irrigation and harvest and the presence of E. coli on onions after packout. Well water was tested and had no E. coli; ditch water intentionally run across a pasture prior to use had 218 to > 2400 MPN of E. coli/100ml. Onions were sampled from those furrow irrigated (ditch water) and those drip irrigated (well water) starting at lifting 3 September 2013 for four consecutive weeks. At 0 and 28 days after lifting, both interior and exterior of the onions were tested for E. coli. At 7, 14, and 21 days after lifting, only the exterior of the onions was tested. None of the onions contained E. coli internally at 0 or 28 days after lifting. At lifting E. coli was present on the exterior of both the drip and furrow irrigated onions and seemed to be largely unrelated to the irrigation water. The exterior E. coli contamination decreased rapidly after lifting. After harvest and packout on 14 October 2013, no E. coli was detected on the onion bulb exteriors from either irrigation treatment. E. coli introduced into the onion field through furrow irrigation was not present on or in the packed out onion bulbs

Movement of Escherichia coli in soil as applied in irrigation water.

The US Food and Drug Administration (FDA) has proposed that If irrigation water exceeds 235 colony-forming units (CFU) of E. coli /100 ml in any one sample or 126 CFU/100 ml in the average of any five consecutive samples, growers would have to cease using that water in any way that directly contacts the surface of fresh produce (FDA 2013). The FDA has proposed that these E. coli levels are an indication of high risk of bacterial contamination of fresh onion (Allium cepa L.) bulbs regardless of the irrigation system. If onion irrigation exceeds 235 CFU, it is not known whether the contaminated water applied by furrow or drip irrigation actually reaches the onion bulb. Soil could filter E. coli and other bacteria before irrigation water reaches onion bulbs. ?Vaquero? onions were grown on Owyhee silt loam. In our preliminary studies reported here, well water free of E. coli was applied to onions through drip irrigation or through furrow irrigation. A second water source was intentionally enriched with E. coli by being run across a pasture and recaptured prior to use. Furrow and drip irrigation were used to apply this water containing 218 to >2400 MPN/100ml for 11+ hours per irrigation. E. coli was monitored in the soil water at the end of irrigation cycles through direct sampling of the soil. Soil water was also sampled using sterile soil solution capsules (SSSC) to sample E. coli in the soil water that moved into place, to differentiate the movement of soil water from the soil water already in place. Soil water measurements were made adjacent to the water source, half way to the bulbs, and immediately adjacent to the onion bulbs. For furrow irrigation with ditch water the E. coli counts in the soil next to the onion bulbs was only 0% and 21% of the counts in the irrigation water following the first and second irrigations, respectively. During subsequent furrow irrigations, the E. coli counts in the soil water next to the onion bulbs exceeded the counts in the irrigation water. For drip irrigation with ditch water, the E. coli counts in the soil solution next to the onion bulbs remained very low. The soil water sampled by the SSSC adjacent to the onion bulbs drip-irrigated with ditch water also had very low E. coli counts

Drip vs. furrow irrigation in the delivery of Escherichia coli to onions

Surface irrigation systems that reuse water may deliver bacteria to produce destined for fresh consumption. Four irrigation systems delivered (1) well water free of Escherichia coli via subsurface drip irrigation, (2) canal water with moderate levels of E. coli via subsurface drip irrigation, (3) canal water with moderate levels of E. coli via furrow irrigation, and (4) canal water with enhanced levels of E. coli via furrow irrigation. The four irrigation systems (replicated five times) applied water to onion on silt loam. Water was sampled hourly for E. coli, and the lateral movement of E. coli in the soil solution was tracked by soil samples following irrigations. Onion bulbs were sampled for E. coli contamination. The most probable numbers of E. coli in water and soil water were determined using IDEXX Colilert® and Colisure®, respectively, and Quanti-Tray/2000®. Under both furrow and subsurface drip irrigation, a fraction of the E. coli was delivered to the soil immediately adjacent to the onion bulbs. The silt loam retained most of the E. coli content away from the onion bulbs and close to where the water entered the soil. No E. coli was detected inside of the onion bulbs from any irrigation treatment. Current subsurface drip or furrow (flood) irrigation practices do not appear to pose a significant risk for bacterial contamination of dry bulb onion grown on silt loam

Inguinal hernia surgery in the Netherlands: are patients treated according to the guidelines?

Purpose In 2003, a dedicated Dutch committee developed vidence-based guidelines for the treatment of nguinal hernia (IH) in children and adults. The aim of this tudy was to describe trends in hernia care before and after he publication of the guidelines on IH surgery in the etherlands. ethods Originally, a retrospective baseline analysis of H surgery in 90 Dutch hospitals was performed among atients treated for IH in 2001. The results of this baseline nalysis were compared with a recently performed second nalysis of patients treated for IH in 2005. esults In children\\4 years of age, the study showed a ignificant decrease of contralateral explorations. In adults, he study showed that significantly more patients were reated with a mesh-based repair in 2005 (95.9 vs. 78.8%, <0.01eover, there was an increase of patients ith bilateral hernia treated with an endoscopic technique 41.5 vs. 22.3%, P<0.01) and more patients were treated n day surgery (53.5 vs. 38.6%, P<0.01). Lastly, a decline n operations performed for recurrent IH in adults was bserved (10.9 vs. 13.3%, P<0.01). onclusion This study showed that most patients with IH n the Netherlands were treated according to the main ecommendations of the Dutch evidence-based guidelines

A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy

In recent years, concomitant chemo-radiotherapy (CCRT) has become an indispensable organ preserving treatment modality for advanced head and neck cancer, improving local control and overall survival in several anatomical sites [1]. Unfortunately, CCRT can have a detrimental effect on many functions of the upper respiratory and digestive system. Sequellae such as pain, oedema, xerostomia and fibrosis negatively affect mouth opening (trismus), chewing, swallowing and speech [1]. Several studies investigating long-term effects of CCRT have concluded that swallowing and nutritional dysfunction tend to be persistent and can be severe [2-4]. Not surprisingly, therefore, CCRT can have a negative effect on patients‟ quality of life (QoL) [2]. Moreover, even before onset of treatment patients may already present with pain, impaired swallowing, trismus, aspiration, dietary restrictions and tube dependency, and loss of body weight, because the tumour may disrupt the normal anatomy and thus interfere with normal function [1]. Many studies refer to the importance of rehabilitation after, and even during treatment, in order to support and improve those functions [2]. However, as yet, few studies have investigated the effects of (preventive) rehabilitation exercises on the predictable and inevitable swallowing and mouth opening problems for this patient group. In addition, little is known about the costs and benefits of such exercise programs for head and neck cancer. As the clinical effectiveness is established [4], it is now relevant to embark on cost-effectiveness as a contribution to decision making on coverage. The aim of this study was to analyze the incremental cost-effectiveness for a preventive exercise program (PREP) versus usual care (UC) for patients with advanced head and neck cancer treated at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL)

Oral symptoms and functional outcome related to oral and oropharyngeal cancer

Purpose This study aimed to assess: (1) oral symptoms of patients treated for oral or oropharyngeal cancer; (2) how patients rank the burden of oral symptoms; (3) the impact of the tumor, the treatment, and oral symptoms on functional outcome. Methods Eighty-nine patients treated for oral or oropharyngeal cancer were asked about their oral symptoms related to mouth opening, dental status, oral sensory function, tongue mobility, salivary function, and pain. They were asked to rank these oral symptoms according to the degree of burden experienced. The Mandibular Function Impairment Questionnaire (MFIQ) was used to assess functional outcome. In a multivariate linear regression analyses, variables related to MFIQ scores (p a parts per thousand currency signaEuro parts per thousand 0.10) were entered as predictors with MFIQ score as the outcome. Results Lack of saliva (52%), restricted mouth opening (48%), and restricted tongue mobility (46%) were the most frequently reported oral symptoms. Lack of saliva was most frequently (32%) ranked as the most burdensome oral symptom. For radiated patients, an inability to wear a dental prosthesis, a T3 or T4 stage, and a higher age were predictive of MFIQ scores. For non-radiated patients, a restricted mouth opening, an inability to wear a dental prosthesis, restricted tongue mobility, and surgery of the mandible were predictive of MFIQ scores. Conclusions Lack of saliva was not only the most frequently reported oral symptom after treatment for oral or oropharyngeal cancer, but also the most burdensome. Functional outcome is strongly influenced by an inability to wear a dental prosthesis in both radiated and non-radiated patients

The influence of socioeconomic environment on the effectiveness of alcohol prevention among European students: a cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Although social environments may influence alcohol-related behaviours in youth, the relationship between neighbourhood socioeconomic context and effectiveness of school-based prevention against underage drinking has been insufficiently investigated. We study whether the social environment affects the impact of a new school-based prevention programme on alcohol use among European students.</p> <p>Methods</p> <p>During the school year 2004-2005, 7079 students 12-14 years of age from 143 schools in nine European centres participated in this cluster randomised controlled trial. Schools were randomly assigned to either control or a 12-session standardised curriculum based on the comprehensive social influence model. Randomisation was blocked within socioeconomic levels of the school environment. Alcohol use and alcohol-related problem behaviours were investigated through a self-completed anonymous questionnaire at baseline and 18 months thereafter. Data were analysed using multilevel models, separately by socioeconomic level.</p> <p>Results</p> <p>At baseline, adolescents in schools of low socioeconomic level were more likely to report problem drinking than other students. Participation in the programme was associated in this group with a decreased odds of reporting episodes of drunkenness (OR = 0.60, 95% CI = 0.44-0.83), intention to get drunk (OR = 0.60, 95% CI = 0.45-0.79), and marginally alcohol-related problem behaviours (OR = 0.70, 95% CI = 0.46-1.06). No significant programme's effects emerged for students in schools of medium or high socioeconomic level. Effects on frequency of alcohol consumption were also stronger among students in disadvantaged schools, although the estimates did not attain statistical significance in any subgroup.</p> <p>Conclusions</p> <p>It is plausible that comprehensive social influence programmes have a more favourable effect on problematic drinking among students in underprivileged social environments.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN18092805">ISRCTN18092805</a></p

Contemporary management of cancer of the oral cavity

Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers