Ulnar-sided wrist pain. II. Clinical imaging and treatment

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Investigation of agglomeration and defluidization during spouted-bed gasification of high-sodium, high-sulfur South Australian lignite

The mechanisms of agglomeration and defluidization during the fluid-bed gasification of an Australian low-rank coal are investigated. Experiments were conducted in a 77 mm inner diameter spouted-bed gasifier with a high-sodium, high-sulfur coal from the Lochiel deposit in South Australia. The effect of the bed temperature, air/fuel ratio, and superficial velocity on the stable operation of the spouted bed over a 4 h period was investigated. The results of this study indicate that stable bed operation is governed by a "high-temperature defluidization limit", suggesting that defluidization can be delayed or avoided by operating the bed with high superficial velocity and/or low bed temperatures. In experiments that resulted in agglomeration and in some experiments that did not, the average particle size within the bed material had increased, which was mainly attributed to coating of mineral particles. These coated particles were observed to be more prevalent in runs that led to defluidization of the bed. Particle growth also coincided with the increased inorganic content of the bed compared to stable runs. Agglomeration and defluidization may hence be avoided or delayed by operating the bed below about 850 °C, increasing the superficial velocity of gas within the bed, or maintaining the ash content of the bed below approximately 80%, where possible. © 2011 American Chemical Society.Daniel P. McCullough, Philip J. van Eyk, Peter J. Ashman, and Peter J. Mullinge

Combustion behavior of algal biomass: carbon release, nitrogen release, and char reactivity

Recent focus on algae biomass as an alternative energy source can be attributed to building pressure for conservation of dwindling fossil fuels and reduced greenhouse gas emissions. Both micro- and macroalgae have many advantages over terrestrial plants, including typically faster growth rates and, therefore, higher rates of carbon fixation. This paper reports the combustion characteristics of a species of microalgae and two species of macroalgae under conditions that are relevant for the large-scale use of biomass for heat and other products. The tested species were Tetraselmis sp. (marine microalgae), Derbersia tenusissima (marine macroalgae), and Oedogonium sp. (freshwater macroalgae). Two variants of Oedogonium were tested. One variant was cultivated using standard nutrient additions, and the other variant was starved of essential nutrients. Carbon conversion to CO and CO2 and the release of N as NO were determined for the algae by oxidizing fixed-bed samples of each alga in air at 800 and 1000 °C. The gasification reactivity of the chars was also characterized by gasifying samples of each alga in a thermobalance in pure CO2 (1 atm) at 800 °C, following in situ devolatilization of the algal samples. Carbon conversion to CO and CO2 exceeded 84% for all of the tested algae. Most of the fuel C was released during fuel devolatilization, consistent with the proximate analysis for these fuels. Nitrogen conversions to NO ranged between 6 and 12 g of N/100 g of fuel N for Tetraselmis, 6–9 g of N/100 g of fuel N for Derbersia, and 11–21 g of N/100 g of fuel N for the two Oedogonium variants, with NO emissions occurring mainly during devolatilization, in most cases. Chars produced from samples of macroalgae were much more reactive than the chars from the microalgae, most likely because of the inhibitory effects on mass transfer caused by the very high ash content of the sample used in the present study. The reactivities of all chars increased at high char conversions