Improved model for air pressure due to wind on 2D freak waves in finite depth

This paper presents an improved model for evaluating air pressure acting on 2D freak waves in a finite depth due to the presence of winds. This pressure model is developed by analysing the pressure distribution over freak waves using the QALE-FEM/StarCD approach, which combines the quasi arbitrary Lagrangian-Eulerian finite element method (QALE-FEM) with the commercial software package StarCD and has been proven to be sufficiently accurate for such cases according to our previous publication Yan and Ma (2010) [8]. In this model for air pressure, the pressure is decomposed into the components related to the local wave profiles and others. By coupling with the QALE-FEM, the accuracy of the pressure model is tested using various cases. The results show that the pressure distribution estimated using this model is close to that computed by using the QALE-FEM/StarCD approach when there is no significant vortex shedding and wave breaking. The accuracy investigation in predicting the freak wave heights and elevations demonstrates that this pressure model is much better than others in the literature so far used for modelling wind effects on freak waves in finite depth

Evolution of Near-Sun Solar Wind Turbulence

This paper presents a preliminary analysis of the turbulence spectrum of the solar wind in the near-Sun region R < 50 Rs, obtained from interplanetary scintillation measurements with the Ooty Radio Telescope at 327 MHz. The results clearly show that the scintillation is dominated by density irregularities of size about 100 - 500 km. The scintillation at the small-scale side of the spectrum, although significantly less in magnitude, has a flatter spectrum than the larger-scale dominant part. Furthermore, the spectral power contained in the flatter portion rapidly increases closer to the Sun. These results on the turbulence spectrum for R < 50 Rs quantify the evidence for radial evolution of the small-scale fluctuations (</= 50 km) generated by Alfven waves.Comment: 8 pages, 5 figures, To appear in "Magnetic Coupling between the Interior and the Atmosphere of the Sun", eds. S.S. Hasan and R.J. Rutten, Astrophysics and Space Science Proceedings, Springer-Verlag, Heidelberg, Berlin, 200

Cell walls of the dimorphic fungal pathogens Sporothrix schenckii and Sporothrix brasiliensis exhibit bilaminate structures and sloughing of extensive and intact layers

This work was supported by the Fundação Carlos Chagas de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), grants E-26/202.974/2015 and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), grants 229755/2013-5, Brazil. LMLB is a senior research fellow of CNPq and Faperj. NG acknowledged support from the Wellcome Trust (Trust (097377, 101873, 200208) and MRC Centre for Medical Mycology (MR/N006364/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Carbon budgets of Scotia Sea mesopelagic zooplankton and micronekton communities during austral spring

This is the final version. Available on open access from Elsevier via the DOI in this recordData availability: Macrozooplankton and nekton vertical distribution and abundance at the sustained observation location P3 in the northern Scotia Sea (Southern Ocean) during November and December 2017 https://doi.org/10.5285/e184e81a-e43c-424e-abec-122036ee2cfd. Micronekton and zooplankton respiration rates on COMICS Cruises DY086 and DY090 https://doi.org/10.5285/b9f5c5ec-100a-7ff0-e053-6c86abc0f494. All other data is available on request.Zooplankton form an integral component of epi- and mesopelagic ecosystems, and there is a need to better understand their role in ocean biogeochemistry. The export and remineralisation of particulate organic matter at depth plays an important role in controlling atmospheric CO2 concentrations. Pelagic mesozooplankton and micronekton communities may influence the fate of organic matter in a number of ways, including: the consumption of primary producers and export of this material as fast-sinking faecal pellets, and the active flux of carbon by animals undertaking diel vertical migration (DVM) into the mesopelagic. We present day and night vertical biomass profiles of mesozooplankton and micronekton communities in the upper 500 m during three visits to an ocean observatory station (P3) to the NW of South Georgia (Scotia Sea, South Atlantic) in austral spring, alongside estimates of their daily rates of ingestion and respiration throughout the water column. Day and night community biomass estimates were dominated by copepods >330 μm, including the lipid-rich species, Calanoides acutus and Rhincalanus gigas. We found little evidence of synchronised DVM, with only Metridia spp. and Salpa thompsoni showing patterns consistent with migratory behaviour. At depths below 250 m, estimated community carbon ingestion rates exceeded those of metabolic costs, supporting the understanding that food quality in the mesopelagic is relatively poor, and organisms have to consume a large amount of food in order to fulfil their nutritional requirements. By contrast, estimated community rates of ingestion and metabolic costs at shallower depths were approximately balanced, but only when we assumed that the animals were predominantly catabolising lipids (i.e. respiratory quotient = 0.7) and had relatively high absorption efficiencies. Our work demonstrates that it is possible to balance the metabolic budgets of mesopelagic animals to within observational uncertainties, but highlights the need for a better understanding of the physiology of lipid-storing animals and how it influences carbon budgeting in the pelagic.Natural Environment Research Council (NERC

Diagnostic delay for giant cell arteritis – a systematic review and meta-analysis

Background Giant cell arteritis (GCA), if untreated, can lead to blindness and stroke. The study’s objectives were to (1) determine a new evidence-based benchmark of the extent of diagnostic delay for GCA and (2) examine the role of GCA-specific characteristics on diagnostic delay. Methods Medical literature databases were searched from inception to November 2015. Articles were included if reporting a time-period of diagnostic delay between onset of GCA symptoms and diagnosis. Two reviewers assessed the quality of the final articles and extracted data from these. Random-effects meta-analysis was used to pool the mean time-period (95% confidence interval (CI)) between GCA symptom onset and diagnosis, and the delay observed for GCA-specific characteristics. Heterogeneity was assessed by I 2 and by 95% prediction interval (PI). Results Of 4128 articles initially identified, 16 provided data for meta-analysis. Mean diagnostic delay was 9.0 weeks (95% CI, 6.5 to 11.4) between symptom onset and GCA diagnosis (I 2 = 96.0%; P < 0.001; 95% PI, 0 to 19.2 weeks). Patients with a cranial presentation of GCA received a diagnosis after 7.7 (95% CI, 2.7 to 12.8) weeks (I 2 = 98.4%; P < 0.001; 95% PI, 0 to 27.6 weeks) and those with non-cranial GCA after 17.6 (95% CI, 9.7 to 25.5) weeks (I 2 = 96.6%; P < 0.001; 95% PI, 0 to 46.1 weeks). Conclusions The mean delay from symptom onset to GCA diagnosis was 9 weeks, or longer when cranial symptoms were absent. Our research provides an evidence-based benchmark for diagnostic delay of GCA and supports the need for improved public awareness and fast-track diagnostic pathways

Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group) versus usual care (control group) after plaster removal in adults with surgically treated ankle fractures.</p> <p>Methods</p> <p>In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS) which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36), timed walking tests, ankle mobility tests, muscle strength tests and radiological status.</p> <p>Results</p> <p>52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028), muscle strength in the plantar flexors (p = 0.029) and dorsiflexors (p = 0.030).</p> <p>Conclusion</p> <p>The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three out of nine outcome measures showed a difference, the beneficial effect from an additional standardised individually suited training program can be expected to be limited. There is need for further studies to elucidate how a training program should be designed to increase and optimise function in patients middle-aged or older.</p> <p>Trial Registration</p> <p>Current Controlled Trials ACTRN12609000327280</p

Thermal responses of single zone offices on existing near-extreme summer weather data

There have been a number of attempts in the past to define “near extreme” weather for facilitating overheating analysis in free running buildings. The most recently efforts include CIBSE latest release of Design Summer Year (DSY) weather using multiple complete weather years and a newly proposed composite DSY. This research aims to assess how various single zone offices respond to these new definitions of near extreme weathers. Parametric studies were carried out on single zone offices through which four sampling sets of models were employed to examine the thermal responses of dry bulb temperature, global solar radiation & wind speed collectively. London weather data from 1976 to 1995 were used and the overheating assessments were made based on CIBSE Guide A & BS EN 15251. The research discovers that solar radiation and wind both influence the predicted indoor warmth with solar radiation has obvious stronger impacts than wind. No perfect correlation was found from observation and Spearman’s rank order analysis on the ranks between the weather warmth and the predicted indoor warmth. The ranks made using multiple weather parameters show better correlation than some of the dry bulb temperature only metrics. The research also discovers that the Test Reference Year weather behaves warmer than expected. It is also found that a single complete year can not represent the near-extreme consistently and there is no evidence a composite DSY is better statistically. These findings support the notion of using multiple complete warm weather years for overheating assessments

Barriers and enablers to the implementation of the 6-PACK falls prevention program: A preimplementation study in hospitals participating in a cluster randomised controlled trial

Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702), and 12 focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment). Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and training for nurses; provision of equipment; audit, reminders and feedback; leadership and champions; and the provision of falls data is key to successful falls prevention program implementation in acute hospitals

The Artelon CMC spacer compared with tendon interposition arthroplasty: A randomized, controlled, multicenter study of 109 patients with osteoarthritis followed for 1 year

Background and purpose The Artelon CMC spacer is designed for surgical treatment of osteoarthritis (OA) in the carpometacarpal joint of the thumb (CMC-I). Good results using this degradable device were previously presented in a pilot study. We now present results from a larger randomized, controlled, multicenter study

Hyaluronic acid as a treatment for ankle osteoarthritis

Viscosupplementation refers to the concept of synovial fluid replacement with intra-articular injections of hyaluronic acid (HA) for the relief of pain associated with osteoarthritis (OA). Intra-articular viscosupplementation was approved by the Food and Drug Administration (FDA) in 1997. It is currently indicated only for the treatment of pain associated with knee OA. However, OA can occur in several of the weight-bearing joints of the foot and ankle. Ankle OA produces chronic disability that directly impacts the quality of life. There is only limited published literature relating to the use of HA in the ankle. This paper will review the authors’ experience, indications, clinical outcomes, and complications of viscosupplementation therapy in patients with ankle OA