Audit on Compliance to Guidelines in CT Scanning for Urolithiasis

Introduction: According to the ALARA principle, CT-imaging procedures should be implemented to optimize radiation doses. The purpose of this study is to determine whether a quality control process has an impact on compliance with procedures. Materials and methods: This retrospective study was conducted in three hospitals, focusing on the selection of the appropriate acquisition protocol and the reduction of acquisition height in abdominal computed tomography (CT) examinations performed to diagnose or rule out urolithiasis. A first audit was conducted to measure the compliance with the procedure. Next, a reminder of the CT-urolithiasis procedure was given to stakeholders. Three months later, a second audit was conducted to measure the impact of the repeat recall information on compliance, and to compare the outcome with an earlier audit conducted five years earlier. Results: We included 517 ‘urolithiasis CT examinations’. The compliance ranged from 41.67% to 64.8% for the first audit. After the reminder of the urolithiasis procedure, compliance ranged from 50% to 76.10%. This improvement was statistically significant for hospital A and B (p < 0.001 for hospital A, p = 0.013 for hospital B) but not for hospital C (p = 0.405). Despite prior demonstration that improved compliance persisted at one year from an initial audit, our actual data show that this compliance had decreased at year five, confirming the need to repeat compliance audits more frequently, or to monitor it continuously. Conclusion: Surveying compliance to procedures can improve compliance but only for a limited duration. Monitoring compliance more frequently or even continuously is recommended

Harvesting Intensity and Aridity Are More Important Than Climate Change in Affecting Future Carbon Stocks of Douglas-Fir Forests

Improved forest management may offer climate mitigation needed to hold warming to below 2°C. However, uncertainties persist about the effects of harvesting intensity on forest carbon sequestration, especially when considering interactions with regional climate and climate change. Here, we investigated the combined effects of harvesting intensity, climatic aridity, and climate change on carbon stocks in Douglas-fir [Pseudotsuga menziesii Mirb. (Franco)] stands. We used the Carbon Budget Model of the Canadian Forest Sector to simulate the harvest and regrowth of seven Douglas-fir stand types covering a 900 km-long climate gradient across British Columbia, Canada. In particular, we simulated stand growth under three regimes (+17%, −17% and historical growth increment) and used three temperature regimes [historical, representative concentration pathways (RCP) 2.6 and RCP 8.5]. Increasing harvesting intensity led to significant losses in total ecosystem carbon stocks 50 years post-harvest. Specifically, forests that underwent clearcutting were projected to stock about 36% less carbon by 2,069 than forests that were left untouched. Belowground carbon stocks 50 years into the future were less sensitive to harvesting intensity than aboveground carbon stocks and carbon losses were greater in arid interior Douglas-fir forests than in humid, more productive forests. In addition, growth multipliers and decay due to the RCP’s had little effect on total ecosystem carbon, but aboveground carbon declined by 7% (95% confidence interval [−10.98, −1.81]) in the high emissions (RCP8.5) scenario. We call attention to the implementation of low intensity harvesting systems to preserve aboveground forest carbon stocks until we have a more complete understanding of the impacts of climate change on British Columbia’s forests

Harvest intensity effects on carbon stocks and biodiversity are dependent on regional climate in Douglas-fir forests of British Columbia

Temperate forests provide crucial ecosystems services as living sinks for atmospheric carbon (C) and repositories of biodiversity. Applying harvesting at intensities that minimize losses offers one means for mitigating global change. However, little is known of overstory retention levels that best conserve ecosystem services in different regional climates, and likewise as climate changes. To quantify the effect of harvest intensity on C stocks and biodiversity, we compared five harvesting intensities (clearcutting,seedtree retention, 30% patch retention, 60% patch retention, and uncut controls) across a climatic aridity gradient that ranged from humid to semi-arid in the Douglas-fir (Pseudostuga menziesii) forests of British Columbia. We found that increased harvesting intensity reduced total ecosystem, aboveground, and live tree C stocks one year post-harvest, and the magnitude of these losses were negatively correlated with climatic aridity. In humid forests, total ecosystem C ranged from 50% loss following clearcut harvest, to 30% loss following large patch retention harvest. In arid forests this range was 60% to 8% loss, respectively. Where lower retention harvests are sought, the small patch retention treatment protected both C stocks and biodiversity in the arid forests, whereas the seedtree method performed as well or better in the humid forests. Belowground C stocks declined by an average of 29% after harvesting, with almost all of the loss from the forest floor and none from the mineral soil. Of the secondary pools, standing and coarse deadwood declined in all harvesting treatments regardless of cutting intensity or aridity, while C stocks in fine fuels and stumps increased. The understory plant C pool declined across all harvesting intensities in the humid forests, but increased in arid forests. Shannon’s diversity and richness of tree and bryoid species declined with harvesting intensity, where tree species losses were greatest in the humid forests and bryoid losses greatest in arid forests. Shrub and herb species were unaffected. This study showed that the highest retention level was best at reducing losses in C stocks and biodiversity, and clearcutting the poorest, and while partial retention of canopy trees can reduce losses in these ecosystem services, outcomes will vary with climatic aridity

Responses of vascular plant fine roots and associated microbial communities to whole-ecosystem warming and elevated CO2 in northern peatlands

Warming and elevated CO2 (eCO2) are expected to facilitate vascular plant encroachment in peatlands. The rhizosphere, where microbial activity is fueled by root turnover and exudates, plays a crucial role in biogeochemical cycling, and will likely at least partially dictate the response of the belowground carbon cycle to climate changes. We leveraged the Spruce and Peatland Responses Under Changing Environments (SPRUCE) experiment, to explore the effects of a whole-ecosystem warming gradient (+0°C to 9°C) and eCO2 on vascular plant fine roots and their associated microbes. We combined trait-based approaches with the profiling of fungal and prokaryote communities in plant roots and rhizospheres, through amplicon sequencing. Warming promoted self-reliance for resource uptake in trees and shrubs, while saprophytic fungi and putative chemoorganoheterotrophic bacteria utilizing plant-derived carbon substrates were favored in the root zone. Conversely, eCO2 promoted associations between trees and ectomycorrhizal fungi. Trees mostly associated with short-distance exploration-type fungi that preferentially use labile soil N. Additionally, eCO2 decreased the relative abundance of saprotrophs in tree roots. Our results indicate that plant fine-root trait variation is a crucial mechanism through which vascular plants in peatlands respond to climate change via their influence on microbial communities that regulate biogeochemical cycles

Cutaneous Infrared Thermometry for Detecting Febrile Patients

We assessed the accuracy of cutaneous infrared thermometry, which measures temperature on the forehead, for detecting patients with fever in patients admitted to an emergency department. Although negative predictive value was excellent (0.99), positive predictive value was low (0.10). Therefore, we question mass detection of febrile patients by using this method

Evidence for shape coexistence in odd-mass rhodium nuclei

Results from the study of the ‘@‘Ru (‘He, d) “‘Rh reaction reveal evidence for shape coexistence in odd-mass rhodium isotopes. The strongly excited states at 786, 806, 969, 1019 and 1355 keV in “‘Rh are good candidates for a rotational-like positive-parity band with J”= l/2+, 3/2+, 5/2+, 7/2+ and 9/2+, respectively, coexisting with spherical shell-model states like lg92 2p12 2p32 and lf52 as well as core-coupled configurations

Nuclear recollisions in laser-assisted α\alpha decay

Laser-induced nuclear recollisions following $\alpha$ decay in the presence of an intense laser field are investigated theoretically. We show that while an intense optical laser does not influence notably the tunneling rate in $\alpha$ decay, it can completely change the $\alpha$ particle spectrum. For intensities of $10^{22}-10^{23}$ W/cm$^{2}$, the field is strong enough to induce recollisions between the emitted $\alpha$ particle and the daughter nucleus. The energy gained by the $\alpha$ particle in the field can reach 20 MeV and suffice to trigger several types of nuclear reactions on a femtosecond time scale. Similar conclusions can be drawn about laser-induced recollisions after proton emission. Prospects for the experimental realization of laser-induced nuclear recollisions are discussed.Comment: 5 pages, 3 figures; v2 extended the motivation and discussion about experimental feasibility; results unchange

Climate-Mediated Changes to Linked Terrestrial and Marine Ecosystems across the Northeast Pacific Coastal Temperate Rainforest Margin

Coastal margins are important areas of materials flux that link terrestrial and marine ecosystems. Consequently, climate-mediated changes to coastal terrestrial ecosystems and hydrologic regimes have high potential to influence nearshore ocean chemistry and food web dynamics. Research from tightly coupled, high-flux coastal ecosystems can advance understanding of terrestrial–marine links and climate sensitivities more generally. In the present article, we use the northeast Pacific coastal temperate rainforest as a model system to evaluate such links. We focus on key above- and belowground production and hydrological transport processes that control the land-to-ocean flow of materials and their influence on nearshore marine ecosystems. We evaluate how these connections may be altered by global climate change and we identify knowledge gaps in our understanding of the source, transport, and fate of terrestrial materials along this coastal margin. Finally, we propose five priority research themes in this region that are relevant for understanding coastal ecosystem links more broadly.Ye

Fénelon et nous

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Molière :Satge and Study. Essays in honour of W.G. Moore. Edited by W.D. Howarth and Merlin Thomas. Oxford, At the Clarendon Press, 1973

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