Groundwater recharge influenced by ephemeral river flow and land use in the semiarid Limpopo Province of South Africa

Determining the sustainability of groundwater use in drylands with high climate variability is complex. Central to this determination is an understanding of groundwater recharge and associated processes and controls. Groundwater recharge in drylands can occur by diffuse and focused recharge (focused recharge being associated with intense episodic rainfall events and ephemeral river flow, predicted to increase and intensify with climate change). This study evaluated the relative significance and dominant controls on these two recharge processes. Ten groundwater hydrographs with multidecadal observations were collated from the Limpopo Province, South Africa, based on their proximity to river channels and rain gauges, representing diversity in local climate, landscape, vegetation, and hydrogeological conditions. The hydrographs showed that groundwater-level rises are sensitive to rainfall intensity during the rainy season, with generally larger increases after years with large episodic rainfall events, which disproportionately contribute to groundwater replenishment. Recharge processes and annual recharge volumes were quantified using the water-table fluctuation method and the numerical model HYDRUS-1D. This allowed for the inference of additional recharge contributions from focused recharge in proximity to ephemeral rivers, up to a factor of five relative to diffuse recharge. The analysis revealed synchronicity and linear correlation between annual river discharge and recharge close to the river, substantiating the importance of focused recharge close to the river network. The study showed that recharge in drylands is subject to large spatial and temporal variation and that consideration of focused and episodic recharge is critically important for managing groundwater resources at various scales in these regions

Evaluation of headache service quality indicators: pilot implementation in two specialist-care centres

Background Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so that deficiencies in headache care worldwide might be recognized and rectified. These indicators themselves require evaluation and proof of fitness for purpose. This pilot study begins this process. Methods We tested the quality indicators in the tertiary headache centres of the University of Duisburg-Essen in Essen, Germany, and the Hospital da Luz in Lisbon, Portugal. Using seven previously-developed enquiry instruments, we interrogated health-care providers (HCPs), including doctors, nurses, psychologists and physiotherapists, as well as consecutive patients and their medical records. Results The questionnaires were easily understood by both HCPs and patients and were not unduly time-consuming. The results from the two headache centres were comparable despite their differences in structure, staffing and language. These findings met the purpose of the study. Diagnoses were made according to ICHD criteria and critically evaluated during follow-up. However, diagnostic diaries and instruments assessing burden and response to treatment were not always in place or routinely utilised. Triage systems adjusted waiting times to urgency of need. Treatment plans included pathways to other specialities. Patients felt welcomed, reassured and educated, and were mostly satisfied. Discussion points arose over inclusion of psychological therapies in treatment plans; over recording of outcomes; over indicators of efficiency and equitability (protocols to limit wastage of resources, systems to measure input costs and means of ensuring equal access to the services); and over protocols for reporting serious adverse events. Conclusion This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service quality evaluation was successful. The project is ready to be taken into its next stages

Parameterized Directed kk-Chinese Postman Problem and kk Arc-Disjoint Cycles Problem on Euler Digraphs

In the Directed $k$-Chinese Postman Problem ($k$-DCPP), we are given a connected weighted digraph $G$ and asked to find $k$ non-empty closed directed walks covering all arcs of $G$ such that the total weight of the walks is minimum. Gutin, Muciaccia and Yeo (Theor. Comput. Sci. 513 (2013) 124--128) asked for the parameterized complexity of $k$-DCPP when $k$ is the parameter. We prove that the $k$-DCPP is fixed-parameter tractable. We also consider a related problem of finding $k$ arc-disjoint directed cycles in an Euler digraph, parameterized by $k$. Slivkins (ESA 2003) showed that this problem is W[1]-hard for general digraphs. Generalizing another result by Slivkins, we prove that the problem is fixed-parameter tractable for Euler digraphs. The corresponding problem on vertex-disjoint cycles in Euler digraphs remains W[1]-hard even for Euler digraphs

Supersymmetric sound in fluids

We consider the hydrodynamics of supersymmetric fluids. Supersymmetry is broken spontaneously and the low energy spectrum includes a fermionic massless mode, the $\mathit{phonino}$. We use two complementary approaches to describe the system: First, we construct a generating functional from which we derive the equations of motion of the fluid and of the phonino propagating through the fluid. We write the form of the leading corrections in the derivative expansion, and show that the so called diffusion terms in the supercurrent are in fact not dissipative. Second, we use an effective field theory approach which utilizes a non-linear realization of supersymmetry to analyze the interactions between phoninos and phonons, and demonstrate the conservation of entropy in ideal fluids. We comment on possible phenomenological consequences for gravitino physics in the early universe.Comment: Modified introduction and discussion of diffusion terms in the supercurren

Fatty acids in bovine milk fat

Milk fat contains approximately 400 different fatty acid, which make it the most complex of all natural fats. The milk fatty acids are derived almost equally from two sources, the feed and the microbial activity in the rumen of the cow and the lipids in bovine milk are mainly present in globules as an oil-in-water emulsion. Almost 70% of the fat in Swedish milk is saturated of which around 11% comprises short-chain fatty acids, almost half of which is butyric acid. Approximately 25% of the fatty acids in milk are mono-unsaturated and 2.3% are poly-unsaturated with omega-6/omega-3 ratio around 2.3. Approximately 2.7% are trans fatty acids

The Debrisoft ® monofilament debridement pad for use in acute or chronic wounds: A NICE medical technology guidance

As part of its Medical Technology Evaluation Programme, the National Institute for Health and Care Excellence (NICE) invited a manufacturer to provide clinical and economic evidence for the evaluation of the Debrisoft ® monofilament debridement pad for use in acute or chronic wounds. The University of Birmingham and Brunel University, acting as a consortium, was commissioned to act as an External Assessment Centre (EAC) for NICE, independently appraising the submission. This article is an overview of the original evidence submitted, the EAC’s findings and the final NICE guidance issued. The sponsor submitted a simple cost analysis to estimate the costs of using Debrisoft® to debride wounds compared with saline and gauze, hydrogel and larvae. Separate analyses were conducted for applications in home and applications in a clinic setting. The analysis took an UK National Health Service (NHS) perspective. It incorporated the costs of the technologies and supplementary technologies (such as dressings) and the costs of their application by a district nurse. The sponsor concluded that Debrisoft® was cost saving relative to the comparators. The EAC made amendments to the sponsor analysis to correct for errors and to reflect alternative assumptions. Debrisoft® remained cost saving in most analyses and savings ranged from £77 to £222 per patient compared with hydrogel, from £97 to £347 compared with saline and gauze, and from £180 to £484 compared with larvae depending on the assumptions included in the analysis and whether debridement took place in a home or clinic setting. All analyses were severely limited by the available data on effectiveness, in particular a lack of comparative studies and that the effectiveness data for the comparators came from studies reporting different clinical endpoints compared with Debrisoft®. The Medical Technologies Advisory Committee made a positive recommendation for adoption of Debrisoft® and this has been published as a NICE medical technology guidance (MTG17).The Birmingham and Brunel Consortium is funded by NICE to act as an External Assessment Centre for the Medical Technologies Evaluation Programme

The influence of groundwater abstraction on interpreting climate controls and extreme recharge events from well hydrographs in semi-arid South Africa

There is a scarcity of long-term groundwater hydrographs from sub-Saharan Africa to investigate groundwater sustainability, processes and controls. This paper presents an analysis of 21 hydrographs from semi-arid South Africa. Hydrographs from 1980 to 2000 were converted to standardised groundwater level indices and rationalised into four types (C1–C4) using hierarchical cluster analysis. Mean hydrographs for each type were cross-correlated with standardised precipitation and streamflow indices. Relationships with the El Niño–Southern Oscillation (ENSO) were also investigated. The four hydrograph types show a transition of autocorrelation over increasing timescales and increasingly subdued responses to rainfall. Type C1 strongly relates to rainfall, responding in most years, whereas C4 notably responds to only a single extreme event in 2000 and has limited relationship with rainfall. Types C2, C3 and C4 have stronger statistical relationships with standardised streamflow than standardised rainfall. C3 and C4 changes are significantly (p < 0.05) correlated to the mean wet season ENSO anomaly, indicating a tendency for substantial or minimal recharge to occur during extreme negative and positive ENSO years, respectively. The range of different hydrograph types, sometimes within only a few kilometres of each other, appears to be a result of abstraction interference and cannot be confidently attributed to variations in climate or hydrogeological setting. It is possible that high groundwater abstraction near C3/C4 sites masks frequent small-scale recharge events observed at C1/C2 sites, resulting in extreme events associated with negative ENSO years being more visible in the time series

Ultrasensitive force and displacement detection using trapped ions

The ability to detect extremely small forces is vital for a variety of disciplines including precision spin-resonance imaging, microscopy, and tests of fundamental physical phenomena. Current force-detection sensitivity limits have surpassed 1 $aN/\sqrt{Hz}$ (atto $=10^{-18}$) through coupling of micro or nanofabricated mechanical resonators to a variety of physical systems including single-electron transistors, superconducting microwave cavities, and individual spins. These experiments have allowed for probing studies of a variety of phenomena, but sensitivity requirements are ever-increasing as new regimes of physical interactions are considered. Here we show that trapped atomic ions are exquisitely sensitive force detectors, with a measured sensitivity more than three orders of magnitude better than existing reports. We demonstrate detection of forces as small as 174 $yN$ (yocto $=10^{-24}$), with a sensitivity 390$\pm150$ $yN/\sqrt{Hz}$ using crystals of $n=60$ $^{9}$Be$^{+}$ ions in a Penning trap. Our technique is based on the excitation of normal motional modes in an ion trap by externally applied electric fields, detection via and phase-coherent Doppler velocimetry, which allows for the discrimination of ion motion with amplitudes on the scale of nanometers. These experimental results and extracted force-detection sensitivities in the single-ion limit validate proposals suggesting that trapped atomic ions are capable of detecting of forces with sensitivity approaching 1 $yN/\sqrt{Hz}$. We anticipate that this demonstration will be strongly motivational for the development of a new class of deployable trapped-ion-based sensors, and will permit scientists to access new regimes in materials science.Comment: Expanded introduction and analysis. Methods section added. Subject to press embarg

Supportive interventions to improve physiological and psychological health outcomes among patients undergoing cystectomy: A systematic review

Background Our understanding of effective perioperative supportive interventions for patients undergoing cystectomy procedures and how these may affect short and long-term health outcomes is limited. Methods Randomised controlled trials involving any non-surgical, perioperative interventions designed to support or improve the patient experience for patients undergoing cystectomy procedures were reviewed. Comparison groups included those exposed to usual clinical care or standard procedure. Studies were excluded if they involved surgical procedure only, involved bowel preparation only or involved an alternative therapy such as aromatherapy. Any short and long-term outcomes reflecting the patient experience or related urological health outcomes were considered. Results 19 articles (representing 15 individual studies) were included for review. Heterogeneity in interventions and outcomes across studies meant meta-analyses were not possible. Participants were all patients with bladder cancer and interventions were delivered over different stages of the perioperative period. The overall quality of evidence and reporting was low and outcomes were predominantly measured in the short-term. However, the findings show potential for exercise therapy, pharmaceuticals, ERAS protocols, psychological/educational programmes, chewing gum and nutrition to benefit a broad range of physiological and psychological health outcomes. Conclusions Supportive interventions to date have taken many different forms with a range of potentially meaningful physiological and psychological health outcomes for cystectomy patients. Questions remain as to what magnitude of short-term health improvements would lead to clinically relevant changes in the overall patient experience of surgery and long-term recovery