Multi-scale topography assessment for site-specific drought management in Sweden

Globally, as well as in Sweden, the occurrence of droughts is expected to increase due to global warming. The drought summer of 2018 revealed the vulnerability of Sweden’s agriculture – with cereal yield losses of up to 50 %. Subsequently, the development of more resilience crop production systems to mitigate future droughts is required. Precision agriculture practices (PAP), widely applied in Sweden, are promising to base such developments upon. Hence, the aim of this study was to investigate the potential usage of topography for site-specific decision support, to extend PAP for advanced drought management in Sweden. Therefore, the drought effect along the study period (between crop development stages DC31-DC75) on crop growth development and related to field topography was assessed in a dry year (2018) and compared to a non-dry year (2019). Two common cereals i.e., Winter wheat and spring barely were selected to conduct this study. The study area was in the south-eastern region of Skåne in Sweden. The scale varied from the whole study area to within the field. Crop growth development was monitored using different vegetation and drought indices i.e., normalized difference vegetation index (NDVI), normalized difference red-edge index (NDRE), normalized difference water index (NDWI) and the normalized difference drought index (NDDI). Topography was analysed at and within the field using different topographic indices i.e., slope, relative height (RE) and the topographic wetness index (TWI). The data required to conduct this study was publicly available and consisted of a highresolution digital elevation model, Sentinel-2 remote sensing data, weather data, field polygon as well as soil texture data. Overall, the results clearly showed an average NDVI, NDRE and NDWI reduction over the study period in 2018 compared to 2019 for both cereals; this reduction was about 25 %, 32 % and 58 % for winter wheat and about 36 %, 43 % and 69 % for spring barley. Topographic related within-field crop growth variations were prominent under dry conditions in 2018 and not present under non-dry conditions in 2019. Within-field crop growth variation increased with an increase in average field slope under dry conditions. The TWI was the most promising index explaining within-field crop growth development. Further studies should include other sitespecific field characteristics besides topography to better delineate within-field drought management zones for PAP

A prospective, randomised, controlled, double-blind phase I-II clinical trial on the safety of A-Part® Gel as adhesion prophylaxis after major abdominal surgery versus non-treated group

<p>Abstract</p> <p>Background</p> <p>Postoperative adhesions occur when fibrous strands of internal scar tissue bind anatomical structures to one another. The most common cause of intra-abdominal adhesions is previous intra-abdominal surgical intervention. Up to 74% of intestinal obstructions are caused by post surgical adhesions. Although a variety of methods and agents have been investigated to prevent post surgical adhesions, the problem of peritoneal adhesions remains largely unsolved. Materials serving as an adhesion barrier are much needed.</p> <p>Methods/Design</p> <p>This is a prospective, randomised, controlled, patient blinded and observer blinded, single centre phase I-II trial, which evaluates the safety of A-Part^®Gel as an adhesion prophylaxis after major abdominal wall surgery, in comparison to an untreated control group. 60 patients undergoing an elective median laparotomy without prior abdominal surgery are randomly allocated into two groups of a 1:1- ratio. Safety parameter and primary endpoint of the study is the occurrence of wound healing impairment or peritonitis within 28 (+10) days after surgery. The frequency of anastomotic leakage within 28 days after operation, occurrence of adverse and serious adverse events during hospital stay up to 3 months and the rate of adhesions along the scar within 3 months are defined as secondary endpoints. After hospital discharge the investigator will examine the enrolled patients at 28 (+10) days and 3 months (±14 days) after surgery.</p> <p>Discussion</p> <p>This trial aims to assess, whether the intra-peritoneal application of A-Part^®Gel is safe and efficacious in the prevention of post-surgical adhesions after median laparotomy, in comparison to untreated controls.</p> <p>Trial registration</p> <p>NCT00646412</p

How to proceed with asymptomatic modular dual taper hip stems in the case of acetabular revision

How to proceed with a clinically asymptomatic modular Metha® Ti alloy stem with dual taper CoCr neck adapter in case of acetabular revision? To systematically answer this question the status of research and appropriate diagnostic methods in context to clinically symptomatic and asymptomatic dual taper stem-neck couplings has been evaluated based on a systematic literature review. A retrieval analysis of thirteen Metha® modular dual taper CoCr/Ti alloy hip stems has been performed and a rational decision making model as basis for a clinical recommendation was developed. From our observations we propose that in cases of acetabular revision, that for patients with a serum cobalt level of > 4 µg/L and a Co/Cr ratio > 3.6, the revision of the modular dual taper stem may be considered. Prior to acetabular revision surgery a systematic diagnostic evaluation should be executed, using specific tests such as serum metal (Co, Cr) ion analysis, plain antero-posterior and lateral radiographs and cross-sectional imaging modalities (Metal Artefact Reduction Sequence Magnetic Resonance Imaging). For an asymptomatic Metha® dual taper Ti alloy/CoCr stem-neck coupling at the stage of acetabular revision careful clinical decision making according to the proposed model should be followed and overreliance on any single examination should be avoided, considering the complete individual differential diagnosis and patient situation