A quasi-annual record of time-transgressive esker formation: implications for ice sheet reconstruction and subglacial hydrology

We identify and map chains of esker beads (series of aligned mounds) up to 15 m high and on average ~ 65 m wide across central Nunavut, Canada from the high-resolution (2 m) ArcticDEM. Based on the close one-to-one association with regularly spaced, sharp crested ridges interpreted as De Geer moraines, we interpret the esker beads to be quasi-annual ice-marginal deposits formed time-transgressively at the mouth of subglacial conduits during deglaciation. Esker beads therefore preserve a high-resolution record of ice-margin retreat and subglacial hydrology. The well-organised beaded esker network implies that subglacial channelised drainage was relatively fixed in space and through time. Downstream esker bead spacing constrains the typical pace of deglaciation in central Nunavut between 7.2 and 6 ka 14C BP to 165–370 m yr−1, although with short periods of more rapid retreat (> 400 m yr−1). Under our time-transgressive interpretation, the lateral spacing of the observed eskers provides a true measure of subglacial conduit spacing for testing mathematical models of subglacial hydrology. Esker beads also record the volume of sediment deposited in each melt season, thus providing a minimum bound on annual sediment fluxes, which is in the range of 103–104 m3 yr−1 in each 6–10 km wide subglacial conduit catchment. We suggest the prevalence of esker beads across this predominantly marine terminating sector of the former Laurentide Ice Sheet is a result of sediment fluxes that were unable to backfill conduits at a rate faster than ice-margin retreat. Esker ridges, conversely, are hypothesised to form when sediment backfilling of the subglacial conduit outpaced retreat resulting in headward esker growth close to but behind the margin. The implication, in accordance with recent modelling results, is that eskers in general record a composite signature of ice-marginal drainage rather than a temporal snapshot of ice-sheet wide subglacial drainage

Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. Case presentation: The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was complicated by pneumoperitoneum which limited the visibility of the pelvic anatomy; however, the mesh was successfully deployed bilaterally. Cautery was used to resect the direct sac on the right. The patient was discharged the same day and doing well with minimal pain and swelling until the fourth day after surgery. That night he presented with sudden-onset pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy. Conclusion: Ischemic orchitis typically presents 2–3 days after inguinal hernia surgery and can progress to infarction. This ischemic injury is likely due to thrombosis of the venous plexus, rathe

'Kids sold, desperate moms need cash': Media representations of Zimbabwean women migrants

The article draws on 575 randomly selected articles from the South African Media database to explore the representation of Zimbabwean women migrants. Using critical discourse analysis (CDA), the article shows that some of the dominant construction types depict a picture of caricatured, stereotypical and stigmatised Zimbabwean migrant women without voice and individuality. In turn, the diversity of their actualities is not captured in the process of constructing the twin images of Zimbabwean women as victims and as purveyors of decadent and other negative social ills in society. We conclude that Zimbabwean women migrants appear in the SA media primarily in three negative images: suppliers of sexual services, as un-motherly, and as victims. We also conclude that there is need for media to capture the voices of migrant women recounting their everyday lived experiences in different political and socio-economic contexts in order to account for the migrant women's voices of resilience, defiance and victimhood and of agency, against the normalising and marginalising influences of political institutions and national border controls. This would also help capture the transformative nature of migration to the women, the 'home' in Zimbabwe and the 'home' in South Africa.IS

Adapting the Nominal Group Technique to a virtual version: an experience report

Objective: To report on the adaptations made to the original Nominal Group Technique (NGT), allowing it to be applied to the virtual format, preserving all its key elements. Method: An experience report on the adaptations and adjustments made to the original NGT to the virtual format using Information and Communication Technologies (ICT), using digital tools that are available free of charge or are low cost and easy to use. Results: The NGT was carried out entirely virtually and underwent adaptations in each of its four stages through the incorporation of specific digital resources. It was possible to present the most voted ideas and obtain final approval from the participants. The participants had no difficulty in using the virtual resources provided and, based on the reaction evaluation, they were satisfied with the tools provided. Conclusion: The adapted NGT proved to be an effective method when used in a virtual setting, capable of producing a significant number of ideas and developing consensus. The adapted tool can be used by other researchers in countries with similar resources or dimensions to Brazil.RESUMEN. Objetivo: Informar sobre las adaptaciones realizadas a la Técnica de Grupo Nominal (TGN) original, permitiendo su aplicación al formato virtual, preservando todos sus elementos clave. Método: Se trata de un informe de experiencia sobre las adaptaciones y ajustes realizados a la TGN original para el formato virtual mediante el uso de las Tecnologías de la Información y la Comunicación (TIC), utilizando herramientas digitales disponibles de forma gratuita o de bajo coste y fácil uso. Resultados: El TGN se realizó íntegramente de manera virtual y sufrió adaptaciones en cada una de sus cuatro etapas mediante la incorporación de recursos digitales específicos. Fue posible presentar las ideas más votadas y obtener la aprobación final de los participantes. Los participantes no tuvieron dificultades para utilizar los recursos virtuales proporcionados y, según los comentarios recibidos, se mostraron satisfechos con las herramientas facilitadas. Conclusión: El TGN adaptado demostró ser un método eficaz cuando se utiliza en un entorno virtual, capaz de producir un número significativo de ideas y desarrollar el consenso. La herramienta adaptada puede ser utilizada por otros investigadores en países con recursos o dimensiones similares a las de Brasil.RESUMO. Objetivo: Relatar as adaptações realizadas na Técnica de Grupo Nominal (TGN) original, permitindo sua aplicação ao formato virtual, preservando todos os seus elementos-chave. Método: Relato de experiência sobre as adaptações e adequações realizadas na TGN original ao formato virtual aplicando as Tecnologias da Informação e Comunicação (TIC), por meio de ferramentas digitais disponibilizadas gratuitamente ou de baixo custo e de fácil manejo. Resultados: A TGN foi realizada integralmente de forma virtual e sofreu adaptações em cada uma das suas quatro etapas através da incorporação de recursos digitais específicos. Foi possível apresentar as ideias mais votadas e obter a aprovação final dos participantes. Os participantes não apresentaram dificuldade para utilizar os recursos virtuais disponibilizados, e, partir da avaliação de reação, mostram-se satisfeitos com as ferramentas disponibilizadas. Conclusão: A TGN adaptada mostrou-se um método efetivo quando utilizada em cenário virtual, sendo capaz de produzir um significativo número de ideias e desenvolver consenso. A ferramenta adaptada pode ser usada por outros pesquisadores em países com recursos ou dimensões semelhantes ao Brasil.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001

The effect of time-to-surgery on outcome in elderly patients with proximal femoral fractures

<p>Abstract</p> <p>Background</p> <p>Whether reducing time-to-surgery for elderly patients suffering from hip fracture results in better outcomes remains subject to controversial debates.</p> <p>Methods</p> <p>As part of a prospective observational study conducted between January 2002 and September 2003 on hip-fracture patients from 268 acute-care hospitals all over Germany, we investigated the relationship of time-to-surgery with frequency of post-operative complications and one-year mortality in elderly patients (age ≥65) with isolated proximal femoral fracture (femoral neck fracture or pertrochanteric femoral fracture). Patients with short (≤12 h), medium (> 12 h to ≤36 h) and long (> 36 h) times-to-surgery, counting from the time of the fracture event, were compared for patient characteristics, operative procedures, post-operative complications and one-year mortality.</p> <p>Results</p> <p>Hospital data were available for 2916 hip-fracture patients (mean age (SD) in years: 82.1 (7.4), median age: 82; 79.7% women). Comparison of groups with short (n = 802), medium (n = 1191) and long (n = 923) time-to-surgery revealed statistically significant differences in a few patient characteristics (age, American Society of Anesthesiologists ratings classification and type of admission) and in operative procedures (total hip endoprosthesis, hemi-endoprosthetic implants, other osteosynthetic procedures). However, comparison of these same groups for frequency of postoperative complications revealed only some non-significant associations with certain complications such as post-operative bleeding requiring treatment (early surgery patients) and urinary tract infections (delayed surgery patients). Both unadjusted rates of one-year all-cause mortality (between 18.1% and 20.5%), and the multivariate-adjusted hazard ratios (HR for time-to-surgery: 1.04; p = 0.55) showed no association between mortality and time-to-surgery.</p> <p>Conclusion</p> <p>Although this study found a trend toward more frequent post-operative complications in the longest time-to-surgery group, there was no effect of time-to-surgery on mortality. Shorter time-to-surgery may be associated with somewhat lower rates of post-operative complications such as decubitus ulcers, urinary tract infections, thromboses, pneumonia and cardiovascular events, and with somewhat higher rates of others such as post-operative bleeding or implant complications.</p

A comparison of echocardiographic and electron beam computed tomographic assessment of aortic valve area in patients with valvular aortic stenosis

The purpose of this study was to compare electron beam computed tomography (EBT) with transthoracic echocardiography (TTE) in determining aortic valve area (AVA). Thirty patients (9 females, 21 males) underwent a contrast-enhanced EBT scan (e-Speed, GE, San Francisco, CA, USA) and TTE within 17 ± 12 days. In end-inspiratory breath hold, a prospectively ecg-triggered scan was acquired with a beam speed of 50–100 ms, a collimation of 2 × 1.5 mm and an increment of 3.0 mm. The AVA was measured with planimetry. A complete TTE study was performed in all patients, and the AVA was computed using the continuity equation. There was close correlation between AVA measured with EBT and AVA assessed with TTE (r = 0.60, P < 0.01). The AVA measured with EBT was 0.51 ± 0.46 cm2 larger than the AVA calculated with TTE measurements. EBT appeared to be a valuable non-invasive method to measure the AVA. EBT measures the anatomical AVA, while with TTE the functional AVA is calculated, which explains the difference in results between the methods