Exposing the evidence gap for complementary and alternative medicine to be integrated into science-based medicine.

When people who advocate integrating conventional science-based medicine with complementary and alternative medicine (CAM) are confronted with the lack of evidence to support CAM they counter by calling for more research, diverting attention to the 'package of care' and its non-specific effects, and recommending unblinded 'pragmatic trials'. We explain why these responses cannot close the evidence gap, and focus on the risk of biased results from open (unblinded) pragmatic trials. These are clinical trials which compare a treatment with 'usual care' or no additional care. Their risk of bias has been overlooked because the components of outcome measurements have not been taken into account. The components of an outcome measure are the specific effect of the intervention and non-specific effects such as true placebo effects, cognitive measurement biases, and other effects (which tend to cancel out when similar groups are compared). Negative true placebo effects ('frustrebo effects') in the comparison group, and cognitive measurement biases in the comparison group and the experimental group make the non-specific effect look like a benefit for the intervention group. However, the clinical importance of these effects is often dismissed or ignored without justification. The bottom line is that, for results from open pragmatic trials to be trusted, research is required to measure the clinical importance of true placebo effects, cognitive bias effects, and specific effects of treatments

Guiding of Rydberg atoms in a high-gradient magnetic guide

We study the guiding of $^{87}$Rb 59D$_{5/2}$ Rydberg atoms in a linear, high-gradient, two-wire magnetic guide. Time delayed microwave ionization and ion detection are used to probe the Rydberg atom motion. We observe guiding of Rydberg atoms over a period of 5 ms following excitation. The decay time of the guided atom signal is about five times that of the initial state. We attribute the lifetime increase to an initial phase of $l$-changing collisions and thermally induced Rydberg-Rydberg transitions. Detailed simulations of Rydberg atom guiding reproduce most experimental observations and offer insight into the internal-state evolution

Self-consistent massive disks in triaxial dark matter halos

Galactic disks in triaxial dark matter halos become deformed by the elliptical potential in the plane of the disk in such a way as to counteract the halo ellipticity. We develop a technique to calculate the equilibrium configuration of such a disk in the combined disk-halo potential, which is based on the method of Jog (2000) but accounts for the radial variation in both the halo potential and the disk ellipticity. This crucial ingredient results in qualitatively different behavior of the disk: the disk circularizes the potential at small radii, even for a reasonably low disk mass. This effect has important implications for proposals to reconcile cuspy halo density profiles with low surface brightness galaxy rotation curves using halo triaxiality. The disk ellipticities in our models are consistent with observational estimates based on two-dimensional velocity fields and isophotal axis ratios.Comment: ApJ, in pres

Offsetting of CO₂ emissions by air capture in mine tailings at the Mount Keith Nickel Mine, Western Australia: Rates, controls and prospects for carbon neutral mining

The hydrated Mg-carbonate mineral, hydromagnesite [Mg₅(CO₃)₄(OH)₂•4H₂O], precipitates within mine tailings at the Mount Keith Nickel Mine, Western Australia as a direct result of mining operations. We have used quantitative mineralogical data and δ¹³C, δ¹⁸O and F¹⁴C isotopic data to quantify the amount of CO₂fixation and identify carbon sources. Our radiocarbon results indicate that at least 80% of carbon stored in hydromagnesite has been captured from the modern atmosphere. Stable isotopic results indicate that dissolution of atmospheric CO₂ into mine tailings water is kinetically limited, which suggests that the current rate of carbon mineralization could be accelerated. Reactive transport modeling is used to describe the observed variation in tailings mineralogy and to estimate rates of CO₂ fixation. Based on our assessment, approximately 39,800 t/yr of atmospheric CO₂ are being trapped and stored in tailings at Mount Keith. This represents an offsetting of approximately 11% of the mine's annual greenhouse gas emissions. Thus, passive sequestration via enhanced weathering of mineral waste can capture and store a significant amount of CO₂. Recommendations are made for changes to tailings management and ore processing practices that have potential to accelerate carbonation of tailings and further reduce or completely offset the net greenhouse gas emissions at Mount Keith and many other mines

The Role of <i>Roles</i> in Risk Management Change:The Case of an Italian Bank

This paper explores the role of roles (i.e. groups of actors characterised by the same functional tasks within an organisation), and of their interactions, within processes of change in risk management (RM). By combining insights from the literature on RM and from institutional studies, this paper suggests that change in RM can be interpreted as a process that involves both enabling and precipitating dynamics [Greenwood, R., &amp; Hinings, C. R. (1996). Understanding radical organizational change: Bringing together the old and the new institutionalism. The Academy of Management Review, 21, 1022\ue2\u80\u931054. doi:10.5465/AMR.1996.9704071862] between different roles. Aiming to address these dynamics empirically, we rely on a longitudinal case study of an Italian bank. The study shows that the interactions between roles were dependent on their respective specific interests, the different institutional templates they supported, and the shifts in power for control over relevant information. These dynamics both affected and were affected by the change in the template-in-use within the bank and allowed a sort of RM ideal (i.e. the search for more RM) to persist over evolving templates

Detection of honey bee viruses in larvae of Vespa orientalis

The Oriental hornet (Vespa orientalis) is native to the southeastern Mediterranean, north-eastern and eastern Africa, the Middle East, Central Asia and it is well established in southern Italy. However, recent reports in Liguria, Trieste and Tuscany show great expansion of its areal probably due to climate change or involuntary anthropic actions. Adults feed on carbohydrates collected from fruit and nectar while brood is fed by workers with animal proteins (grasshoppers, flies, yellowjackets and bees). The interaction between the two species could lead to possible spillover of pathogens in both directions. Previous studies have already reported the presence of honey bee pathogens (virus, fungi and bacteria), in Vespae and have underlined their role in disseminating pathogens which could represent a threat for honey bees. Aim of this study was to detect the presence in V.orientalis of six honey bee viruses, more precisely Acute Bee Paralysis Virus (ABPV), Black Queen Cell Virus (BQCV), Chronic Bee Paralysis Virus (CBPV), Deformed Wing Virus (DWV), Kashmir Bee Virus (KBV), Sac Brood Virus (SBV), and to investigate possible transmission route. 30 adults and 29 larvae of V.orientalis and 2 pools of 10 honey bees (Apis mellifera ligustica) each were collected from the managed nest and apiary located both at the Department of Agricultural, Food and Forest Sciences-University of Palermo, and sent to the Department of Veterinary Medicine and Animal Productions- University of Naples “Federico II”. Samples were observed by stereomicroscope to assess possible alterations which could be indicative of the action of viruses and then subjected to multiplex PCR to detect viruses. No morphological alterations were identified despite the biomolecular results showed 25/30 adults and 24/29 larvae were infected with at least one virus (DWV). Adult samples presented also ABPV (19/30), BQCV (13/30), SBV (1/30); while larvae presented SBV (10/29), ABPV (5/29), BQCV (5/29). No sample resulted positive for CBPV and only 1/30 adult resulted positive for KBV. Honey bees’ positivities reflected those of the hornets: 2/2 DWV, 2/2 SBV, 2/2 BQCV and 1/2 ABPV. The viruses detected in our study are the most prevalent in apiaries across Italy and the overlapping of positivities between hornets and honey bees collected in the same site suggests possible transmission of honey bee viruses through ingestion of infected honey bees

A case-control study of risk factors for wound infection in a colorectal unit

INTRODUCTION Postoperative wound infections have been responsible for increasing morbidity and are associated with an increased use of hospital resources. Previous studies have identified several risk factors. However, most studies are outdated, and few relate to the era of enhanced recovery and laparoscopic surgery. This study investigated the association between patient and operative factors and the development of postoperative wound infections in colorectal surgery. METHODS Patients with documented wound infections or dehiscences were identified from a database of elective and emergency colorectal surgery. Patients with wound infections were matched by operation type to a control group of colorectal patients. Differences in patient and operative factors between case and control group were analysed using conditional logistic regression. RESULTS A total of 56 patients with wound infection were identified from 647 operations (8.6%). Fifty-seven per cent were emergency operations and eighty-eight per cent were performed as open surgery or as laparoscopic surgery converted to open. Forty per cent of patients had high ASA (American Society of Anesthesiologists) grades (3 or 4). Multivariate logistical regression showed that obese patients and those having open surgery had the highest risk of infections. The median postoperative hospital stay for patients with wound infections was twice as long as for those patients without wound infections. CONCLUSIONS Open surgery and obesity are independent risk factor for wound infections. An increase in laparoscopically performed operations and new strategies for managing wounds in obese patients may help to reduce the rate of wound infection

Program on Earth Observation Data Management Systems (EODMS), appendixes

The needs of state, regional, and local agencies involved in natural resources management in Illinois, Iowa, Minnesota, Missouri, and Wisconsin are investigated to determine the design of satellite remotely sensed derivable information products. It is concluded that an operational Earth Observation Data Management System (EODMS) will be most beneficial if it provides a full range of services - from raw data acquisition to interpretation and dissemination of final information products. Included is a cost and performance analysis of alternative processing centers, and an assessment of the impacts of policy, regulation, and government structure on implementing large scale use of remote sensing technology in this community of users