The learning curve associated with the introduction of the subcutaneous implantable defibrillator

Aims: The subcutaneous implantable cardioverter defibrillator (S-ICD) was introduced to overcome complications related to transvenous leads. Adoption of the S-ICD requires implanters to learn a new implantation technique. The aim of this study was to assess the learning curve for S-ICD implanters with respect to implant-related complications, procedure time, and inappropriate shocks (IASs). Methods and results: In a pooled cohort from two clinical S-ICD databases, the IDE Trial and the EFFORTLESS Registry, complications, IASs at 180 days follow-up and implant procedure duration were assessed. Patients were grouped in quartiles based on experience of the implanter and Kaplan-Meier estimates of complication and IAS rates were calculated. A total of 882 patients implanted in 61 centres by 107 implanters with a median of 4 implants (IQR 1,8) were analysed. There were a total of 59 patients with complications and 48 patients with IAS. The complication rate decreased significantly from 9.8% in Quartile 1 (least experience) to 5.4% in Quartile 4 (most experience) (P = 0.02) and non-significantly for IAS from 7.9 to 4.8% (P = 0.10). Multivariable analysis demonstrated a hazard ratio of 0.78 (P = 0.045) for complications and 1.01 (P = 0.958) for IAS. Dual-zone programming increased with experience of the individual implanter (P 13 implants). Conclusion: There is a short and significant learning curve associated with physicians adopting the S-ICD. Performance stab

Strangeness nuclear physics: a critical review on selected topics

Selected topics in strangeness nuclear physics are critically reviewed. This includes production, structure and weak decay of $\Lambda$--Hypernuclei, the $\bar K$ nuclear interaction and the possible existence of $\bar K$ bound states in nuclei. Perspectives for future studies on these issues are also outlined.Comment: 63 pages, 51 figures, accepted for publication on European Physical Journal

Ammonia and nitrous oxide emission factors for excreta deposited by livestock and land-applied manure

Manure application to land and deposition of urine and dung by grazing animals are major sources of ammonia (NH3) and nitrous oxide (N2O) emissions. Utilizing data on NH3 and N2O emissions following land-applied manures and excreta deposited during grazing, emission factors (EFs) disaggregated by climate zone were developed and effects of mitigation strategies evaluated. The NH3 data represents emissions from cattle and swine manures in temperate wet climates, while the N2O data includes cattle, sheep and swine manure emissions in temperate wet/dry and tropical wet/dry climates. The NH3 EFs for broadcast cattle solid manure and slurry were 0.03 and 0.24 kg NH3-N kg-1 total N (TN), respectively, while broadcast swine slurry was 0.29. Emissions from both cattle and swine slurry were reduced between 46 and 62% with low emissions application methods. Land application of cattle and swine manure in wet climates had EFs of 0.005 and 0.011 kg N2O-N kg-1 TN, respectively, while in dry climates the EF for cattle manure was 0.0031. The N2O EF for cattle urine and dung in wet climates was 0.0095 and 0.002 kg N2O-N kg-1 TN, respectively, which were three times greater than for dry climates. The N2O EFs for sheep urine and dung in wet climates were 0.0043 and 0.0005, respectively. The use of nitrification inhibitors reduced emissions in swine manure, cattle urine/dung and sheep urine by 45 to 63%. These enhanced EFs can improve national inventories; however, more data is needed across multiple livestock species and climates

DataMan: A global dataset of nitrous oxide and ammonia emission factors for excreta deposited by livestock and land-applied manure

Nitrous oxide (N2O), ammonia (NH3) and methane (CH4) emissions from the manure management chain of livestock production systems are important contributors to greenhouse gases (GHG) and NH3 emitted by human activities. Several studies have evaluated manure-related emissions and associated key variables at regional, national or continental scales. However, there have been few studies focusing on these emissions using a global dataset. An international project was created (DataMan) to develop a global database on GHG and NH3 emissions from the manure management chain (housing, storage and field), to identify key variables influencing emissions, and ultimately to refine EFs for future national GHG inventories and NH3 emission reporting. This paper describes the “field” database that focuses on N2O and NH3 EFs from land-applied manure and excreta deposited by grazing livestock. We collated relevant information (EFs, manure characteristics, soil properties and climatic conditions) from published peer-reviewed research, theses, conference papers and existing databases. The database, containing 5,632 observations compiled from 184 studies, was relatively evenly split between N2O and NH3 (56% and 44% of the EF values, respectively). The N2O data were derived from studies conducted in 21 countries on five continents, with New Zealand, the UK, Kenya and Brazil representing 86% of the data. The NH3 data originated from studies conducted in 17 countries on four continents, with the UK, Denmark, Canada and the Netherlands representing 79% of the data. Wet temperate climates represented 90% of the total database. The DataMan field database is available online at http:// dataman.azurewebsites.net

Role of genetic testing for inherited prostate cancer risk: Philadelphia prostate cancer consensus conference 2017

Purpose: Guidelines are limited for genetic testing for prostate cancer (PCA). The goal of this conference was to develop an expert consensus-dri