Volunteerism among hospitalists and non-hospitalists at academic and community medical centers in North Carolina

Volunteerism is common in the United States, though less is known about volunteerism among medical professionals. We aimed to record and compare volunteer activities among hospitalists and non-hospitalists in academic and community centers.Includes bibliographical reference

Seismic wave propagation around subsurface igneous sill complexes

Acknowledgements This work was undertaken during O.G.S’s PhD at Durham University, funded by Eni through the Volcanic Margins Research Consortium (Phase 2). Seismic modelling was performed using the open source SOFI2D (Bohlen 2002) and post-processed using Seismic Un*x (Stockwell & Cohen 2012). Figures were prepared using the open source Generic Mapping Tools (GMT) (Wessel & Smith W. H. F. 1998) and Seismic Un*x. Zoeppritz amplitude coefficients were calculated using the CREWES Matlab toolbox of the University of Calgary (Margrave and Lamoureux 2019). This work made use of the facilities of the Hamilton HPC Service of Durham UniversityPeer reviewe

Specific leaf area responses to environmental gradients through space and time

Plant communities can respond to environmental changes by altering their species composition and by individuals (within species) adjusting their physiology. These responses can be captured by measuring key functional traits among and within species along important environmental gradients. Some anthropogenic changes (such as fertilizer runoff) are known to induce distinct community responses, but rarely have responses across natural and anthropogenic gradients been compared in the same system. In this study, we used comprehensive specific leaf area (SLA) data from a diverse Australian annual plant system to examine how individual species and whole communities respond to natural and anthropogenic gradients, and to climatically different growing seasons. We also investigated the influence of different leaf-sampling strategies on community-level results. Many species had similar mean SLA values but differed in SLA responses to spatial and temporal environmental variation. At the community scale, we identified distinct SLA responses to natural and anthropogenic gradients. Along anthropogenic gradients, increased mean SLA, coupled with SLA convergence, revealed evidence of competitive exclusion. This was further supported by the dominance of species turnover (vs. intraspecific variation) along these gradients. We also revealed strong temporal changes in SLA distributions in response to increasing growing-season precipitation. These climate-driven changes highlight differences among co-occurring species in their adaptive capacity to exploit abundant water resources during favorable seasons, differences that are likely to be important for species coexistence in this system. In relation to leaf-sampling strategies, we found that using leaves from a climatically different growing season can lead to misleading conclusions at the community scale

Long term changes in health-related quality of life for people with heart failure:the ECHOES study

Aims: Heart failure (HF) impairs all aspects of health-related quality of life (HRQoL), but little is known about the effect of developing HF on HRQoL over time. We aimed to report changes in HRQoL over a 13-year period. Methods and results: HRQoL was measured in the Echocardiographic Heart of England Screening (ECHOES) study and the ECHOES-X follow-up study (N = 1618) using the SF-36 questionnaire (Version 1). Mixed modelling compared changes in HRQoL across diagnostic groups, adjusting for potential predictors and design variables. Patients who had developed HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) at rescreening had significantly greater reduction in physical functioning (PF) and role physical (RP) scores compared with those without HF; adjusted mean difference in PF: HFrEF −16.1, [95% confidence interval (CI) −22.2 to −10.1]; HFpEF −14.6, (95% CI −21.2 to −8.1); in RP: HFrEF −20.7, (95% CI −31.8 to −9.7); HFpEF −19.3, (95% CI −31.0 to −7.6). Changes in HRQoL of those with a HF diagnosis at baseline and rescreen, with exception of role emotion, were similar to those without HF but started from a much lower baseline score. Conclusions: People with a new diagnosis of HF at rescreening had a significant reduction in HRQoL. Conversely, for those with HF detected on initial screening, little change was observed in HRQoL scores on rescreening. Further research is required to understand the development of HF over time and to test interventions designed to prevent decline in HRQoL, potentially through earlier diagnosis and treatment optimization.</p

Gas venting that bypasses the feather edge of marine hydrate, offshore Mauritania

Methane can be released from the vast marine hydrate reservoirs that surround continents into oceans and perhaps the atmosphere. But how these pathways work within the global carbon cycle now and during a warmer world is only partially understood. Here we use 3-D seismic data to identify what we interpret to be a gas venting system that bypasses the hydrate stability zone (HSZ) offshore of Mauritania. This venting is manifested by the presence of the acoustic wipe-out (AWO) across a densely faulted succession above a salt diapir and a set of morphological features including a substantial, ∼260 m wide and ∼32 m deep, pockmark at the seabed. The base of the HSZ is marked by a bottom simulating reflector (BSR) which deflects upwards above the diapir, rather than mimicking the seabed. We use a numerical modelling to show that this deflection is caused by the underlying salt diapir. It creates a trapping geometry for gas sealed by hydrate-clogged sediment. After entering the HSZ, some methane accumulated as hydrate in the levees of a buried canyon. Venting in this locality probably reduces the flux of gas to the landward limit of feather edge of hydrate, reducing the volume of gas that would be susceptible for release during a warmer world

Investigating the Goban Spur rifted continental margin, offshore Ireland, through integration of new seismic reflection and potential field data

The Goban Spur, offshore Ireland, is a magma-poor rifted continental margin conjugate to the well-studied Newfoundland margin, offshore Canada. Published studies demonstrated that a 70-km-wide zone of exhumed serpentinized mantle lies between oceanic crust and stretched continental crust at the seaward limit of Goban Spur. However, the along-strike extent of this serpentinized zone has, until now, been unknown due to insufficient data coverage. The crustal architecture of the margin is complicated due to its multi-staged tectonic history. Here, six newly acquired multi-channel seismic reflection lines are processed and interpreted, along with vintage seismic profiles, to characterize its structure and evolution. These seismic profiles reveal significant along-strike structural variations along the Goban Spur margin, and allow us to delimit five distinct crustal zones related to different rifting stages and their regional extents. The geometries of each crustal domain are variable along the margin strike, probably suggestive of different extension rates during the evolution of the margin or inherited variations in crustal composition and rheology. The transitional zone between oceanic crust and stretched continental crust consists of both shallow peridotite ridges and deeper exhumed serpentinized mantle, much like the conjugate Iberian and Newfoundland margins. Above the top basement in the exhumed domain, the syn-exhumed sediments show strikingly weak reflectivity, rarely seen at other magma-poor margins. Magmatic events occur coincident with each rifting stage, and the volume of magmatic accretions increases from NW to SE, more than previously interpreted. Plate reconstruction of the Goban Spur and its possible conjugate – the Flemish Cap, shows asymmetry in the crustal architectures, likely due to rift evolution involving more 3-D complexity than can be explained by simple 2-D extensional kinematics

Combined physeal fractures of the distal radius and ulna: complications associated with K-wire fixation and long-term prognosis in six cats

Objectives The objective was to describe the complications and long-term outcome associated with Kirschner (K)-wire fixation of combined distal radial and ulnar physeal fractures in six cats. Methods Medical records (2002-2014) of six referral institutions were searched for cats with combined distal radial and ulnar physeal fractures. Cases with complete clinical files, radiographs and surgical records were retrospectively reviewed. Long-term outcome was assessed via telephone interviews using an owner questionnaire. Results Complete files were available for 6/9 identified cases (cases 1-6). All fractures were classified as Salter-Harris type I or II. Five cases underwent open reduction and internal fixation via cross-pinning of the distal radius and intramedullary pinning of the ulna (cases 1-3); fixation of the distal radial and ulnar physes with one K-wire each (case 4); and K-wire fixation of the radial physis in combination with two transulnoradial K-wires (case 5). One case underwent closed reduction and percutaneous cross-pinning of the distal radius under fluoroscopic guidance (case 6). The complications encountered were: reduced radiocarpal range of motion (ROM) (cases 1, 3, 4, 5); implant loosening/migration (cases 1, 2, 5); and radioulnar synostosis (case 4). None of the cats developed angular limb deformity. Long-term outcome (12 months to 7 years after surgery) was graded as 'excellent' by the owners in all cases. Conclusions and relevance Prognosis is favourable for feline combined distal radial and ulnar physeal fractures following K-wire fixation in cats over 7 months of age. Implant removal after bony union is recommended to minimise reduction in ROM and to prevent implant loosening/migration

Drop Impact on Liquid Surfaces: Formation of Lens and Spherical Drops at the Air-Liquid Interface

Droplets at the air-liquid interface of immiscible liquids usually form partially-submerged lens shapes (e.g. water on oil). In addition to this structure, we showed that droplets released from critical heights above the target liquid can sustain the impact and at the end maintain a spherical ball-shape configuration above the surface, despite undergoing large deformation. Spherical drops are unstable and will transform into the lens mode due to slight disturbances. Precision dispensing needles with various tip diameter sizes were used to release pendant drops of deionized water onto the surface of fluorocarbon liquid (FC-43, 3M). A cubic relationship was found between the nozzle tip diameter and the released droplet diameter. Drop impact was recorded by a high speed camera at a rate of 2000 frames per second. In order for the water drops to sustain the impact and retain a spherical configuration at the surface of the target liquid pool, it is required that they be of a critical size and be released from a certain height; otherwise the commonly observed lens shape droplets will form at the surface