Magnetohydrodynamic wave mode identification in circular and elliptical sunspot umbrae: evidence for high order modes

In this paper we provide clear direct evidence of multiple concurrent higher order magnetohydrodynamic (MHD) modes in circular and elliptical sunspots by applying both Proper Orthogonal Decomposition (POD) and Dynamic Mode Decomposition (DMD) techniques on solar observational data. These techniques are well documented and validated in the areas of fluid mechanics, hydraulics, and granular flows, yet are relatively new to the field of solar physics. While POD identifies modes based on orthogonality in space and it provides a clear ranking of modes in terms of their contribution to the variance of the signal, DMD resolves modes that are orthogonal in time. The clear presence of the fundamental slow sausage and kink body modes, as well as higher order slow sausage and kink body modes have been identified using POD and DMD analysis of the chromospheric H$\alpha$ line at 6562.808~{\AA} for both the circular and elliptical sunspots. Additionally, to the various slow body modes, evidence for the presence of the fast surface kink mode was found in the circular sunspot. All the MHD modes patterns were cross-correlated with their theoretically predicted counterparts and we demonstrated that ellipticity cannot be neglected when interpreting MHD wave modes. The higher-order MHD wave modes are even more sensitive to irregularities in umbral cross-sectional shapes, hence this must be taken into account for more accurate modelling of the modes in sunspots and pores.Comment: Figures 21 and 22 should be presented in the appendix section and then followed by reference

Large scale coherent magnetohydrodynamic oscillations in a sunspot

Although theoretically predicted, the simultaneous excitation of several resonant modes in sunspots has not been observed. Like any harmonic oscillator, a solar magnetic flux tube can support a variety of resonances, which constitute the natural response of the system to external forcing. Apart from a few single low order eigenmodes in small scale magnetic structures, several simultaneous resonant modes were not found in extremely large sunspots. Here we report the detection of the largest-scale coherent oscillations observed in a sunspot, with a spectrum significantly different from the Sun’s global acoustic oscillations, incorporating a superposition of many resonant wave modes. Magnetohydrodynamic numerical modeling agrees with the observations. Our findings not only demonstrate the possible excitation of coherent oscillations over spatial scales as large as 30–40 Mm in extreme magnetic flux regions in the solar atmosphere, but also paves the way for their diagnostic applications in other astrophysical contexts

An ecological exploration of the Internet of Toys in early childhood everyday life

Throughout this chapter, the focus is on the importance of children’s agency in their use of Internet of Toys (IoToys). We think about children’s capabilities as part of digitally mediated eco-communities. Informed by the socio-ecological model, children’s, practitioners’ and parents’ dispositions helped contextualise the factors that shape children’s use of IoToys. We provide the following key messages throughout the chapter: 1.A discussion of passivity or empowerment as part of children’s digital lives with IoToys, in line with Craft’s (2013) work. 2.A reanalysis of perceptions of childhood in the digital age, linking to the sociological models of childhood and the role of children as competent and agentic. 3.An account of socio-ecological influences on digital lives, likened to Rogoff’s (2008) three planes relating to individual, interpersonal and community alongside a discussion of how the interpersonal plane can be reimagined to include interactions between child and machine. 4.A note of caution against the passive child agenda and recurrent moral panic

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

The Translation of Qur’an-Bound Terms in the Qur’an: an Analytical Study of Twelve English Translations of Surat an-Nisa’

Qur’anic terms are very important for understanding the meaning of the Qur’an. These terms are highly specific, i.e. bound to the place and time of the revelation of the text. Understanding Qur’an-bound terms (QBTs) depends on understanding the context, and this can be particularly complex when translating cultural elements between two different cultures. This study examines the translation of QBTs, which give rise to problems when translated into English. Twelve translations of QBTs in sËrat an-NisÉ’ are chosen to investigate the semantic and cultural challenges for the translator and to assess which translation procedures were chosen based on the model of Dickins (2012). The analysis shows that QBTs do not retain all their original features and meaning when translated into English due to their dependence on context and culture. Even if the SL and TL words share some components, analysis shows that no Arabic QBT has a one-to-one equivalent in the English language/culture. In the translation of polysemous QBTs, some translators consider the context and convey the intended secondary sense of the QBTs, while others inappropriately translate the primary sense of them when a secondary sense is intended. Concerning the translation of autohyponymous and figurative QBTs, some translators choose a literal translation of the basic sense when a secondary meaning is intended. This means they fail to convey the ST sense in the context. Figurative sense is a feature of polysemous terms with secondary senses. The figurative components are analysed based on Dickins’ (2005) model for metaphor analysis, which can be extended to the analysis of other figures of speech, such as metonymy and synecdoche. The ST analysis of the figurative QBTs shows that all are lexicalised, and the translation analysis shows that the translators typically use non-figurative equivalents. Regarding the translation procedures employed to render figurative Qur’anic QBTs, the results demonstrate that, as in the translation of autohyponymous terms, translators who opt for a basic-sense literal translation procedure fail to convey the ST figurative sense in the context. While those who opt for an explanation of the figurative sense achieve to some extent to convey this sense. This signifies that those who employ explanation procedure were aware of both the contextual meaning and figurative components – although they do not manage to produce a similar figurative image in TT

Eco-consciousness, dwelling and anxiety in selected works of John Burnside

This thesis studied children exploitation, rape, and paranoia from an interdisciplinary perspective, namely, ecocriticism and psychoanalysis.The concepts of ecoconsciousness and dwelling were applied to analyze the selected works’ environmental places, such as gardens, forests, landscapes and so forth. On the other hand, psychoanalysis was specified to Freud’s concept of anxiety to analyze the protagonists’ anxious feelings caused by children exploitation, rape, and paranoia.By utilizing these concepts, the study unraveled the selected works’ natural settings as being therapeutic exits for the protagonists’ anxiety. Thus, the selected works’ the protagonists in the selected works are studied as seeking solace and peace of mind in nature. Therefore, the dissertation aimed to examine nature and anxiety in John Burnside’s novels The Dumb House (1997), The Locust Room (2001), and A Summer of Drowning (2011). The study achieved three objectives. The first objective examined the selected works protagonists’ anxiety as a result of children exploitation, rape, and paranoia. The second objective discovered the role of natural settings for the protagonists’ anxious feelings. Ultimately, the third objective identified the connection between natural settings and anxiety in the selected works. The conceptual interdisciplinarity was limited to ecocriticism and psychoanalysis. The main focus was on two ecocritical concepts; dwelling and eco-consciousness. First, the concept of dwelling was mainly cited by using Greg Garrard’s concept of dwelling and its use to analyze the natural settings of fictional works. Dwelling, therefore, was applied to analyze the selected works’ settings since they are abound with natural scenes, such as forests, landscapes, gardens and so forth. Second, the analysis drew upon Cheryll Glotfelty’s concept of eco-consciousness and its critical interface with the concept of dwelling. Both concepts are the ecocritical side of the research. On the other hand, psychoanalysis was limited to Sigmund Freud’s concept of anxiety. The concept of anxiety was used to explore the protagonists’ anxious inner feelings in the selected works.The protagonists share a common trait of anxiety, and consequently, they become psychologically anxious and begin seeking refuge for psychic comfort in nature. This is because they suffer from their involvement in children exploitation, rape, and paranoia, in Burnside’s The Dumb House (1997), The Locust Room (2001), and A Summer of Drowning (2011), respectively. As a result, they go sauntering in natural places, like forest paths, gardens, and meadows and meet some animals where they feel psychically calm. Hence, the selected works’ natural settings were analyzed as remedial exits for the protagonists’ anxiety. Thus, the significance of this study was its analysis of the anxious protagonists who seek peace and solace of mind in nature. In the light of these findings, the study provided three recommendations for further research. First, the selected works could be studied by applying ecocriticism but from an ecological perspective.For example, the killing of certain animals, such as locusts and rabbits, in The Locust Room, may lead to their extinction. Therefore, the selected works might be interpreted as a response to probable imminent ecological apocalypse. Second, the study of paranoia and anxiety could be elaborated by using feminism theory. In A Summer of Drowning, the protagonist Liv would be studied in terms of feminist insights. She becomes paranoid of men whom she thinks are responsible of destroying her mother. In this sense, the novel could be studied as a critique of androcentric hegemony. Third, the technical structure of the selected works would be identified by applying formalism. The narrative omniscient narrator might be a subject for formalistic analysis. As in The Dumb House, the novel’s depiction of precise natural settings might be explored as the author’s own interest in nature where he finds tranquility and psychic comfort. Thus, the selected works could also be studied by applying children psychoanalysis to explore major themes in relation to anxiety and paranoia