Transport in rough self-affine fractures

Transport properties of three-dimensional self-affine rough fractures are studied by means of an effective-medium analysis and numerical simulations using the Lattice-Boltzmann method. The numerical results show that the effective-medium approximation predicts the right scaling behavior of the permeability and of the velocity fluctuations, in terms of the aperture of the fracture, the roughness exponent and the characteristic length of the fracture surfaces, in the limit of small separation between surfaces. The permeability of the fractures is also investigated as a function of the normal and lateral relative displacements between surfaces, and is shown that it can be bounded by the permeability of two-dimensional fractures. The development of channel-like structures in the velocity field is also numerically investigated for different relative displacements between surfaces. Finally, the dispersion of tracer particles in the velocity field of the fractures is investigated by analytic and numerical methods. The asymptotic dominant role of the geometric dispersion, due to velocity fluctuations and their spatial correlations, is shown in the limit of very small separation between fracture surfaces.Comment: submitted to PR

Impact of Patching and Atropine Treatment on the Child and Family in the Amblyopia Treatment Study

Objective To assess the psychosocial impact on the child and family of patching and atropine as treatments for moderate amblyopia in children younger than 7 years. Methods In a randomized, controlled clinical trial, 419 children younger than 7 years with amblyopic eye visual acuity in the range of 20/40 to 20/100 were assigned to receive treatment with either patching or atropine at 47 clinical sites. After 5 weeks of treatment, a parental quality-of-life questionnaire was completed for 364 (87%) of the 419 patients. Main Outcome Measure Overall and subscale scores on the Amblyopia Treatment Index. Results High internal validity and reliability were demonstrated for the Amblyopia Treatment Index questionnaire. The overall Amblyopia Treatment Index scores and the 3 subscale scores were consistently higher (worse) in the patching group compared with the atropine-treated group (overall mean, 2.52 vs 2.02, P<.001; adverse effects of treatment: mean, 2.35 vs 2.11, P = .002; difficulty with compliance: mean, 2.46 vs 1.99, P<.001; and social stigma: mean, 3.09 vs 1.84, P<.001, respectively). Conclusion Although the Amblyopia Treatment Index questionnaire results indicated that both atropine and patching treatments were well tolerated by the child and family, atropine received more favorable scores overall and on all 3 questionnaire subscales

Cobalt and precious metals in sulphides of peridotite xenoliths and inferences concerning their distribution according to geodynamic environment: A case study from the Scottish lithospheric mantle

Abundances of precious metals and cobalt in the lithospheric mantle are typically obtained by bulk geochemical analyses of mantle xenoliths. These elements are strongly chalcophile and the mineralogy, texture and trace element composition of sulphide phases in such samples must be considered. In this study we assess the mineralogy, textures and trace element compositions of sulphides in spinel lherzolites from four Scottish lithospheric terranes, which provide an ideal testing ground to examine the variability of sulphides and their precious metal endowments according to terrane age and geodynamic environment. Specifically we test differences in sulphide composition from Archaean-Palaeoproterozoic cratonic sub-continental lithospheric mantle (SCLM) in northern terranes vs. Palaeozoic lithospheric mantle in southern terranes, as divided by the Great Glen Fault (GGF). Cobalt is consistently elevated in sulphides from Palaeozoic terranes (south of the GGF) with Co concentrations > 2.9 wt.% and Co/Ni ratios > 0.048 (chondrite). In contrast, sulphides from Archaean cratonic terranes (north of the GGF) have low abundances of Co (< 3600 ppm) and low Co/Ni ratios (< 0.030). The causes for Co enrichment remain unclear, but we highlight that globally significant Co mineralisation is associated with ophiolites (e.g., Bou Azzer, Morocco and Outokumpu, Finland) or in oceanic peridotite-floored settings at slow-spreading ridges. Thus we suggest an oceanic affinity for the Co enrichment in the southern terranes of Scotland, likely directly related to the subduction of Co-enriched oceanic crust during the Caledonian Orogeny. Further, we identify a distinction between Pt/Pd ratio across the GGF, such that sulphides in the cratonic SCLM have Pt/Pd ≥ chondrite whilst Palaeozoic sulphides have Pt/Pd < chondrite. We observe that Pt-rich sulphides with discrete Pt-minerals (e.g., PtS) are associated with carbonate and phosphates in two xenolith suites north of the GGF. This three-way immiscibility (carbonate-sulphide-phosphate) indicates carbonatitic metasomatism is responsible for Pt-enrichment in this (marginal) cratonic setting. These Co and Pt-enrichments may fundamentally reflect the geodynamic setting of cratonic vs. non-cratonic lithospheric terranes and offer potential tools to facilitate geochemical mapping of the lithospheric mantle

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

TGF-β1 Inhibits TLR-mediated Odontoblast Responses to Oral Bacteria

TGF-β1 exerts diverse functions in tooth development and tissue repair, but its role in microbial defenses of the tooth is not well-understood. Odontoblasts extending their cellular processes into the dentin are the first cells to recognize signals from TGF-β1 and bacteria in carious dentin. This study aimed to determine the role of TGF-β1 in modulating odontoblast responses to oral bacteria. We show that these responses depend upon the expression levels of microbial recognition receptors TLR2 and TLR4 on the cell surface. Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum activated both TLRs, but TLR4 played a greater role. Lack of cell-surface TLR2 was associated with poor response to Streptococcus mutans, Enterococcus faecalis, and Lactobacillus casei. TGF-β1 inhibited TLR2 and TLR4 expression and attenuated odontoblast responses. Our findings suggest that the balance between TLR-mediated inflammation and TGF-β1 anti-inflammatory activity plays an important role in pulpal inflammation