Technical Note: Comparison of storage strategies of sea surface microlayer samples

The sea surface microlayer (SML) is an important biogeochemical system whose physico-chemical analysis often necessitates some degree of sample storage. However, many SML components degrade with time so the development of optimal storage protocols is paramount. We here briefly review some commonly used treatment and storage protocols. Using freshwater and saline SML samples from a river estuary, we investigated temporal changes in surfactant activity (SA) and the absorbance and fluorescence of chromophoric dissolved organic matter (CDOM) over four weeks, following selected sample treatment and storage protocols. Some variability in the effectiveness of individual protocols most likely reflects sample provenance. None of the various protocols examined performed any better than dark storage at 4 °C without pre-treatment. We therefore recommend storing samples refrigerated in the dark

Treatment of refractory hip pain with sodium hyaluronate (Hyalgan©) in a patient with the Marshall-Smith Syndrome: A case report

The Marshall Smith Syndrome (MSS) is a rare congenital disorder, displaying a constellation of unique symptoms, including orofacial dysmorphisms, accelerated osseous maturation and dysplasias, mental retardation, and respiratory maladies. Few individuals with MSS survive past early childhood. In this case report, we describe a unique treatment for a 30 year-old patient with MSS who presented to our pain medicine clinic for management of pain secondary to uncontrolled bilateral hip dysplasias

Monitoring practices of training load and biological maturity in UK soccer academies

Purpose: Overuse injury risk increases during periods of accelerated growth, which can subsequently impact development in academy soccer, suggesting a need to quantify training exposure. Nonprescriptive development scheme legislation could lead to inconsistent approaches to monitoring maturity and training load. Therefore, this study aimed to communicate current practices of UK soccer academies toward biological maturity and training load. Methods: Forty-nine respondents completed an online survey representing support staff from male Premier League academies (n = 38) and female Regional Talent Clubs (n = 11). The survey included 16 questions covering maturity and training-load monitoring. Questions were multiple-choice or unipolar scaled (agreement 0-100) with a magnitude-based decision approach used for interpretation. Results: Injury prevention was deemed highest importance for maturity (83.0 [5.3], mean [SD]) and training-load monitoring (80.0 [2.8]). There were large differences in methods adopted for maturity estimation and moderate differences for training-loadmonitoring between academies. Predictions of maturity were deemed comparatively low in importance for bio-banded (biological classification) training (61.0 [3.3]) and low for bio-banded competition (56.0 [1.8]) across academies. Few respondents reported maturity (42%) and training load (16%) to parent/guardians, and only 9% of medical staff were routinely provided this data. Conclusions: Although consistencies between academies exist, disparities in monitoring approaches are likely reflective of environment-specific resource and logistical constraints. Designating consistent and qualified responsibility to staff will help promote fidelity, feedback, and transparency to advise stakeholders of maturity-load relationships. Practitioners should consider biological categorization to manage load prescription to promote maturity-appropriate dose-responses and to help reduce the risk of noncontact injury

Localism and the will to housing: neighbourhood development plans and their role in local housing site delivery in England

The planning system in England is regarded as a key mechanism for the delivery of housing but is also seen by some as a brake on its supply. In this context the introduction of neighbourhood planning in 2011 has been promoted as a mechanism to reduce opposition to new housing and aid housing growth. This paper focusses on how this policy tool has been implemented with a view to mobilising communities to assist in the allocation of housing sites. The paper draws on empirical data to illustrate the role, motivations, and response to neighbourhood planning and its impact on the delivery of housing

Increased utilization of total joint arthroplasty after Medicaid expansion

BACKGROUND: The expansion of state Medicaid programs under the U.S. Affordable Care Act has led to a dramatic increase in the number of Americans with health insurance coverage. Prior analyses of a limited number of states have suggested that greater utilization of total hip arthroplasty (THA) and total knee arthroplasty (TKA) should be expected after Medicaid expansion. The purpose of our study was to examine whether increased utilization of THA and TKA occurred across a broader range of states after Medicaid expansion. METHODS: We analyzed administrative data from the Healthcare Cost and Utilization Project from 9 states (Arkansas, Arizona, Colorado, Iowa, Massachusetts, Maryland, Nevada, New York, and Vermont) that expanded Medicaid in 2014 and 2 states that did not expand Medicaid (Florida and Missouri). We included patients who were 18 to 64 years of age and had a primary THA or TKA from 2012 to 2015 with Medicaid as the primary payer. Other payers (including dual-eligible Medicaid and Medicare beneficiaries) were excluded. We performed multivariable regression modeling with the number of Medicaid-insured THAs or TKAs as the dependent variable and the interaction between the state Medicaid expansion status and year as the main policy independent variable, with adjustment for community characteristics. RESULTS: Among all 11 states, there were 39,452 total joint arthroplasties (42% THA and 58% TKA) funded by Medicaid from 2012 to 2015. After adjusting for community characteristics, within expansion states, compared with 2013, THA and TKA increased 15% in 2014 (p \u3c 0.0001) and 23% in 2015 (p \u3c 0.0001) within expansion states. Within non-expansion states, compared with 2013, there were significant utilization decreases of 18% in 2014 (p \u3c 0.0001) and 11% in 2015 (p = 0.0002). CONCLUSIONS: Medicaid expansion was associated with significant increases in Medicaid-funded THA and TKA utilization in 9 states. As additional states consider expanding Medicaid programs and as alternative health reforms that increase insurance eligibility are debated, surgeons, administrators, and policymakers should prepare for a surge in the utilization of THA and TKA

Relationships of internal and external training load in elite-level adolescent soccer

Introduction and Purpose: The quantification of locomotive demands such as high-speed running (>13 kmh-1) are now commonplace within the monitoring of external training load metrics. However, limitations linked to discounting energetically demanding changes in running speed and lack of sensitivity between individual locomotor profiles raise concerns over the accuracy of this variable (1). Recent findings have identified tri-axial accelerometer data to be an effective measure of movement efficiency and that it could be a more suitable measure of external training load than locomotive demands alone (1, 2). It is also becoming increasingly common that practitioners seek quantification of the physiological responses to these external training loads, referred to as internal training load (such as heart rate and rating of perceived exertion [RPE]) (2). Combining external and internal training load variables has been shown to provide a more useful approach than using either independently as this permits a better understanding of the dose-response of activity (2, 3). Therefore, the aim of this study was to observe the magnitude of associations between internal and external training load amongst elite-level adolescent soccer players. Methods: Thirty-four male adolescent soccer players (Age: 13.85 ± 1.02 yrs; Weight: 55.1 ± 12.8 kg; Height: 166.9 ± 10.3 cm) from the same category one academy were monitored over a two-week training period. High-resolution tri-axial accelerometers using a vector-magnitude algorithm (PlayerLoadTM), high-intensity distance (HID) (MinimaxX v4.0, Catapult InnovationsTM, Melbourne, Australia) and session RPE (sRPE; CR10) (15 mins post training) were collected from three training sessions per player. From this, RPELoad was calculated using training session duration (mins) multiplied by sRPE. Between-subject correlations were used to determine relationships using a standardised scale of magnitudes. Results: The relationship between RPELoad and PlayerLoadTM was moderate (r = 0.41; 90% confidence interval 0.14 to 0.62), small for sRPE and PlayerLoadTM (r = 0.22; -0.07 to 0.48), and trivial for sRPE and HID (r = 0.12; -0.17 to 0.39) and RPELoad and HID (r = 0.07; -0.22 to 0.35). Conclusions: The strongest associations between internal and external training load in adolescent soccer exist between RPELoad and PlayerLoadTM. Both sRPE and RPELoad have a limited association with HID. This suggests that tri-axial accelerometer data combined with post-activity perceived exertion ratings may offer a better indicator of the dose-response than high-speed locomotor metrics. However, due to the relatively trivial overall associations, it is advised that where possible practitioners routinely monitor a combination of both external training load (i.e., PlayerLoadTM and HID) alongside internal RPELoad to inform training load monitoring

The riverine source of CH4 and N2O from the Republic of Congo, western Congo Basin

We discuss concentrations of dissolved CH4, N2O, O2, NO3− and NH4+, and emission fluxes of CH4 and N2O for river sites in the western Congo Basin, Republic of Congo (ROC). Savannah, swamp forest and tropical forest samples were collected from the Congo main stem and seven of its tributaries during November 2010 (41 samples; “wet season”) and August 2011 (25 samples; “dry season”; CH4 and N2O only). Dissolved inorganic nitrogen (DIN: NH4+ + NO3−; wet season) was dominated by NO3- (63 ± 19 % of DIN). Total DIN concentrations (1.5–45.3 µmol L−1) were consistent with the near absence of agricultural, domestic and industrial sources for all three land types. Dissolved O2 (wet season) was mostly undersaturated in swamp forest (36 ± 29%) and tropical forest (77 ± 36%) rivers but predominantly supersaturated in savannah rivers (100 ± 17%). The dissolved concentrations of CH4 and N2O were within the range of values reported earlier for sub-Saharan African rivers. Dissolved CH4 was found to be supersaturated (11.2–9553 nmol L−1; 440–354,444 %), whereas N2O ranged from strong undersaturation to super-saturation (3.2–20.6 nmol L −1 ; 47–205%). Evidently, rivers of the ROC are persistent local sources of CH4 and can be minor sources or sinks for N2O. During the dry season the mean and range of CH4 and N2O concentrations were quite similar for the three land types. Wet and dry season mean concentrations and ranges were not significant for N2O for any land type or for CH4 in savannah rivers. The latter observation is consistent with seasonal buffering of river discharge by an underlying sandstone aquifer. Significantly higher wet season CH4 concentrations in swamp and forest rivers suggest that CH4 can be derived from floating macrophytes during flooding and/or enhanced methanogenesis in adjacent flooded soils. Swamp rivers also exhibited both low (47%) and high (205%) N2O saturation but wet season values were overall significantly lower than in either tropical forest or savannah rivers, which were always supersaturated (103–266%) and for which the overall means and ranges of N2O were not significantly different. In swamp and forest rivers O2 saturation co-varied inversely with CH4 saturation (log %) and positively with % N2O. A significant positive correlation between N2O and O2 saturation in swamp rivers was coincident with strong N2O and O2 undersaturation, indicating N2O consumption during denitrification in the sediments. In savannah rivers persistent N2O supersaturation and a negative correlation between N2O and O2 suggest N2O production mainly by nitrification. This is consistent with a stronger correlation between N2O and NH4+ than between N2O and NO3− . Our ranges of values for CH4 and N2O emission fluxes (33–48 705 µmol CH4 m−2 d−1 ; 1–67 µmol N2O m−2 d−1) are within the ranges previously estimated for sub-Saharan African rivers but they include uncertainties deriving from our use of "basin-wide" values for CH4 and N2O gas transfer velocities. Even so, because we did not account for any contribution from ebullition, which is quite likely for CH4 (at least 20%), we consider our emission fluxes for CH4 to be conservative