Sealing a rubber bladder between two sections of an accumulator

Leak-free clamping of a two section accumulator is accomplished by a flat metallic ring molded peripherally to the rubber flange of the bladder, and an inset rubber seal bonded to the face of the flange of each section. Method maintains constant torque on the clamping bolts

Simultaneous data-based optimization of a 1D-ecosystem model at three locations in the North Atlantic: Part II—Standing stocks and nitrogen fluxes

This study relates the performance of an optimized one-dimensional ecosystem model to observations at three sites in the North Atlantic Ocean: the Bermuda Atlantic Time Series Study (BATS, 31N 64W), the location of the North Atlantic Bloom Experiment (NABE, 47N 20W), and Ocean Weather Ship INDIA (OWS-INDIA, 59N 19W). The ecosystem model is based on nitrogen and resolves dissolved inorganic nitrogen (N), phytoplankton (P), zooplankton (Z) and detritus (D), therefore called the NPZD-model. Physical forcing, such as temperature and eddy diffusivities are taken from an eddy-permitting general circulation model of the North Atlantic Ocean, covering a period from 1989 through 1993. When an optimized parameter set is applied, the recycling of organic nitrogen becomes significantly enhanced, compared to previously published results of the NPZD model. The optimized model yields improved estimates of the annual ratio of regenerated to total primary production (f-ratio). The annual f-ratios are 0.09, 0.31, and 0.42 for the locations of BATS, NABE, and OWS-INDIA, respectively. Nevertheless, three major model deficiencies are identified. Most conspicuous are systematic discrepancies between measured 14C-fixation rates and modeled primary production under nutrient depleted conditions. This error is primarily attributed to the assumption of a constant carbon-to-nitrogen ratio for nutrient acquisition. Secondly, the initial period of the modeled phytoplankton blooms is hardly tracked by the model. That particular model deficiency becomes most apparent at the OWS-INDIA site. The interplay between algal growth and short-term alterations in stratification and mixing is believed to be insufficiently resolved by the physical model. Eventually, the model\u27s representation of the vertical nitrogen export appears to be too simple in order to match, at the same time, remineralization within the upper 300 meters and the biomass export to greater depths

Supportive care needs of men with prostate cancer: A systematic review update

Background: Prostate cancer is highly prevalent and impacts profoundly on patients' quality of life, leading to a range of supportive care needs. Methods: An updated systematic review and thematic synthesis of qualitative data using the Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines, to explore prostate cancer patients' experience of, and need for, supportive care. Five databases (Medline, Embase, PsycInfo, Emcare and ASSIA) were searched; extracted data were synthesised using Corbin and Strauss's ‘Three Lines of Work’ framework. Results: Searches identified 2091 citations, of which 105 were included. Overarching themes emerged under the headings of illness, everyday life and biographical work. Illness work needs include consistency and continuity of information, tailored to ethnicity, age and sexual orientation. Biographical work focused on a desire to preserve identity in the context of damaging sexual side effects. Everyday life needs centred around exercise and diet support and supportive relationships with partners and peers. Work-related issues were highlighted specifically by younger patients, whereas gay and bisexual men emphasised a lack of specialised support. Conclusion: While demonstrating some overarching needs common to most patients with prostate cancer, this review offers novel insight into the unique experiences and needs of men of different demographic backgrounds, which will enable clinicians to deliver individually tailored supportive care

The Impact of Social Media Use Interventions on Mental Well-Being: Systematic Review

BACKGROUND: There is some evidence that more social media use is related to poorer mental well-being and that social media use can become problematic when it starts to interfere with a person's daily life and mental well-being. To address this issue and improve users' mental well-being, social media use interventions (eg, abstinence from social media) have been developed and evaluated. However, there is limited understanding of the effectiveness of these interventions in improving mental well-being. OBJECTIVE: This systematic review aimed to synthesize the literature on the effectiveness of social media use interventions in improving mental well-being in adults. METHODS: A systematic search (January 1, 2004, to July 31, 2022) was completed across 3 databases in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Experimental studies evaluating the impact of social media use interventions on mental well-being in adults were included. Outcomes related to mental well-being, such as depression, anxiety, stress, and loneliness, were included. A narrative synthesis without meta-analysis was completed to summarize the study characteristics and effectiveness by outcome and intervention type. The Effective Public Health Practice Project Quality Assessment Tool was used to measure the quality of the studies. RESULTS: Of the 2785 studies identified through the systematic search, 23 (0.83%) were included in the analysis. Many of the included studies (9/23, 39%) found improvements in mental well-being, some (7/23, 30%) found mixed effects, and others (7/23, 30%) found no effect on mental well-being. Therapy-based interventions that used techniques such as cognitive behavioral therapy were more effective than limiting use of social media or full abstinence from social media, with 83% (5/6) of these studies showing improvements in mental well-being compared with 20% (1/5) and 25% (3/12), respectively. Depression was the most frequently investigated and improved outcome with 70% (7/10) of the studies showing a significant improvement in depression after the intervention, whereas other outcomes showed more varied results. Quality was poor, with 96% (22/23) of the studies receiving a weak global score, mostly for issues related to selection bias because most of the studies (16/23, 70%) used a convenience sampling of university students. CONCLUSIONS: This review provides some evidence that social media use interventions are effective in improving mental well-being, especially for depression and when using therapy-based interventions. Further experimental and longitudinal research is needed with representative samples to investigate who may benefit most from social media use interventions. This will help to develop guidance and recommendations for policy makers and clinicians on how best to manage problematic social media use

Assessing potential nondirected altruistic kidney donors: a case note audit

Kidney transplantation is now generally accepted as the preferred mode of renal replacement therapy, as it has superior long-term survival compared with dialysis treatment. However, kidney transplantation is limited by the shortage of donor organs; currently, approximately 7,500 patients are on the transplant list for a kidney donation in the UK

Potential sources of variability in mesocosm experiments on the response of phytoplankton to ocean acidification

Mesocosm experiments on phytoplankton dynamics under high CO2 concentrations mimic the response of marine primary producers to future ocean acidification. However, potential acidification effects can be hindered by the high standard deviation typically found in the replicates of the same CO2 treatment level. In experiments with multiple unresolved factors and a sub-optimal number of replicates, post-processing statistical inference tools might fail to detect an effect that is present. We propose that in such cases, data-based model analyses might be suitable tools to unearth potential responses to the treatment and identify the uncertainties that could produce the observed variability. As test cases, we used data from two independent mesocosm experiments. Both experiments showed high standard deviations and, according to statistical inference tools, biomass appeared insensitive to changing CO2 conditions. Conversely, our simulations showed earlier and more intense phytoplankton blooms in modeled replicates at high CO2 concentrations and suggested that uncertainties in average cell size, phytoplankton biomass losses, and initial nutrient concentration potentially outweigh acidification effects by triggering strong variability during the bloom phase. We also estimated the thresholds below which uncertainties do not escalate to high variability. This information might help in designing future mesocosm experiments and interpreting controversial results on the effect of acidification or other pressures on ecosystem function

Association of Recent Fatherhood With Antidepressant Treatment Initiation Among Men in the United Kingdom

IMPORTANCE: There is some evidence that men may be at higher risk of depression directly following the birth of their child and that approximately 1 in 10 men will experience depression in the year after birth, but less is known about men's antidepressant treatment during this time. Likewise, few direct comparisons have been made with antidepressant treatment in men who have not recently become fathers. OBJECTIVES: To determine whether recently having a child was associated with increased odds of antidepressant treatment in men. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used UK primary care electronic health records from the IQVIA Medical Research Database. Participants included men aged 15 to 55 years who had had a child in the previous year, from January 2007 to December 2016, and compared with up to 5 men who did not have a child in the same calendar year. Data were analyzed from January 2022 to March 2023. EXPOSURE: A record of having a child in the previous year was identified through linked primary care records using a family identification number. MAIN OUTCOMES AND MEASURES: The main outcome was antidepressant initiation in the year after childbirth or in the year after this index date for men who did not have a child. Random-effects Poisson regression was used to determine associations of cohort, age group, social deprivation, history of antidepressant treatment, and calendar year with having an antidepressant prescription in the year after index date using prevalence risk rates (PPRs). RESULTS: Analysis included 90 736 men who had had a child in the previous year and 453 632 men in the comparison cohort. Most men in the study (463 879 men [85.2%]) were aged between 25 and 44 years, and there were more men living in the least deprived areas (130 277 men [23.9%]) than the most deprived areas (72 268 men [13.3%]). Overall, 4439 men (4.9%) had at least 1 antidepressant prescription in the year after they had a child, compared with 26 646 men (5.9%) who did not have a child in the same year. However, after adjustment there was no difference in antidepressant treatment between groups (adjusted PRR [aPRR], 1.01; 95% CI, 0.98-1.04). In fathers, those who had recently received antidepressant treatment were much more likely to receive antidepressant treatment after childbirth compared with fathers with no history of antidepressant treatment (aPRR, 32.31; 95% CI, 30.37-34.38). Fathers living in the most deprived areas were 18% more likely to have an antidepressant prescription compared with fathers living in the least deprived areas (aPRR, 1.18; 95% CI, 1.07-1.30). CONCLUSIONS AND RELEVANCE: These findings suggest that recently having a child was not associated with an increase in antidepressant treatment among men, but previous antidepressant treatment in fathers was strongly associated with treatment after childbirth. Further research is needed to determine whether antidepressant treatment or experiencing depression can be a barrier to fatherhood and whether fatherhood is a barrier to receiving antidepressant treatment