Enhancement of hadron–electron discrimination in calorimeters by detection of the neutron component

In many physics experiments where calorimeters are employed, the requirement of an accurate energy measurement is accompanied by the requirement of very high hadronelectron discrimination power. Normally the latter requirement is achieved by designing a high-granularity detector with sufficient depth so that the showers can fully develop. This method has many drawbacks ranging from the high number of electronic channels to the high mass of the detector itself. Some of these drawbacks may in fact severely limit the deployment of such a detector in many experiments, most notably in space-based ones. Another method, proposed by our group and currently under investigation, relies on the use of scintillation detectors which are sensitive to the neutron component of the hadron showers. Here a review of the current status will be presented starting with the simulations performed both with GEANT4 and FLUKA. A small prototype detector has been built and has been tested in a high-energy pion/electron beam behind a "shallow" calorimeter. Results are encouraging and indicate that it is possible to enhance the discrimination power of an existing calorimeter by the addition of a small-mass neutron detector, thus paving the way for better performing astroparticle experiments. © 2010 Elsevier B.V. All rights reserved

A novel model for cyanobacteria bloom formation: the critical role of anoxia and ferrous iron

SUMMARY 1. A novel conceptual model linking anoxia, phosphorus (P), nitrogen (N), iron (Fe) and sulphate to the formation of noxious filamentous and colonial cyanobacteria blooms is presented that reconciles seemingly contradictory ideas about the roles of P, N and Fe in bloom formation. 2. The model has several critical concepts: (i) P regulates biomass and productivity in fresh waters until excessive loading renders a system N-limited or light-limited, but it is the availability of ferrous ions (Fe 2+ ) that regulates the ability of cyanobacteria to compete with its eukaryotic competitors; (ii) Fe 2+ diffusing from anoxic sediments is a major Fe source for cyanobacteria, which acquire it by migrating downwards into Fe 2+ -rich anoxic waters from oxygenated waters; and (iii) subsequent cyanobacterial siderophore production provides a supply of Fe 3+ for reduction at cyanobacteria cell membranes that leads to very low Fe 3+ concentrations in the mixing zone. 3. When light and temperature are physiologically suitable for cyanobacteria growth, bloom onset is regulated by the onset of internal Fe 2+ loading which in turn is controlled by anoxia, reducible Fe content of surface sediments and sulphate reduction rate. 4. This conceptual model provides the basis for improving the success of approaches to eutrophication management because of its far-reaching explanatory power over the wide range of conditions where noxious cyanobacteria blooms have been observed

High frequency of otolaryngology/ENT encounters in Canadian primary care despite low medical undergraduate experiences

Otolaryngology involves the treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. Many medical students in Canada have limited experiences in ENT and a vast majority of these students go on to pursue a career as primary care physicians. Physicians at a primary care facility classified patient’s visits as either being “ENT” related or not, to assess the amount of ENT related concerns they typically encounter. The data was collected separately in the summer and winter months to assess any seasonal variability. One in eight patient encounters presented with an ENT related concern. The percentage of ENT related symptom presentation visits in the pediatric population for both data collection periods (29%) was more than three times that of the adult population (9%). The rate of ENT symptom presentation in both adult and pediatric populations was not affected by seasonality. Primary care physicians will encounter new patients presenting with ENT related concerns quite frequently. This is especially true in the pediatric patient population. Increased ENT medical education is both necessary and essential for undergraduate medical students, residents, and primary care physicians.L’oto-rhino-laryngologie (ORL) concerne les maladies et les troubles de l’oreille, du nez, de la gorge et des structures connexes de la tête et du cou. De nombreux étudiants au Canada n’ont qu’une expérience limitée de cette spécialité alors que la grande majorité d’entre eux poursuivent une carrière de médecin de soins primaires. Les médecins d’un établissement de soins primaires ont classé les visites des patients afin de déterminer le volume de consultations en lien avec l’ORL. Les données ont été recueillies séparément pendant les mois d’été et d’hiver pour évaluer la variabilité saisonnière. D’après les données, une consultation sur huit était liée à la présence de symptômes ORL. Le pourcentage de consultations chez la population pédiatrique pour les deux périodes de collecte de données (29 %) était plus de trois fois supérieur à celui de la population adulte (9 %). La survenance de symptômes ORL n’était pas affectée par la saisonnalité, ni chez l’une ni chez l’autre. Les médecins de soins primaires voient assez souvent de nouveaux patients présentant des problèmes ORL, particulièrement des enfants. Un renforcement de l’enseignement de la médecine ORL est à la fois nécessaire et essentiel pour les étudiants en médecine de premier cycle, les résidents et les médecins de soins primaires

Effect of delayed versus immediate umbilical cord clamping in vaginal delivery at term: A randomized clinical trial

Objective: To compare maternal blood loss with immediate cord clamping versus delayed cord clamping in women undergoing spontaneous vaginal delivery at term. Methods: Parallel group non-blinded randomized trial conducted at a single center in Italy. Women with singleton gestations who underwent spontaneous vaginal delivery at term were eligible and were randomized in a 1:1 ratio to either immediate or delayed cord clamping. In the immediate cord clamping group, cord clamping was within 15 s after birth. In the delayed cord clamping group, cord clamping was after more than 60 s, or when the cord had stopped pulsing. The primary outcome was change in maternal hemoglobin level from the day of delivery to day one after delivery. Results: A total of 122 participants were enrolled in the trial. There were no significant differences in maternal blood loss as assessed by comparing the decrease in maternal hemoglobin level (mean difference − 0.10 g/dl, 95% confidence interval − 0.28 to 0.08) between the two groups. The mean hemoglobin level at postdelivery day 1 was 11.0 ± 1.5 g/dl in the delayed group and 11.3 ± 1.6 g/dl in the immediate group. Conclusions: Delayed umbilical cord clamping, compared with immediate umbilical cord clamping, resulted in no significant change in maternal hemoglobin level 1 day after delivery. Trial Registration: Clinicaltrials.gov NCT04353544

Non-communicable diseases among adolescents: Current status, determinants, interventions and policies

Background: Addressing non-communicable disease (NCDs) is a global priority in the Sustainable Development Goals, especially for adolescents. However, existing literature on NCD burden, risk factors and determinants, and effective interventions and policies for targeting these diseases in adolescents, is limited. This study develops an evidence-based conceptual framework, and highlights pathways between risk factors and interventions to NCD development during adolescence (ages 10-19 years) and continuing into adulthood. Additionally, the epidemiologic profile of key NCD risk factors and outcomes among adolescents and preventative NCD policies/laws/legislations are examined, and a multivariable analysis is conducted to explore the determinants of NCDs among adolescents and adults.Methods: We reviewed literature to develop an adolescent-specific conceptual framework for NCDs. Global data repositories were searched from Jan-July 2018 for data on NCD-related risk factors, outcomes, and policy data for 194 countries from 1990 to 2016. Disability-Adjusted Life Years were used to assess disease burden. A hierarchical modeling approach and ordinary least squares regression was used to explore the basic and underlying causes of NCD burden.Results: Mental health disorders are the most common NCDs found in adolescents. Adverse behaviours and lifestyle factors, specifically smoking, alcohol and drug use, poor diet and metabolic syndrome, are key risk factors for NCD development in adolescence. Across countries, laws and policies for preventing NCD-related risk factors exist, however those targeting contraceptive use, drug harm reduction, mental health and nutrition are generally limited. Many effective interventions for NCD prevention exist but must be implemented at scale through multisectoral action utilizing diverse delivery mechanisms. Multivariable analyses showed that structural/macro, community and household factors have significant associations with NCD burden among adolescents and adults.Conclusions: Multi-sectoral efforts are needed to target NCD risk factors among adolescents to mitigate disease burden and adverse outcomes in adulthood. Findings could guide policy and programming to reduce NCD burden in the sustainable development era

Non-communicable diseases among adolescents: current status, determinants, interventions and policies

Abstract Background Addressing non-communicable disease (NCDs) is a global priority in the Sustainable Development Goals, especially for adolescents. However, existing literature on NCD burden, risk factors and determinants, and effective interventions and policies for targeting these diseases in adolescents, is limited. This study develops an evidence-based conceptual framework, and highlights pathways between risk factors and interventions to NCD development during adolescence (ages 10–19 years) and continuing into adulthood. Additionally, the epidemiologic profile of key NCD risk factors and outcomes among adolescents and preventative NCD policies/laws/legislations are examined, and a multivariable analysis is conducted to explore the determinants of NCDs among adolescents and adults. Methods We reviewed literature to develop an adolescent-specific conceptual framework for NCDs. Global data repositories were searched from Jan-July 2018 for data on NCD-related risk factors, outcomes, and policy data for 194 countries from 1990 to 2016. Disability-Adjusted Life Years were used to assess disease burden. A hierarchical modeling approach and ordinary least squares regression was used to explore the basic and underlying causes of NCD burden. Results Mental health disorders are the most common NCDs found in adolescents. Adverse behaviours and lifestyle factors, specifically smoking, alcohol and drug use, poor diet and metabolic syndrome, are key risk factors for NCD development in adolescence. Across countries, laws and policies for preventing NCD-related risk factors exist, however those targeting contraceptive use, drug harm reduction, mental health and nutrition are generally limited. Many effective interventions for NCD prevention exist but must be implemented at scale through multisectoral action utilizing diverse delivery mechanisms. Multivariable analyses showed that structural/macro, community and household factors have significant associations with NCD burden among adolescents and adults. Conclusions Multi-sectoral efforts are needed to target NCD risk factors among adolescents to mitigate disease burden and adverse outcomes in adulthood. Findings could guide policy and programming to reduce NCD burden in the sustainable development era. </jats:sec