Measuring corporate Paris Compliance using a strict science-based approach.

The achievement of the Paris Agreement climate goals of well-below 2 degrees of warming requires companies to align their greenhouse gas emission reductions with this goal. To measure whether companies are compliant with the Paris targets we propose several strict conditions that any emissions allocation methodology must meet before it can be classified as Paris-Compliant. Our conditions focus on the need for a common, and early as practicable, base year for all companies and consistency with an underlying Paris-aligned decarbonisation pathway. Additionally, we propose four operationalisation requirements to ensure companies can declare they are on a Paris Compliant Pathway including calculations of their carbon budgets and re-alignment pathways. Applying example Paris-Compliant Pathways and associated metrics to ten high emission electric utility companies and ten cement companies, we find that all but one of these companies are not currently Paris-compliant, with every year of delayed action increasing their required rate of decarbonisation and hence the exposure of billions of investment dollars to transition risk. Applying this proposed method will ensure the Paris carbon budget is met and that progress can be tracked accurately - an imperative for any companies and stakeholders seeking to align their decision-making with the Paris Agreement.

A systems-based assessment of Palestine's current and future infrastructure requirements.

The occupied Palestinian territories of West Bank and Gaza Strip are currently experiencing many challenges in the provision of infrastructure services for their inhabitants. This includes an undersupply of infrastructure services across multiple sectors - an issue exacerbated by population growth, increasing urbanisation, economic growth and climate change. We address this challenge by providing a systems-based assessment of Palestine's infrastructure requirements and identifying broad strategies for how those needs might be met. This assessment involved four key components including: 1) defining and assessing the current system and planned infrastructure investments; 2) assessing potential future demand for infrastructure services; 3) identifying alternative strategies for future infrastructure provision beyond planned investments; and 4) analysing the performance of each strategy against a series of key performance indicators. Results from the assessment highlight the magnitude of the current and future need for urgent infrastructure investment in Palestine. The most immediate need is to alleviate the water crises in Gaza Strip, which will require at least twice as much water infrastructure investment over the coming decade than is currently in the pipeline, even if the goal is only to achieve the most basic World Health Organisation water availability requirements. To move beyond this protracted state of crises will then require a doubling of investments across all sectors to bring Palestine up to the standards of services already enjoyed by its neighbours. Such investments can have even greater impact on delivery of infrastructure services through the strategic use of interdependencies between infrastructure sectors, such as water re-use and energy-from-waste. In the pursuit of global sustainable development, the systems-based approach presented here provides an important first step in the assessment of infrastructure needs and opportunities for any country. It is particularly important for states like Palestine where key resources, such as water and energy, are so acutely constrained.

Varied uses of the medial sural artery perforator flap.

BACKGROUND AND AIM: The aim of the study was to demonstrate how the medial sural artery perforator flap can be used in a wide range of settings and not focused on one area, as previous papers have done. We also wanted to demonstrate that larger flaps can be harvested from the donor site and still closed directly to optimise the appearance of the donor site. METHODS: We describe the use of the medial sural artery perforator flap in 18 patients with defects of the head and neck, upper and lower limbs. RESULTS: All 18 flaps survived, although one suffered some delayed partial loss due to pressure damage. All donor sites were closed directly to optimise the appearance of the donor site. There were complications with the donor site wound in 2 patients. This resulted in further surgery in one case. CONCLUSION: The advantages of the flap are discussed over some of the more commonly used options for reconstruction of these areas. It is a good source of thin, pliable soft tissue with a long pedicle, which makes it very adaptable. The skin paddle is small but if designed appropriately allows the donor site to be closed directly, leaving an aesthetically good result.

Development of schooling behaviour during the downstream migration of Atlantic salmon Salmo salar smolts in a chalk stream.

The downstream migratory behaviour of wild Atlantic salmon Salmo salar smolts was monitored using passive integrated transponder (PIT) antennae systems over 10 years in the lower reaches of a small chalk stream in southern England, U.K. The timing of smolt movements and the likely occurrence of schooling were investigated and compared to previous studies. In nine of the 10 consecutive years of study, the observed diel downstream patterns of S. salar smolt migration appeared to be synchronized with the onset of darkness. The distribution of time intervals between successive nocturnal detections of PIT-tagged smolts was as expected if generated randomly from observed hourly rates. There were, however, significantly more short intervals than expected for smolts detected migrating during the day. For each year from 2006 to 2011, the observed 10th percentile of the daytime intervals was <4 s, compared to ≥55 s for the simulated random times, indicating greater incidence of groups of smolts. Groups with the shortest time intervals between successive PIT tag detections originated from numerous parr tagging sites (used as a proxy for relatedness). The results suggest that the ecological drivers influencing daily smolt movements in the lower reaches of chalk stream catchments are similar to those previously reported at the onset of migration for smolts leaving their natal tributaries; that smolts detected migrating during the night are moving independently following initiation by a common environmental factor (presumably darkness), whereas those detected migrating during the day often move in groups, and that such schools may not be site (kin)-structured. The importance of understanding smolt migratory behaviour is considered with reference to stock monitoring programmes and enhancing downstream passage past barriers.

Percutaneous dilational and surgical tracheostomy in burn patients: incidence of complications and dysphagia.

The aim of this study is to evaluate the incidence of complications and dysphagia in relation to the timing of tracheostomy and tracheostomy technique in 49 consecutive adult burn patients. We analysed prospectively collected data. Bronchoscopy was used to diagnose tracheal stenosis and a modified Evans blue dye test was used to diagnose dysphagia. Eighteen patients received a percutaneous dilatational tracheostomy (PDT) and thirty-one patients received an open surgical tracheostomy (OST). Eight patients developed significant complications (16%) following tracheostomy, there is no difference in the incidence of complications; post op infection, stoma infection or tracheal stenosis between PDT and OST groups. Patients with full thickness neck burn who developed complications had a tracheostomy significantly earlier following autografting (p=0.05). Failed extubation is associated with dysphagia (p=0.02) whereas prolonged intubation and ventilation prior to tracheostomy independently predicts dysphagia (p=0.03). We conclude that there is no difference in the complication rates for PDT and OST in our burn patients. We recommend early closure of neck burns and tracheostomy through fully adherent autograft or at least 10 days after grafting to reduce stomal infections. For patients with no neck burn, we support early tracheostomy to reduce the likelihood of dysphagia.

Water quality and health in a Sahelian semi-arid urban context: an integrated geographical approach in Nouakchott, Mauritania.

Access to sufficient quantities of safe drinking water is a human right. Moreover, access to clean water is of public health relevance, particularly in semi-arid and Sahelian cities due to the risks of water contamination and transmission of water-borne diseases. We conducted a study in Nouakchott, the capital of Mauritania, to deepen the understanding of diarrhoeal incidence in space and time. We used an integrated geographical approach, combining socio-environmental, microbiological and epidemiological data from various sources, including spatially explicit surveys, laboratory analysis of water samples and reported diarrhoeal episodes. A geospatial technique was applied to determine the environmental and microbiological risk factors that govern diarrhoeal transmission. Statistical and cartographic analyses revealed concentration of unimproved sources of drinking water in the most densely populated areas of the city, coupled with a daily water allocation below the recommended standard of 20 l per person. Bacteriological analysis indicated that 93% of the non-piped water sources supplied at water points were contaminated with 10-80 coliform bacteria per 100 ml. Diarrhoea was the second most important disease reported at health centres, accounting for 12.8% of health care service consultations on average. Diarrhoeal episodes were concentrated in municipalities with the largest number of contaminated water sources. Environmental factors (e.g. lack of improved water sources) and bacteriological aspects (e.g. water contamination with coliform bacteria) are the main drivers explaining the spatio-temporal distribution of diarrhoea. We conclude that integrating environmental, microbiological and epidemiological variables with statistical regression models facilitates risk profiling of diarrhoeal diseases. Modes of water supply and water contamination were the main drivers of diarrhoea in this semi-arid urban context of Nouakchott, and hence require a strategy to improve water quality at the various levels of the supply chain.

Never fear, a perforator will always appear: the use of a perforator flap based on the vasa nervosum of the anterior branch of the femoral cutaneous nerve.

A 30 year old tree surgeon presented to our services with a Gustilo IIIB fracture to his right lower leg. An anterolateral thigh flap was planned for the reconstruction. Intraoperatively, there were no suitable perforators seen and a neurocutaneous perforator flap based on the vessels associated with the anterior branch of the femoral cutaneous nerve was used. The nerve was preserved in the flap harvest. He was discharged and later followed up in clinic with no complications.

Recovery of biosolids from constructed wetlands used for faecal sludge dewatering in tropical regions.

Biosolids recovered from yard-scale vertical-flow constructed wetlands used for faecal sludge dewatering in Cameroon, were analyzed to assess their degree of maturity, nutrient and heavy metals contents, as well as their hygienic quality. Six beds were loaded weekly at nominal loading rate of 100, 200, and 300 kg TS/m2/year. The quality of the biosolids accumulated in the beds was monitored during 6 additional months of resting period prior to final harvest. Results showed that C/N ratio (11.3), humification index (14%), humification rate (1.8%), and degree of polymerization (3.7) of the biosolids generated were comparable to those of mature composts. Biosolids quality appeared to having high fertilizing value (N: 2%, P2O5: 2.3%, CaO: 1%, MgO: 0.14%, K2O: 0.03, and Na2O: 0.09%) with low heavy metals contamination (63, 14, 26, 2.4, 575, 703, 186, and 32 mg/kg for Pb, Ni, Cr, Cd, Cu, Zn, Mn, and Se, respectively). The concentration of fertile ascaris was reduced from 40 eggs/g TS after one month storage to <4 eggs/g TS after six month of storage, a level which does not significantly increase health risk exposure as compare to the WHO guidelines.

A comprehensive study of chromosome 16q in invasive ductal and lobular breast carcinoma using array CGH.

We analysed chromosome 16q in 106 breast cancers using tiling-path array-comparative genomic hybridization (aCGH). About 80% of ductal cancers (IDCs) and all lobular cancers (ILCs) lost at least part of 16q. Grade I (GI) IDCs and ILCs often lost the whole chromosome arm. Grade II (GII) and grade III (GIII) IDCs showed less frequent whole-arm loss, but often had complex changes, typically small regions of gain together with larger regions of loss. The boundaries of gains/losses tended to cluster, common sites being 54.5-55.5 Mb and 57.4-58.8 Mb. Overall, the peak frequency of loss (83% cancers) occurred at 61.9-62.9 Mb. We also found several 'minimal' regions of loss/gain. However, no mutations in candidate genes (TRADD, CDH5, CDH8 and CDH11) were detected. Cluster analysis based on copy number changes identified a large group of cancers that had lost most of 16q, and two smaller groups (one with few changes, one with a tendency to show copy number gain). Although all morphological types occurred in each cluster group, IDCs (especially GII/GIII) were relatively overrepresented in the smaller groups. Cluster groups were not independently associated with survival. Use of tiling-path aCGH prompted re-evaluation of the hypothetical pathways of breast carcinogenesis. ILCs have the simplest changes on 16q and probably diverge from the IDC lineage close to the stage of 16q loss. Higher-grade IDCs probably develop from low-grade lesions in most cases, but there remains evidence that some GII/GIII IDCs arise without a GI precursor.

Effects of alloimmune injury on contraction and relaxation in cultured myocytes and intact cardiac allografts.

OBJECTIVES: This study was performed to determine the mechanisms by which allosensitized lymphocytes cause contractile dysfunction in cultured ventricular myocytes and to compare the effects on isolated myocytes with those observed in an intact heart preparation during allograft rejection. BACKGROUND: Allograft rejection may be associated with reversible abnormalities of both systolic and diastolic function. The immunologic mechanisms that cause ventricular dysfunction are poorly understood. METHODS: Vascularized heterotopic abdominal heart transplantation was performed in mice. Contractile function of excised allografts undergoing rejection was assessed using a Langendorff perfusion apparatus and a strain gauge. Spontaneously beating monolayers of cultured ventricular myocytes from donor strain fetal mice were exposed to the allosensitized cytotoxic T lymphocytes, and the effects on myocyte motion, intracellular calcium transients, relaxation half-time, membrane potential and myocyte lysis (chromium-51 release) were measured. RESULTS: In intact hearts, histologically mild rejection without myocyte necrosis was associated with decreased systolic function without slowing of relaxation. In cultured fetal myocytes, sensitized lymphocytes induced a progressive decrease in the amplitudes of myocyte motion and calcium transients, with cessation of beating within 40 min. Also, the diastolic membrane potential and amplitude of the action potential decreased. Relaxation half-time, as estimated by measurement of cell motion, was unchanged. The effect was allospecific and was reversible with early removal of lymphocytes from the myocyte monolayer. Pretreatment of lymphocytes with the degranulation inhibitor 4,4'-diisothiocyano-2,2'-disulfonic acid stilbene blocked both the negative inotropic effect and myocyte lysis. CONCLUSIONS: We conclude that impaired relaxation is not a prominent feature of contractile dysfunction caused directly in myocytes by alloimmune injury from cytotoxic lymphocytes. Allosensitized lymphocytes can cause reversible systolic dysfunction in myocytes by means of a direct cell-cell interaction. This effect may be in part responsible for the reversible systolic dysfunction associated with allograft rejection.

Antiulcer drugs and gastric mucosal integrity. Effects of misoprostol, 16,16-dimethyl PGE2, and cimetidine on hemodynamics and metabolic rate in canine gastric mucosa.

Although prostaglandins (PGs) of the E series have gastric antisecretory and cytoprotective properties, many have different effects on the barrier integrity of the gastric mucosa. The direct effect of antiulcer drugs on gastric mucosal blood flow, mucosal barrier permeability, and metabolic rate have not been adequately studied. These factors are important in the defense of the gastric mucosa. Part of the difficulty relates to the possible influence of gastric mucosal blood flow on gastric acid secretion. To rule out this confounding factor, omeprazole can be used to reveal the true pharmacologic effects of these antiulcer drugs independent of the effect of gastric secretion per se. The study examined the effects of 16,16-dimethyl PGE2 (dmPGE2), misoprostol, and cimetidine on gastric mucosal blood flow, oxygen consumption, potential difference (PD), electrolytes, and fluid flux using the ex vivo gastric chamber dog model. The PGs were administered intraluminally with an isotonic acid solution; cimetidine was administered by arterial infusion. None of the drug treatments had any significant effect on mean systemic arterial pressure, arterial blood gases, body temperature, or oxygen consumption. dmPGE2 significantly (P less than 0.001) decreased PD and enhanced the electrolytes (Na+, K+) and fluid flux across the mucosa (P less than 0.05). Misoprostol significantly increased gastric mucosal blood flow (P less than 0.02) and fluid efflux but decreased PD values. Cimetidine did not have any significant effects on barrier or metabolic functions of the stomach. These results suggest that a considerable difference exists in the pharmacology of gastric antisecretory drugs in relation to their effect on several factors affecting gastric mucosal integrity.

Hyperacute rejection of the transplanted mouse heart.

Mouse hearts transplanted heterotopically to MHC-disparate recipients can be hyperacutely rejected (HAR) after a single or 3 sequential donor type skin grafts, or a single intradermal injection of lymphoid cells. In the combinations tested, not all hearts are HAR; most of them are rejected in accelerated fashion. Our results with transplanted rat hearts are similar, even in a genetic combination for which HAR of all hearts has been reported. However, in rats, HAR tends to occur more rapidly and to be associated with more-intense vascular changes. Transfer of serum from mice or rats sensitized by 3 sequential skin grafts likewise resulted in occasional hyperacute but never accelerated rejection. Transfer of lymph node cells from mice sensitized with a single skin graft always resulted in accelerated but never in hyperacute rejection; transfer of cells after 3 sequential skin grafts caused neither accelerated nor hyperacute rejection.

Role of corrosion in Harrington and Luque rods failure.

Ten in-vivo failed spinal instrumentation systems, i.e. six Harrington distraction rods with sublaminar hooks, one Harrington distraction rod with segmental wiring and three Luque rods with sublaminar wires, were fractographically analysed. In both Harrington and Luque rods corrosion fatigue was the predominant mechanism resulting in the failure. Five Harrington rods fractured at the first ratchet junction; fractures of the Luque rods were initiated by fretting of sublaminar wire with the rod surface in the presence of spinal non-union. Fretting and crevice corrosion were found to play an important role in compromising the segmental spinal instrumentation. The susceptibility of the 316 L CW austenitic stainless steel to pitting and relative resistance to crevice corrosion were measured by cyclic anodic polarization tests. The oxide inclusions have been found to play a significant role in the pitting of the alloy.

Omeprazole and cimetidine versus pentagastrin in canine ex vivo gastric chamber.

The effects of acid inhibitory doses of omeprazole were compared with equieffective doses of cimetidine in the canine ex vivo stomach model (n = 30). Systemic blood pressure, temperature, stomach fluid and ion fluxes, potential difference, blood flow rates, and arterial and venous blood gases were monitored during each of nine 30-min periods. Two resting periods preceded seven periods of pentagastrin stimulation. During the last four of these, the drug effect was recorded (cimetidine 1.2 or 4.8 mumol.kg-1.h-1; omeprazole 0.3, 0.6, or 1.2 mumol/kg). Omeprazole (1.2 mumol/kg) produced 100% inhibition of stimulated acid efflux, no significant decrease in total gastric blood flow (venous outflow), 90% return of potential difference (PD) toward resting values, and a 55% reduction in stimulated oxygen consumption. Omeprazole also showed a dose-dependent K+ efflux at the two lower doses. Cimetidine (4.8 mumol.kg-1.h-1) given during pentagastrin stimulation showed a 70% decrease in total gastric blood flow, a 40% return of PD toward resting, and a 77% reduction in stimulated oxygen consumption. Neither drug showed significant changes in mucosal blood flow from resting values, thus supporting the principle that changes in gastric acid secretion and changes in blood flow are not necessarily correlated.

The application of scanning transmission electron microscopy (STEM) to the study of thin anodic films on nickel and nickel-molybdenum alloys.

Anodized thin-film samples of nickel, molybdenum and a nickel-13 w/o molybdenum alloy have been analysed by scanning transmission electron microscopy, using selected area diffraction, microdiffraction and X-ray micro-analysis. Thin-film samples were obtained by ion thinning with argon and by electropolishing in acetic acid-perchloric acid. Electropolishing is the preferred technique for these studies, producing a surface with roughness on a scale of 1 nm. The anodized films on nickel and nickel 13 w/o molybdenum alloy exhibit a rugosity with a 'particle' size of 3 nm. The crystal structure of the films is similar to f.c.c. nickel oxide. Molybdenum enrichment was detected in the anodized alloy surfaces but there is no electron diffraction evidence for a crystalline molybdenum oxide. The electron diffraction pattern from anodized pure molybdenum suggests that the surface film is amorphous.