Warm Circumpolar Deep Water transport toward Antarctica driven by local dense water export in canyons.

Poleward transport of warm Circumpolar Deep Water (CDW) has been linked to melting of Antarctic ice shelves. However, even the steady-state spatial distribution and mechanisms of CDW transport remain poorly understood. Using a global, eddying ocean model, we explore the relationship between the cross-slope transports of CDW and descending Dense Shelf Water (DSW). We find large spatial variability in CDW heat and volume transport around Antarctica, with substantially enhanced flow where DSW descends in canyons. The CDW and DSW transports are highly spatially correlated within ~20 km and temporally correlated on subdaily time scales. Focusing on the Ross Sea, we show that the relationship is driven by pulses of overflowing DSW lowering sea surface height, leading to net onshore CDW transport. The majority of simulated onshore CDW transport is concentrated in cold-water regions, rather than warm-water regions, with potential implications for ice-ocean interactions and global sea level rise.

Association of the Functional Movement Screen™ with match-injury burden in men's community rugby union.

Evidence supporting use of the Functional Movement Screen (FMSTM) to identify athletes' risk of injury is equivocal. Furthermore, few studies account for exposure to risk during analysis. This study investigated the association of FMSTM performance with incidence and burden of match-injuries in adult community rugby players. 277 players performed the FMSTM during pre-season and in-season time-loss injuries and match exposure were recorded. The associations between FMSTM score, pain, and movement-pattern asymmetries with match-injury incidence (≥8-days time-loss/1000hours), severe match-injury incidence (>28-days time-loss/1000hours), and match-injury burden (total time-loss days/1000hours for ≥8-days match-injuries) were analysed using Poisson regression. Multivariate analysis indicated players with pain and movement-pattern asymmetry during pre-season had 2.9 times higher severe match-injury incidence (RR, 90%CI = 2.9, 0.9-9.7) and match-injury burden (RR, 90%CI = 2.9, 1.3-6.6). Players with a typically low FMSTM score (mean - 1SD threshold) were estimated to have a 50% greater match-injury burden compared to players with a typically high FMSTM score (mean + 1SD threshold) as match-injury burden was 10% lower per 1-unit increase in FMSTM score. As the strongest association with injury outcome was found for players with pain and asymmetry, when implementing the FMSTM it is advisable to prioritise these players for further assessment and subsequent treatment.

Author Correction: Choosing the future of Antarctica.

On page 234 of this Perspective, '50% decrease' has been corrected online to '50% increase' in the sentence "The pH of surface waters south of 60° S decreased by 0.2 between 2017 and 2070, equivalent to a 50% increase in the concentration of hydrogen ions since the pre-industrial period1."

Southern Hemisphere westerlies as a driver of the early deglacial atmospheric CO2 rise.

The early part of the last deglaciation is characterised by a ~40 ppm atmospheric CO2 rise occurring in two abrupt phases. The underlying mechanisms driving these increases remain a subject of intense debate. Here, we successfully reproduce changes in CO2, δ13C and Δ14C as recorded by paleo-records during Heinrich stadial 1 (HS1). We show that HS1 CO2 increase can be explained by enhanced Southern Ocean upwelling of carbon-rich Pacific deep and intermediate waters, resulting from intensified Southern Ocean convection and Southern Hemisphere (SH) westerlies. While enhanced Antarctic Bottom Water formation leads to a millennial CO2 outgassing, intensified SH westerlies induce a multi-decadal atmospheric CO2 rise. A strengthening of SH westerlies in a global eddy-permitting ocean model further supports a multi-decadal CO2 outgassing from the Southern Ocean. Our results highlight the crucial role of SH westerlies in the global climate and carbon cycle system with important implications for future climate projections.

Choosing the future of Antarctica.

We present two narratives on the future of Antarctica and the Southern Ocean, from the perspective of an observer looking back from 2070. In the first scenario, greenhouse gas emissions remained unchecked, the climate continued to warm, and the policy response was ineffective; this had large ramifications in Antarctica and the Southern Ocean, with worldwide impacts. In the second scenario, ambitious action was taken to limit greenhouse gas emissions and to establish policies that reduced anthropogenic pressure on the environment, slowing the rate of change in Antarctica. Choices made in the next decade will determine what trajectory is realized.

Blood-feeding patterns of native mosquitoes and insights into their potential role as pathogen vectors in the Thames estuary region of the United Kingdom.

BACKGROUND: The range of vertebrate hosts on which species of mosquito blood-feed is an important parameter for identifying potential vectors and in assessing the risk of incursion and establishment of vector-borne pathogens. In the United Kingdom, studies of mosquito host range have collected relatively few specimens and used techniques that could only broadly identify host species. This study conducted intensive collection and analysis of mosquitoes from a grazing marsh environment in southeast England. This site provides extensive wetland habitat for resident and migratory birds and has abundant human nuisance biting mosquitoes. The aim was to identify the blood-feeding patterns of mosquito species present at the site which could contribute to the transmission of pathogens. METHODS: Twice-weekly collections of mosquitoes were made from Elmley Nature Reserve, Kent, between June and October 2014. Mosquitoes were collected using resting boxes, by aspiration from man-made structures and using a Mosquito Magnet Pro baited with 1-octen-3-ol. Blood-fed specimens were classified according to the degree of blood meal digestion using the Sella scale and vertebrate origin determined using sequencing of a fragment of the mitochondrial cytochrome C oxidase subunit I gene. Mosquitoes that were morphologically cryptic were identified to species level using multiplex PCR and sequencing methods. RESULTS: A total of 20,666 mosquitoes of 11 species were collected, and 2,159 (10.4%) were blood-fed (Sella scale II-VI); of these 1,341 blood-fed specimens were selected for blood meal analysis. Vertebrate origin was successfully identified in 964 specimens (72%). Collections of blood-fed individuals were dominated by Anopheles maculipennis complex (73.5%), Culiseta annulata (21.2%) and Culex pipiens form pipiens (10.4%). Nineteen vertebrate hosts comprising five mammals and 14 birds were identified as hosts for mosquitoes, including two migratory bird species. Feeding on birds by Culex modestus and Anopheles atroparvus populations in England was demonstrated. CONCLUSIONS: This study expands the vertebrate host range of mosquitoes in the Thames estuary region of the UK. Feeding on both resident and migratory bird species by potential arbovirus vectors including Cx. pipiens f. pipiens and Cx. modestus indicates the potential for enzootic transmission of an introduced arbovirus between migratory and local bird species by native mosquito species.

The efficacy of a movement control exercise programme to reduce injuries in youth rugby: a cluster randomised controlled trial.

BACKGROUND: Injuries to youth rugby players have become an increasingly prominent health concern, highlighting the importance of developing and implementing appropriate preventive strategies. A growing body of evidence from other youth sports has demonstrated the efficacy of targeted exercise regimens to reduce injury risk. However, studies have yet to investigate the effect of such interventions in youth contact sport populations like rugby union. OBJECTIVE: To determine the efficacy of an evidence-based movement control exercise programme compared with a sham exercise programme to reduce injury risk in youth rugby players. Exercise programme compliance between trial arms and the effect of coach attitudes on compliance will also be evaluated. SETTING: School rugby coaches in England will be the target of the researcher intervention, with the effects of the injury prevention programmes being measured in male youth players aged 14-18 years in school rugby programmes over the 2015-2016 school winter term. METHODS: A cluster-randomised controlled trial with schools randomly allocated to either a movement control exercise programme or a sham exercise programme, both of which are coach-delivered. Injury measures will derive from field-based injury surveillance, with match and training exposure and compliance recorded. A questionnaire will be used to evaluate coach attitudes, knowledge, beliefs and behaviours both prior to and on the conclusion of the study period. OUTCOME MEASURES: Summary injury measures (incidence, severity and burden) will be compared between trial arms, as will the influence of coach attitudes on compliance and injury burden. Additionally, changes in these outcomes through using the exercise programmes will be evaluated. TRIAL REGISTRATION NUMBER: ISRTCNN13422001.

Shoulder Injuries in English Community Rugby Union.

The aim of this study was to describe the incidence, severity and type of shoulder injuries resulting from match play in adult community rugby union between 2009-2013. A total of 254 time-loss shoulder injuries were reported, an overall incidence of 2.2 per 1 000 h (95% CI: 1.9 to 2.4), and a mean injury severity of 9.5 weeks missed (95% CI: 8.2 to 10.8). The semi-professional group had an incidence of 2.8 injuries per 1 000 h (95% CI: 2.2 to 3.5), which was higher than the recreational group at 1.8 injuries per 1 000 h (95% CI: 1.4 to 2.2, p=0.004). The incidence of acromioclavicular joint injury for semi-professional players was 1.2 per 1 000 h (95% CI: 0.8 to 1.6); which was significantly higher than the incidence of this injury type in recreational players (0.5 per 1 000 h 95% CI: 0.3 to 0.7, p=0.002). Overall, back row players sustained the highest incidence of all shoulder injuries for a given playing position, 2.9 injuries per 1 000 h (95% CI: 2.2 to 3.6). The tackle was the main event associated with injury. Injury prevention programs and coaching strategies that consider tackle technique and physical conditioning of the shoulder region are therefore considered important.

Pre-binding prior to full engagement improves loading conditions for front-row players in contested Rugby Union scrums.

We investigated the effect of a "PreBind" engagement protocol on the biomechanics of contested Rugby Union scrummaging at different playing levels. "PreBind" requires front-row props to take a bind on opposing players prior to the engagement, and to maintain the bind throughout the scrum duration. Twenty-seven teams from five different playing levels performed live scrums under realistic conditions. Video analysis, pressures sensors, and inertial measurement units measured biomechanical outcomes as teams scrummaged following different engagement protocols: the CTPE (referee calls "crouch-touch-pause-engage"), the CTS ("crouch-touch-set"), and the PreBind ("crouch-bind-set") variants. PreBind reduced the set-up distance between the packs (-27%) and the speed at which they came into contact by more than 20%. The peak biomechanical stresses acting on front rows during the engagement phase were decreased in PreBind by 14-25% with respect to CTPE and CTS, without reducing the capability to generate force in the subsequent sustained push. No relevant main effects were recorded for playing level due to within-group variability and there were no interaction effects between playing level and engagement protocol. Pre-binding reduced many mechanical quantities that have been indicated as possible factors for chronic and acute injury, and may lead to safer engagement conditions without affecting subsequent performance.

Response to Comment on "Atlantic and Pacific multidecadal oscillations and Northern Hemisphere temperatures".

Kravtsov et al. claim that we incorrectly assess the statistical independence of simulated samples of internal climate variability and that we underestimate uncertainty in our calculations of observed internal variability. Their analysis is fundamentally flawed, owing to the use of model ensembles with too few realizations and the fact that no one model can adequately represent the forced signal.

Obliquity Control On Southern Hemisphere Climate During The Last Glacial.

Recent paleoclimate reconstructions have challenged the traditional view that Northern Hemisphere insolation and associated feedbacks drove synchronous global climate and ice-sheet volume during the last glacial cycle. Here we focus on the response of the Patagonian Ice Sheet, and demonstrate that its maximum expansion culminated at 28,400 ± 500 years before present (28.4 ± 0.5 ka), more than 5,000 years before the minima in 65 °N summer insolation and the formally-defined Last Glacial Maximum (LGM) at 21,000 ± 2,000 years before present. To investigate the potential drivers of this early LGM (eLGM), we simulate the effects of orbital changes using a suite of climate models incorporating prescribed and evolving sea-ice anomalies. Our analyses suggest that Antarctic sea-ice expansion at 28.5 ka altered the location and intensity of the Southern Hemisphere storm track, triggering regional cooling over Patagonia of 5 °C that extends across the wider mid-southern latitudes. In contrast, at the LGM, continued sea-ice expansion reduced regional temperature and precipitation further, effectively starving the ice sheet and resulting in reduced glacial expansion. Our findings highlight the dominant role that orbital changes can play in driving Southern Hemisphere glacial climate via the sensitivity of mid-latitude regions to changes in Antarctic sea-ice extent.

Culicoides biting midges (Diptera, Ceratopogonidae) in various climatic zones of Russia and adjacent lands.

Culicoides biting midges play an important role in the epidemiology of many vector-borne infections, including bluetongue virus, an internationally important virus of ruminants. The territory of the Russian Federation includes regions with diverse climatic conditions and a wide range of habitats suitable for Culicoides. This review summarizes available data on Culicoides studied in the Russian Federation covering geographically different regions, as well as findings from adjacent countries. Previous literature on species composition, ranges of dominant species, breeding sites, and host preferences is reviewed and suggestions made for future studies to elucidate vector-virus relationships.

Antarctic contribution to meltwater pulse 1A from reduced Southern Ocean overturning.

During the last glacial termination, the upwelling strength of the southern polar limb of the Atlantic Meridional Overturning Circulation varied, changing the ventilation and stratification of the high-latitude Southern Ocean. During the same period, at least two phases of abrupt global sea-level rise--meltwater pulses--took place. Although the timing and magnitude of these events have become better constrained, a causal link between ocean stratification, the meltwater pulses and accelerated ice loss from Antarctica has not been proven. Here we simulate Antarctic ice sheet evolution over the last 25 kyr using a data-constrained ice-sheet model forced by changes in Southern Ocean temperature from an Earth system model. Results reveal several episodes of accelerated ice-sheet recession, the largest being coincident with meltwater pulse 1A. This resulted from reduced Southern Ocean overturning following Heinrich Event 1, when warmer subsurface water thermally eroded grounded marine-based ice and instigated a positive feedback that further accelerated ice-sheet retreat.

The influence of playing level on the biomechanical demands experienced by rugby union forwards during machine scrummaging.

This study investigated machine scrummaging at different playing levels in rugby union and analysed kinetic factors that might influence performance and injury risk. Thirty-four forward packs from six different playing levels scrummaged against an instrumented scrum machine under real environmental conditions. Applied forces were measured in three orthogonal directions. The peak (SD) of the overall compression forces during engagement ranged between 16.5 (1.4) kN (International-Elite) and 8.7 (0.1) kN (Women), while sustained compression forces spanned between 8.3 (1.0) kN (International) and 4.8 (0.5) kN (Women). The peak of the overall vertical force during the initial engagement phase was between -3.9 (0.7) kN (Elite) and -2.0 (1.0) kN (School), and the range of lateral forces was between 1.8 (0.3) kN (International) and 1.1 (0.3) kN (School). Forces measured across all playing levels, particularly during initial engagement, were generally higher than those measured in the most commonly cited previous studies. This increase may be due to a combination of changes in modern scrummaging technique, changes in players' anthropometrics, and experimental conditions that better respect ecological validity. The magnitude of the measured forces is in the range of values that studies on cadaveric specimens have indicated as potentially hazardous for (chronic) spine injuries.

Simultaneous irradiation of the breast and regional lymph nodes in prone position using helical tomotherapy.

OBJECTIVE: We investigated dosimetric advantages of using helical tomotherapy to simultaneously irradiate the breast and regional lymph nodes for patients positioned prone, and compared tomotherapy plan qualities for the prone position with those previously published for the supine position. METHODS: Tomotherapy plans for 11 patients (5 left breast, 6 right) simulated with the involved breast suspended downward were generated. Each target (ipsilateral breast and supraclavicular, axillary and internal mammary chain nodes) was to receive 45 Gy. RESULTS: For targets, V(40.5)≥99.9% and V(42.8)≥99.5% for all patients, where V(40.5) and V(42.8) denote the relative target volume receiving at least 40.5 and 42.8 Gy, respectively. The targets' maximum dose was, on average, approximately 49.5 Gy. The mean doses to the contralateral lung and heart were lower for right-breast cases (2.8 Gy lung, 2.7 Gy heart) than for left-breast cases (3.8 Gy lung, 8.7 Gy heart). Mean organ doses to the ipsilateral lung (9.3 Gy) and contralateral breast (2.3 Gy) from the prone breast tomotherapy plans were similar to those reported for conventional radiotherapy techniques. For the left breast with regional nodes, tomotherapy plans for prone-positioned patients yielded lower mean doses to the contralateral breast and heart than previously reported data for tomotherapy plans for supine-positioned patients. CONCLUSION: Helical tomotherapy with prone breast positioning can simultaneously cover the breast and regional nodes with acceptable uniformity and can provide reduced mean dose to proximal organs at risk compared with tomotherapy with supine position. The similarity of plan quality to existing data for conventional breast radiotherapy indicates that this planning approach is appropriate, and that the risk of secondary tumour formation should not be significantly greater.

The case for early treatment of dislocations of the cervical spine with cord involvement sustained playing rugby.

The most common injury in rugby resulting in spinal cord injury (SCI) is cervical facet dislocation. We report on the outcome of a series of 57 patients with acute SCI and facet dislocation sustained when playing rugby and treated by reduction between 1988 and 2000 in Conradie Hospital, Cape Town. A total of 32 patients were completely paralysed at the time of reduction. Of these 32, eight were reduced within four hours of injury and five of them made a full recovery. Of the remaining 24 who were reduced after four hours of injury, none made a full recovery and only one made a partial recovery that was useful. Our results suggest that low-velocity trauma causing SCI, such as might occur in a rugby accident, presents an opportunity for secondary prevention of permanent SCI. In these cases the permanent damage appears to result from secondary injury, rather than primary mechanical spinal cord damage. In common with other central nervous system injuries where ischaemia determines the outcome, the time from injury to reduction, and hence reperfusion, is probably important. In order to prevent permanent neurological damage after rugby injuries, cervical facet dislocations should probably be reduced within four hours of injury.

Effect of distillers dried grains with solubles and ractopamine (Paylean) on quality and shelf-life of fresh pork and bacon.

Pigs (n = 240) were allotted in a 5 x 2 factorial arrangement with 5 levels of distillers dried grains with solubles (DDGS): 0, 15, 30, 45, and 60%, and 2 ractopamine (RAC) levels: 0 and 5 mg/kg. Four pigs per pen (2 barrows, 2 gilts) closest to pen mean BW were used for meat quality evaluation. Loins (n = 119) were evaluated for objective color; moisture and fat; subjective color, marbling, and firmness; and drip loss. Bellies (n = 119) were evaluated for weight, length, width, thickness, objective fat color, and firmness. Cured bellies were evaluated for pump yield, cook loss, and sliced bacon cook loss. Loin thiobarbituric acid reactive substances (TBARS) were evaluated on enhanced (salt and phosphate) boneless chops held in modified atmosphere (80% O(2)/20% CO(2)) packages for 0, 7, 14, and 21 d. Bacon TBARS were evaluated on sliced bacon held in vacuum packages for 0, 28, 56, and 84 d. Fat samples were collected from each jowl and belly and evaluated for fatty acid profile and iodine value (IV). Increasing DDGS decreased subjective marbling (P = 0.0134) and firmness (P = 0.0235), and increased drip loss (P = 0.0046). Distillers dried grains with solubles did not affect loin pH, subjective or objective color, percent moisture, or percent fat (P > 0.05). The RAC decreased subjective color (P = 0.0239), marbling (P = 0.0445), and a* (P = 0.0355). Increasing DDGS decreased belly weight (P = 0.0155), length (P = 0.0008), thickness (P = 0.0019), and firmness (P = 0.0054); decreased belly fat L* (P = 0.0818); and increased belly cook loss (P = 0.0890). Ractopamine did not affect any belly measurements, and there were no DDGS x RAC interactions (P > 0.05). Distillers dried grains with solubles did not affect loin TBARS at 0, 7, or 14 d. At 21 d, loin TBARS from 30, 45, and 60% DDGS groups were increased compared with 0 and 15% groups (P < 0.05). Ractopamine did not affect (P > 0.05) loin TBARS, and there were no (P > 0.05) DDGS x RAC interactions. Distillers dried grains with solubles and RAC did not affect bacon TBARS (P > 0.05). Increasing DDGS increased belly (P = 0.0207) and jowl (P < 0.0001) IV, and decreased MUFA:PUFA in belly (P < 0.0001) and jowl (P < 0.0001) fat. Ratio of SFA:unsaturated fatty acids decreased in jowl (P = 0.0002) and belly fat (P = 0.2815). Ractopamine did not affect fatty acid profiles or IV, and there were no DDGS x RAC interactions (P > 0.05). Results indicate that increased DDGS have minimal effects on loin quality, but decrease belly quality, bacon processing characteristics, and fat stability. Ractopamine does not negatively affect these characteristics and does not interact with DDGS.

A statewide community cancer center videoconferencing program.

INTRODUCTION: The multidisciplinary approach to cancer care has been established through a statewide videoconferencing network to discuss prospective patient management issues. To our knowledge this is the first report of a statewide community cancer center videoconferencing network in the USA. METHODS: Four of seven American College of Surgeons Commission on Cancer community hospitals in the state of Delaware agreed to participate in a statewide videoconferencing network. Through information technology all centers can communicate pathology and radiology results via visualization methodology. Information is shared on a weekly basis with discussion of treatment decisions and diagnostic procedures. The videoconferencing occurs over a 60-min period. RESULTS: All cases have been prospectively presented. The videoconferencing has led to an increase in National Cancer Institute (NCI) treatment and cancer control clinical trials accrual. American Society of Clinical Oncology (ASCO) guidelines and the National Comprehensive Cancer Center Network (NCCN) guidelines have been followed in 92% of case presentations as recommended by the videoconference participants. Physician and support personnel do not have to travel to any of the centers since technology allows communication amongst all participants through their own community cancer centers. CONCLUSION: A statewide community cancer center videoconferencing network has resulted in high compliance with ASCO and NCCN guidelines and improvement in accrual to NCI Clinical trials.

Using intranasal lidocaine to reduce food intake.

OBJECTIVE: Develop a dose-response curve for the effect of intranasal lidocaine on food intake. DESIGN: Healthy obese subjects had food intake, ratings of hunger, desire to eat, craving and fullness measured at lunch after an overnight fast. Four treatments were given as nose drops (0.5-0.6 ml per nostril) 5 min before the meal in a double-blind manner with a four period crossover design including a 7-day washout between periods. The treatments were saline, 2.5, 10 and 25 mg lidocaine per nostril. The order of administration was randomly assigned to each subject. Electrocardiograms, vital signs, chemistry panels, complete blood counts (CBC) and nasal inspections were carried out before and after each dose. SUBJECTS: Forty-seven subjects were screened, 34 were randomized and 20 subjects completed all four study periods in the trial. The subjects were 39+/-12.5 (s.d) years of age, had a weight of 91+/-13.0 kg, a height of 167+/-10.3 cm, 56% were women, 47% were African-American and 53% were Caucasian. MEASUREMENTS: Food intake, rating of hunger, desire to eat, craving and fullness are measures of efficacy. Adverse events, electrocardiograms, vital signs, chemistry panels, nasal inspections, CBC and physical exams are measures of safety. RESULTS: The mean reduction in food intake vs saline control in the 20 subjects completing all four study periods was 3.3+/-7% (s.d), 4.2+/-8.5% and 7.4+/-7.3% in the 2.5 mg, 10 and 25 mg per nostril groups, respectively (P=NS). Hunger and desire to eat in subjects who completed at least one study period decreased dose dependently (P<0.03, at the 25 mg per nostril dose). There were no clinically significant changes in safety measures, electrocardiograms, vital signs, chemistry panels, CBC or nasal inspections. CONCLUSION: Intranasal lidocaine reduced hunger and the desire to eat, but this did not translate into a significant reduction in food intake suggesting that intranasal lidocaine will not have value in treating obesity.