Reconstructing river flows remotely on Earth, Titan, and Mars.

Alluvial rivers are conveyor belts of fluid and sediment that provide a record of upstream climate and erosion on Earth, Titan, and Mars. However, many of Earth's rivers remain unsurveyed, Titan's rivers are not well resolved by current spacecraft data, and Mars' rivers are no longer active, hindering reconstructions of planetary surface conditions. To overcome these problems, we use dimensionless hydraulic geometry relations-scaling laws that relate river channel dimensions to flow and sediment transport rates-to calculate in-channel conditions using only remote sensing measurements of channel width and slope. On Earth, this offers a way to predict flow and sediment flux in rivers that lack field measurements and shows that the distinct dynamics of bedload-dominated, suspended load-dominated, and bedrock rivers give rise to distinct channel characteristics. On Mars, this approach not only predicts grain sizes at Gale Crater and Jezero Crater that overlap with those measured by the Curiosity and Perseverance rovers, it enables reconstructions of past flow conditions that are consistent with proposed long-lived hydrologic activity at both craters. On Titan, our predicted sediment fluxes to the coast of Ontario Lacus could build the lake's river delta in as little as ~1,000 y, and our scaling relationships suggest that Titan's rivers may be wider, slope more gently, and transport sediment at lower flows than rivers on Earth or Mars. Our approach provides a template for predicting channel properties remotely for alluvial rivers across Earth, along with interpreting spacecraft observations of rivers on Titan and Mars.

Quantifying groundwater flow variability in a poorly cemented fractured sandstone aquifer to inform in situ remediation.

This study applies innovative methods to characterize and quantify the magnitude of groundwater flow in a fractured and variably cemented sandstone aquifer to inform an in-situ remediation strategy for trichloroethene (TCE) contamination. A modified active-distributed temperature sensing (A-DTS) approach in which fiber optic cables were permanently grouted in the borehole was used to quantify groundwater flow rates. Two additional tracer tests were conducted: 1) fluorescein tracer injection followed by rock coring and sampling for visual mapping and porewater analysis, and 2) deployment of passive flux meters in conventional monitoring wells to evaluate groundwater velocity and mass flux distributions. Forced gradient injection of fluorescein tracer suggests a dual porosity flow system wherein higher rates of groundwater flow occur within discrete features including highly permeable bedding planes and fractures, with slower flow occurring within the rock matrix. Tracer was observed and detected in the unfractured matrix porewater >1.5 m away from the injection well. Beyond this distance, >6 m radially away from the injection hole, tracer was primarily detected within and adjacent to high transmissivity fractures serving as preferential flow paths. The Darcy flux calculated using active distributed temperature sensing (A-DTS) shows depth-discrete values ranging from 7 to 60 cm/day, with average and median values of 23 and 17 cm/day, respectively. Passive Flux Meters (PFMs) deployed in three conventional monitoring wells with slotted screens and sand filter packs showed groundwater flux values ranging from 2 to 11 cm/day, with an overall average of 4 cm/day and are likely biased low due to spreading in the sand pack. The study results were used to inform an in-situ remediation system design including the proposed injection well spacing and the amendment delivery approach. In addition, the results were used to build confidence in the viability of delivering an oxidant to the rock matrix via advective processes. This is important because 1) the matrix is where the majority of the TCE mass occurs, and 2) it provides insights on processes that directly affect remedial performance expectations given advective delivery to preferential pathways and the matrix overcomes diffusion only conditions.

Femoral side-only revision options for the Birmingham resurfacing arthroplasty.

BACKGROUND: The Birmingham Hip Resurfacing (BHR) system (Smith and Nephew) was developed as an alternative to conventional total joint replacement for younger, more active patients. Among other complications exists the risk for femoral component failure. The only marketed revision option for such a complication involves exchange of all components for a total replacement arthroplasty. This presents as a considerable and potentially unnecessary operative burden where revision of only the femoral prosthesis would suffice. We have analysed revision options for BHR in the context of periprosthetic femoral fractures with a stable acetabular component. METHODS: Technical details of dual mobility hip systems available in Australia were collated and analysed to assess for potential 'off label' use with an existing BHR acetabular component. These data were then compared with the custom-made Smith and Nephew dual mobility implant with respect to clearance and sizing. RESULTS: Two dual mobility articulation modalities from two companies were identified as appropriate for potential usage with four products analysed in detail. These two demonstrated acceptable sizing and clearance measurements. CONCLUSION: Comparison between readily available dual mobility prostheses with custom-made implants showed off label dual mobility prosthetic use to be a viable alternative for femoral-only revisions with in situ BHR. Single component revision has several advantages which include: a less complex surgical procedure, shorter operative time, decreased blood loss and the expectation of resultant lower morbidity. Furthermore, this less complex revision surgery should give comparable results to that of primary total hip arthroplasty.

Consistent head up cardiopulmonary resuscitation haemodynamics are observed across porcine and human cadaver translational models.

AIM: The objectives were: 1) replicate key elements of Head Up (HUP) cardiopulmonary resuscitation (CPR) physiology in a traditional swine model of ventricular fibrillation (VF), 2) compare HUP CPR physiology in pig cadavers (PC) to the VF model 3) develop a new human cadaver (HC) CPR model, and 4) assess HUP CPR in HC. METHODS: Nine female pigs were intubated, and anesthetized. Venous, arterial, and intracranial access were obtained. After 6 min of VF, CPR was performed for 2 min epochs as follows: Standard (S)-CPR supine (SUP), Active compression decompression (ACD) CPR + impedance threshold device (ITD-16) CPR SUP, then ACD + ITD HUP CPR. The same sequence was performed in PC 3 h later. In 9 HC, similar vascular and intracranial access were obtained and CPR performed for 1 min epochs using the same sequence as above. RESULTS: The mean cerebral perfusion pressure (CerPP, mmHg) was 14.5 ±â€¯6 for ACD + ITD SUP and 28.7 ±â€¯10 for ACD + ITD HUP (p = .007) in VF, -3.6 ±â€¯5 for ACD + ITD SUP and 7.8 ±â€¯9 for ACD + ITD HUP (p = .007) in PC, and 1.3 ±â€¯4 for ACD + ITD SUP and 11.3 ±â€¯5 for ACD + ITD HUP (p = .007) in HC. Mean systolic and diastolic intracranial pressures (ICP) (mmHg) were significantly lower in the ACD + ITD HUP group versus the ACD + ITD SUP group in all three CPR models. CONCLUSION: HUP CPR decreased ICP while increasing CerPP in pigs in VF as well as in PC and HC CPR models. This first-time demonstration of HUP CPR physiology in humans provides important implications for future resuscitation research and treatment.

Chest compliance is altered by static compression and decompression as revealed by changes in anteroposterior chest height during CPR using the ResQPUMP in a human cadaver model.

INTRODUCTION: Chest compliance plays a fundamental role in the generation of circulation during cardiopulmonary resuscitation (CPR). To study potential changes in chest compliance over time, anterior posterior (AP) chest height measurements were performed on newly deceased (never frozen) human cadavers during CPR before and after 5min of automated CPR. We tested the hypothesis that after 5min of CPR chest compliance would be significantly increased. METHODS: Static compression (30, 40, and 50kg) and decompression forces (-10, -15kg) were applied with a manual ACD-CPR device (ResQPUMP, ZOLL) before and after 5min of automated CPR. Lateral chest x-rays were obtained with multiple reference markers to assess changes in AP distance. RESULTS: In 9 cadavers, changes (mean±SD) in the AP distance (cm) during the applied forces were 2.1±1.2 for a compression force of 30kg, 2.9±1.3 for 40kg, 4.3±1.0 for 50kg, 1.0±0.8 for a decompression force of -10kg and 1.8±0.6 for -15kg. After 5min of automated CPR, AP excursion distances were significantly greater (p<0.05). AP distance increased to 3.7±1.4 for a compression force of 30kg, 4.9±1.6 for 40kg, 6.3±1.9 for 50kg, 2.3±0.9 for -10kg of lift and 2.7±1.1 for -15kg of lift. CONCLUSIONS: These data demonstrate chest compliance increases significantly over time as demonstrated by the significant increase in the measured AP distance after 5min of CPR. These findings suggest that adjustments in compression and decompression forces may be needed to optimize CPR over time.

Fluvial response to climate variations and anthropogenic perturbations for the Ebro River, Spain in the last 4,000 years.

Fluvial sediment discharge can vary in response to climate changes and human activities, which in return influences human settlements and ecosystems through coastline progradation and retreat. To understand the mechanisms controlling the variations of fluvial water and sediment discharge for the Ebro drainage basin, Spain, we apply a hydrological model HydroTrend. Comparison of model results with a 47-year observational record (AD 1953-1999) suggests that the model adequately captures annual average water discharge (simulated 408 m(3)s(-1) versus observed 425 m(3)s(-1)) and sediment load (simulated 0.3 Mt yr(-1) versus observed 0.28 ± 0.04 Mt yr(-1)) for the Ebro basin. A long-term (4000-year) simulation, driven by paleoclimate and anthropogenic land cover change scenarios, indicates that water discharge is controlled by the changes in precipitation, which has a high annual variability but no long-term trend. Modeled suspended sediment load, however, has an increasing trend over time, which is closely related to anthropogenic land cover variations with no significant correlation to climatic changes. The simulation suggests that 4,000 years ago the annual sediment load to the ocean was 30.5 Mt yr(-1), which increased over time to 47.2 Mt yr(-1) (AD 1860-1960). In the second half of the 20th century, the emplacement of large dams resulted in a dramatic decrease in suspended sediment discharge, eventually reducing the flux to the ocean by more than 99% (mean value changes from 38.1 Mt yr(-1) to 0.3 Mt yr(-1)).

Instability and finite-amplitude self-organization of large-scale coastline shapes.

Recent research addresses the formation of patterns on sandy coastlines on alongshore scales that are large compared with the cross-shore extent of active sediment transport. A simple morphodynamic instability arises from the feedback between wave-driven alongshore sediment flux and coastline shape. Coastline segments with different orientations experience different alongshore sediment fluxes, so that curvatures in coastline shape drive gradients in sediment flux, which can augment the shoreline curvatures. In a simple numerical model, this instability, and subsequent finite-amplitude interactions between pattern elements, lead to a wide range of different rhythmic shapes and behaviours-ranging from symmetric cuspate capes and bays to alongshore migrating 'flying spits'-depending on the characteristics of the input wave forcing. The scale of the pattern coarsens in some cases because of the merger of migrating coastline features, and in other cases because of non-local screening interactions between coastline protrusions, which affect the waves reaching other parts of the coastline. Features growing on opposite sides of an enclosed water body mutually affect the waves reaching each other in ways that lead to the segmentation of elongated water bodies. Initial tests of model predictions and comparison with observations suggest that modes of pattern formation in the model are relevant in nature.

Instability and finite-amplitude self-organization of large-scale coastline shapes.

Recent research addresses the formation of patterns on sandy coastlines on alongshore scales that are large compared with the cross-shore extent of active sediment transport. A simple morphodynamic instability arises from the feedback between wave-driven alongshore sediment flux and coastline shape. Coastline segments with different orientations experience different alongshore sediment fluxes, so that curvatures in coastline shape drive gradients in sediment flux, which can augment the shoreline curvatures. In a simple numerical model, this instability, and subsequent finite-amplitude inter-actions between pattern elements, lead to a wide range of different rhythmic shapes and behaviours--ranging from symmetric cuspate capes and bays to alongshore migrating 'flying spits'--depending on the characteristics of the input wave forcing. The scale of the pattern coarsens in some cases because of the merger of migrating coastline features, and in other cases because of non-local screening interactions between coastline protrusions, which affect the waves reaching other parts of the coastline. Features growing on opposite sides of an enclosed water body mutually affect the waves reaching each other in ways that lead to the segmentation of elongated water bodies. Initial tests of model predictions and comparison with observations suggest that modes of pattern formation in the model are relevant in nature.

Reliability of three methods of computer-aided thermal pattern analysis.

BACKGROUND: The objective of this study was to assess three methods of computer-aided thermal pattern analysis for a) examiner reliability, b) inter-method differences, and c) determine which method yields the highest percent-similarity between paired test-retest scans. METHODS: Three examiners compared two sets of thermal scans from the same 30 subjects using three different methods of scan alignment. The results were evaluated by the Intraclass Correlation Coefficient and the Wilcoxon signed-rank test, at the 5% level of significance. RESULTS: Intra and inter-examiner ICC scores for all methods were acceptable (> 0.75). There were no statistically significant differences (at the Bonferroni-corrected level of significance of 0.0004%) in percent similarity of the scans between the three methods CONCLUSIONS: The results contribute evidence to the reliability of TPC program software. Manually aligning the readings plays an important role in obtaining precise TPC percent-similarities.

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Antithrombotic treatment of below knee deep venous thrombosis.

A short cut review was carried out to establish whether oral anticoagulation is necessary to prevent pulmonary embolisation in patients with below knee deep venous thrombosis. A total of 425 papers were found using the reported search, of which 11 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.