Implications of crop model ensemble size and composition for estimates of adaptation effects and agreement of recommendations.

Climate change is expected to severely affect cropping systems and food production in many parts of the world unless local adaptation can ameliorate these impacts. Ensembles of crop simulation models can be useful tools for assessing if proposed adaptation options are capable of achieving target yields, whilst also quantifying the share of uncertainty in the simulated crop impact resulting from the crop models themselves. Although some studies have analysed the influence of ensemble size on model outcomes, the effect of ensemble composition has not yet been properly appraised. Moreover, results and derived recommendations typically rely on averaged ensemble simulation results without accounting sufficiently for the spread of model outcomes. Therefore, we developed an Ensemble Outcome Agreement (EOA) index, which analyses the effect of changes in composition and size of a multi-model ensemble (MME) to evaluate the level of agreement between MME outcomes with respect to a given hypothesis (e.g. that adaptation measures result in positive crop responses). We analysed the recommendations of a previous study performed with an ensemble of 17 crop models and testing 54 adaptation options for rainfed winter wheat (Triticum aestivum L.) at Lleida (NE Spain) under perturbed conditions of temperature, precipitation and atmospheric CO2 concentration. Our results confirmed that most adaptations recommended in the previous study have a positive effect. However, we also showed that some options did not remain recommendable in specific conditions if different ensembles were considered. Using EOA, we were able to identify the adaptation options for which there is high confidence in their effectiveness at enhancing yields, even under severe climate perturbations. These include substituting spring wheat for winter wheat combined with earlier sowing dates and standard or longer duration cultivars, or introducing supplementary irrigation, the latter increasing EOA values in all cases. There is low confidence in recovering yields to baseline levels, although this target could be attained for some adaptation options under moderate climate perturbations. Recommendations derived from such robust results may provide crucial information for stakeholders seeking to implement adaptation measures.

A randomized, observer-blind comparison between the Neurotip mounted Neuropen and a disposable plastic neurological wheel for assessing the level of spinal blockade at cesarean section.

BACKGROUND: Various methods are used to assess the height of sensory block to touch under spinal anesthesia for cesarean section. We tested a novel, inexpensive, miniature, user-dependent plastic neurological wheel against the user-independent Neurotip mounted Neuropen. METHODS: Patients received either spinal or combined spinal-epidural anesthesia. For each patient assessment, the devices were randomly assigned to one of two independent investigators. The order of device application was randomly permuted. Neither researcher was involved with anesthetic care. At 5-min intervals for 20 min after spinal injection, and again at the end of the operation, the levels of block to loss-of-touch sensation were assessed. While one investigator evaluated the block, the other left the operating room and vice versa. Mixed-effects regression and Bland-Altman analysis were used to weigh agreement between devices. RESULTS: The mean difference in level-to-touch was 0.04 (95% CI -0.18, 0.27) dermatome levels. Measurement error standard deviation associated with the Neurotip mounted Neuropen and plastic neurological wheel was 1.36 (95% CI 1.26, 1.41) and 1.33 (95% CI 1.26, 1.46) dermatome levels, respectively. The difference in measurement error standard deviation was -0.03 (95% CI -0.16, 0.24). This evidence excludes the possibility, with 95% confidence, of clinically significant bias or measurement error differences between methods. Occasional wide variances in dermatome level were observed with both instruments at the initial assessment only. CONCLUSION: The compact plastic neurological wheel is as clinically reliable as the Neurotip mounted Neuropen.

Demonstration of polarization-independent resonant subwavelength grating filter arrays.

We demonstrate a two-dimensional (2D) polarization-independent resonant subwavelength grating (RSG) in a filter array. RSGs, also called guided mode resonant filters, are traditionally one-dimensional gratings; however, this leads to TE and TM resonances at different wavelengths and with different spectral shape. A 2D grating can remove the polarization dependence at normal incidence, while maintaining the desirable RSG properties of high reflectivity, narrow passband, and low sidebands without ripple. We designed and fabricated 2D gratings with near-identical responses for both polarizations at normal incidence in the telecommunication band. Ninety percent reflectivity is achieved at the resonant wavelengths.

Full-mouth tooth extraction lowers systemic inflammatory and thrombotic markers of cardiovascular risk.

Prior studies of a link between periodontal and cardiovascular disease have been limited by being predominantly observational. We used a treatment intervention model to study the relationship between periodontitis and systemic inflammatory and thrombotic cardiovascular indicators of risk. We studied 67 adults with advanced periodontitis requiring full-mouth tooth extraction. Blood samples were obtained: (1) at initial presentation, immediately prior to treatment of presenting symptoms; (2) one to two weeks later, before all teeth were removed; and (3) 12 weeks after full-mouth tooth extraction. After full-mouth tooth extraction, there was a significant decrease in C-reactive protein, plasminogen activator inhibitor-1 and fibrinogen, and white cell and platelet counts. This study shows that elimination of advanced periodontitis by full-mouth tooth extraction reduces systemic inflammatory and thrombotic markers of cardiovascular risk. Analysis of the data supports the hypothesis that treatment of periodontal disease may lower cardiovascular risk, and provides a rationale for further randomized studies.

HIV partner notification: a 2002 Victorian audit.

This audit was carried out in August 2003 and examined HIV notification data in Victoria. We aimed to determine the proportion of partners reported as being traced from newly diagnosed HIV individuals, the type of contact tracing used and identify the number of HIV cases newly diagnosed from contact tracing. We compared men who have sex with men (MSM) with all other newly diagnosed HIV individuals in Victoria (non-MSM). Of the 215 newly diagnosed HIV-positive individuals, 49% (n = 105) could potentially carry out contact tracing. There was a difference between MSM and non-MSM in the proportion of contactable partners (44% vs 63% respectively, P = 0.017). MSM less commonly used provider referral than non-MSM (12% vs 53% respectively, P < 0.001) but more commonly used patient referral (41% MSM vs 9% non-MSM, P = 0.001). Of the 13 individuals found to be HIV-positive through contact tracing, nine (69%) were non-MSM.

Isokinetic evaluation of anterior cruciate ligament reconstruction: hamstring versus patellar tendon.

The purpose of the study was to compare the hamstring and quadriceps isokinetic results 6 months postoperatively in patients having patellar tendon or hamstring anterior cruciate ligament (ACL) reconstruction. The study group was comprised of 106 randomly selected patients who had ACL reconstruction with either autogenous patellar tendon (PT), semitendinosus (ST), or semitendinosus and gracilis (ST/G). Hamstring and quadriceps isokinetic strength were assessed at 180 degrees/sec and 300 degrees/sec with the results of the operatively treated leg expressed as a percent compared with the nonoperative leg. The mean results for knee extension at 180 degrees/sec were 68.3%, 74.3%, and 78.1%; and at 300 degrees/sec were 70.7%, 76.7%, and 81.7% for PT, ST, and ST/G, respectively. The mean results for knee flexion at 180 degrees/sec were 86.1%, 80.6%, and 81.7%; and at 300 degrees/sec were 77.6%, 79.1%, and 75.6% for PT, ST, and ST/G, respectively. No statistically significant differences were found in regard to knee extension or flexion strength when evaluating the different tissue sources. The results show that selection of autogenous hamstring or PT used for ACL reconstruction should not be based solely on the assumption of the tissue source altering the recovery of quadriceps and/or hamstring strength. In addition, a majority of the patients had not achieved adequate strength to safely partake in unlimited activities at 6 months postoperatively.

Heavy fragment production cross sections from 1.05 GeV/nucleon 56Fe in C, Al, Cu, Pb, and CH2 targets.

We have obtained charge-changing cross sections and partial cross sections for fragmentation of 1.05 GeV/nucleon Fe projectiles incident on H, C, Al, Cu, and Pb nuclei. The energy region covered by this experiment is critical for an understanding of galactic cosmic ray propagation and space radiation biophysics. Surviving primary beam particles and fragments with charges from 12 to 25 produced within a forward cone of half-angle 61 mrad were detected using a silicon detector telescope to identify their charge and the cross sections were calculated after correction of the measured yields for finite target thickness effects. The cross sections are compared to model calculations and to previous measurements. Cross sections for the production of fragments with even-numbered nuclear charges are seen to be enhanced in almost all cases.

Functional postoperative treatment of Achilles tendon repair.

Twenty-one patients with surgically repaired Achilles tendon tears that were treated postoperatively with a functional orthosis rather than routine cast immobilization were evaluated. The orthosis allowed unrestricted plantar flexion and limited dorsiflexion to neutral. Toe-touch weightbearing crutch ambulation was allowed immediately and was gradually increased over the 6 to 8 weeks of treatment. Of the 21 patients, 14 were men and 7 were women; the average age at injury was 35.6 years (range, 19 to 65). The minimum followup was 2 years, with an average of 31 months. The repairs were acute in 18 of the patients and chronic in 3. Subjectively, 16 patients felt they returned to their preinjury level of activity and only 1 was not satisfied with his result. Objectively, there were no significant alterations in ankle range of motion when compared to the contralateral limb, with plantar flexion unchanged and dorsiflexion increased an average of only 2 degrees. The average plantar flexion and dorsiflexion strength, power, and endurance of the ankles as measured by isokinetic testing revealed no significant differences when comparing the operated leg to the nonoperated side: strength, 99% and 93%, respectively; power, 98% and 96%, respectively; and endurance, 93% and 91%, respectively. The angles at which the peak torques occurred were similarly not statistically different. Two patients had superficial wound infections, and 1 had scar adherence of the skin to the tendon. No one had rerupture of the tendon. In conclusion, while the many benefits of postoperative early motion are well proven, there has been hesitation to implement this after Achilles tendon surgery due to the concern of compromising the repair. As shown by this study, early controlled motion can safely and effectively be used following Achilles tendon repair in the motivated, reliable patient.

Climatic changes and future land use potential in Europe

Future climatic changes due to increasing atmospheric concentrations of radiatively active trace gases are likely to induce significant regional changes in land use potential in Europe. Three approaches to assessing the effects of climatic change on land use potential are identified : descriptive, correlational and physiological. These are illustrated (with particular reference to agriculture) using examples from assessments already completed both within Europe and elsewhere in the world. Potential technological and management responses to climatic change are also briefly outlined. (AU)

Osteoid osteoma of the hip: an alternate method of excision.

An osteoid osteoma of the femoral neck was successfully excised with a modified core decompression technique. The procedure is superior to the standard methods of excising lesions from the femoral head and neck region of the hip. A discussion of the exposure techniques, excision methods, and incidence of complications is presented. Osteoid osteoma of the hip is a common, benign bone lesion. While much has been written concerning its clinical, roentgenographic, and pathologic features, few articles directly address the technical difficulties in excising lesions from this area. The case presented describes a method of excising an osteoid osteoma from the femoral head and neck areas.

Agriculture: Climatic change and its implications.

In spite of many uncertainties surrounding the nature of future changes in climate, a number of indications are emerging of the likely implications for agriculture. At high mid-latitudes, agriculture is at present constrained by low temperatures; projections of preferential warming at these latitudes suggest that their productive potential may be enhanced, although the traditional balance between agriculture and forestry may be disrupted by a poleward retreat of the boreal zone, and by the problem of over-production of grain crops. Mid-latitude continental areas, containing the world's 'breadbasket' regions, may suffer declines in productivity due to increased moisture stress during the growing season. The most inherently vulnerable regions, generally located at lower middle and low latitudes, appear to be particularly at risk as any changes in climate may further stress the already limited production capacity.

The role of fine needle aspiration cytology in the diagnosis of lymphoma.

The accuracy of fine needle aspiration (FNA) cytology for the diagnosis of lymphoma and other hematolymphoid malignancies was investigated by a review of 158 FNA specimens from 143 patients. Patients included in the study had either a diagnosis of a hematolymphoid malignancy by FNA cytology or a biopsy diagnosis of lymphoma that was preceded by FNA cytology. Biopsy specimens were obtained from 85% of the patients. Of the 158 needle aspirates, 118 (75%) were diagnosed as lymphoma, 13 (8%) as suspicious of lymphoma, 8 (5%) as myelomas, 3 (2%) as leukemias, 12 (8%) as positive for malignancy and 4 (2%) as negative for malignancy. Two of the 118 needle aspirates diagnosed as lymphoma were false positives while 3 of 13 diagnosed as suspicious for lymphoma were found to be benign. Overall, there were four false negatives. Morphologic subclassification of the lymphomas, originally attempted for 60 needle aspirates, was identical to the histologic subclassification in 51 cases (85%). FNA cytology provided the initial diagnosis of a hematolymphoid malignancy in 51% of the cases and allowed the documentation of recurrent disease in 49%. The results demonstrate the usefulness of FNA cytology for the diagnosis and management of patients with lymphoma.

Intramammary lymph node gold deposits simulating microcalcifications on mammogram.

Gold deposition occurs in a variety of tissues following chrysotherapy. We describe a woman who had intramammary lymph node gold deposits simulating microcalcifications on mammogram.

Pneumocystis carinii infection of the small intestine in a patient with acquired immune deficiency syndrome.

The authors describe a patient with acquired immune deficiency syndrome (AIDS) who presented with an acute abdomen. A plaque-like tumor of the small intestine was resected and found to consist of masses of Pneumocystis carinii organisms. The organisms also exhibited a perivascular and intravascular distribution. Identical changes were found in regional lymph nodes. In addition to silver stains and electron microscopy, an immunohistochemical method for the demonstration of P. carinii was employed. The technique may have advantages over silver staining, as it identifies trophozoites in addition to cysts. A review of the literature concerning extrapulmonary pneumocystosis indicates that affected patients nearly always have concurrent pulmonary infection. The pattern of organ involvement and the finding of perivascular and intravascular organisms are consistent with lymphatic or hematogenous dissemination from the pulmonary focus. Pulmonary pneumocystosis was not documented in the patient described herein, although there were radiographic densities in one pulmonary lobe.