Developing managed aquifer recharge (MAR) to augment irrigation water resources in the sand and gravel (Crag) aquifer of coastal Suffolk, UK.

Managed aquifer recharge (MAR) offers a potential innovative solution for addressing groundwater resource issues, enabling excess surface water to be stored underground for later abstraction. Given its favourable hydrogeological properties, the Pliocene sand and gravel (Crag) aquifer in Suffolk, UK, was selected for a demonstration MAR scheme, with the goal of supplying additional summer irrigation water. The recharge source was a 4.6 km drainage channel that discharges to the River Deben estuary. Trialling the scheme in June 2022, 12,262 m3 of source water were recharged to the aquifer over 12 days via a lagoon and an array of 565 m of buried slotted pipes. Groundwater levels were raised by 0.3 m at the centre of the recharge mound with an approximate radius of 250 m, with no detrimental impact on local water features observed. The source water quality remained stable during the trial with a mean chloride concentration (133 mg L-1) below the regulatory requirement (165 mg L-1). The fraction of recharge water mixing with the groundwater ranged from 69% close to the centre and 5% at the boundary of the recharge mound, leading to a reduction in nitrate-N concentration of 23.6 mg L-1 at the centre of the mound. During July-September 2022, 12,301 m3 of recharge water were abstracted from two, 18 m boreholes to supplement surface irrigation reservoirs during drought conditions. However, the hydraulic conductivity of the Crag aquifer (∼10 m day-1) restricted the yield and thereby reduced the economic viability of the scheme. Construction costs for the MAR system were comparatively low but the high costs of data collection and securing regulatory permits brought the overall capital costs to within 18% of an equivalent surface storage reservoir, demonstrating that market-based mechanisms and more streamlined regulatory processes are required to incentivise similar MAR schemes.

Synthesis and Reactivity of an Aluminium N-heterocyclic Aminal.

Tethered N-heterocyclic carbenes (NHCs) are an emerging class of ligand, as they feature all the desirable aspects of NHCs (ease of synthesis, high tunabilty) but also enable metal-ligand cooperativity when combined with Lewis acidic metal centres due to the donor-acceptor nature of the complexes formed. Herein we report a simple ethoxy-tethered NHC for the stabilisation of Al(III) hydrides, resulting in the unexpected formation of a bicyclic N-heterocyclic aminal (1). Compound 1 behaves as a metal hydride, capable of reducing benzophenone and carbodiimide to yield compounds 2 and 3, respectively. Furthermore, we show that 1 behaves as an efficient catalyst in the dehydrocoupling of amine-boranes due to the hemi-labile nature of the supporting ligand.

An Acute Mortality Event Associated with Novel Macrorhabdus ornithogaster Infection and Underlying Factors in a Newly-Established Captive Group of American White Ibis (Eudocimus albus) Nestlings.

Twenty-four American white ibis (Eudocimus albus) nestlings were collected in Florida (USA) on 17 April 2017 to establish a captive flock. On 7 May 2017, three birds died suddenly, following severe lethargy, hemorrhaging from the mouth and nares, anorexia, and production of bright-green colored feces. An additional ibis with delayed growth and pathological fractures was euthanized 18 May 2017. Severe ventriculitis associated with Macrorhabdus ornithogaster was noted in all four birds, bacterial sepsis was confirmed in one bird by culture and histologic examination, and bacterial endotoxemia was suspected in two birds based on gross and histologic examination, but no bacteria were isolated from these birds. Birds also had vitamin E liver levels consistent with coagulopathy previously described in pelicans. We sampled feces from 91 adult, free-living, healthy ibis in Florida in July 2017 and found 71% were shedding organisms with morphologic characteristics consistent with Macrorhabdus sp. Molecular characterization of the ibis-origin M. ornithogaster showed it was phylogenetically related to numerous M. ornithogaster sequences. It is unknown if M. ornithogaster infection resulted in clinical disease as a result of dietary or stress-related dysbiosis, or other factors. Macrorhabdus-associated disease has not previously been confirmed in wading birds. We discuss potential associations of gastric M. ornithogaster infection with morbidity and mortality in these cases and highlight the need for additional studies on this pathogen in free-living birds.

Humanizing Dementia: Effects of Counter-Stereotypical Messages on Patronizing Speech toward People with a Stigmatized Health Condition.

Patronizing speech and dehumanization both have negative impacts on the health and wellbeing of the recipients of these behaviors. This experiment applied Fiske's stereotype content model, Haslam's dual model of dehumanization, and Hummert's model of patronizing speech to assess the effects of warmth- and competence-enhancing messages about a person with dementia on perceptions of humanness and patronizing speech toward people with dementia. Results supported our predictions that warmth- and competence-enhancing messages would translate into general tendencies to humanize people with dementia as a group. Predicted effects on patronizing communication did not materialize, but there were some unanticipated ways in which warmth- and competence-enhancing messages did influence intentions to use patronizing speech.

Associations between diabetes status and grip strength trajectory sub-groups in adulthood: findings from over 16 years of follow-up in the MRC National Survey of Health and Development.

BACKGROUND: Cross-sectional studies suggest a relationship between diabetes status and weaker grip strength (GS) in adulthood and limited evidence from longitudinal studies has focussed on the association with average change in GS. We aimed to investigate whether diabetes status was related to membership of distinct GS trajectories in mid-to-late adulthood in 2,263 participants in the Medical Research Council National Survey of Health and Development. METHODS: Grip strength (kg) was measured at 53, 60-64 and 69 years. Pre-/diabetes was defined at 53 years based on HbA1c > 5.6% and/or doctor-diagnosis of diabetes. Sex-specific latent class trajectory models were developed and multinomial logistic regression was used to investigate the association between pre-/diabetes status and membership into GS trajectory classes. RESULTS: For both males and females, a 3-class solution ('High', 'Intermediate', 'Low') provided the best representation of the GS data and the most plausible solution. There was no evidence that pre-/diabetes status was associated with class membership in either sex: e.g., adjusted odds ratios of being in the 'Low' class (vs. 'High') for males with pre-/diabetes (vs. no-diabetes) was 1.07 (95% CI:0.45,2.55). CONCLUSION: Using a flexible data-driven approach to identify GS trajectories between 53 and 69 years, we observed three distinct GS trajectories, all declining, in both sexes. There was no association between pre-/diabetes status at 53 years and membership into these GS trajectories. Understanding the diabetes status-GS trajectories association is vital to ascertain the consequences that projected increases in pre-/diabetes prevalence's are likely to have.

Neighborhood disadvantage has an indirect effect on problem drinking through increased psychological distress.

OBJECTIVE: Neighborhood disadvantage has been documented as a risk factor for problem drinking. The specific aim of this investigation is to test a model of neighborhood disadvantage, psychological distress, and problem drinking in a demographically and socioeconomically diverse sample. METHOD: A sample of 618 adults (21-65-year-olds; Mage = 30.80, SD = 9.81; 58% female) who reported drinking alcohol at least once in the past 6 months, completed an online questionnaire with questions about psychological distress (depression, stress, social isolation) and problem drinking (drinking problems, drinking to cope, binge drinking) twice over the course of 6 months. Their data were merged with the American Community Survey data from the U.S. Census Bureau to form an index of neighborhood disadvantage (median income, % residents with less than high school education, % living in poverty, % receiving income assistance). RESULTS: A structural equation modeling analysis showed that neighborhood disadvantage was associated with increases in psychological distress during the T1-T2 interval. Psychological distress was also positively associated with problem drinking at both T1 and T2. There was an indirect effect of neighborhood disadvantage on problem drinking through increased psychological distress. However, there was no direct effect of neighborhood disadvantage on problem drinking in this sample. CONCLUSIONS: Increased psychological distress may be a key mechanism that links living in disadvantaged neighborhoods and problem drinking. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

When goodbyes matter: The conditional relationship between final conversations and symptoms of depression.

An online survey of 528 people who lost someone close to them in the last 5 years was used to test associations between having final conversations (FCs) and depression. The direct effect was nonsignificant, but there were two significant moderation effects. Time since bereavement moderated the FC-depression relationship; there was a negative relationship between FCs and depression shortly following bereavement, but no relationship after more time had passed. The age of the deceased also moderated this relationship; there was a negative relationship between FCs and depression when the deceased was older, but no relationship when the deceased was younger.

The Outcomes of Pelvic Fracture Urethral Injuries Stratified by Urethral Injury Severity: A Prospective Multi-institutional Genitourinary Trauma Study (MiGUTS).

OBJECTIVE: To determine patient outcomes across a range of pelvic fracture urethral injury (PFUI) severity. PFUI is a devastating consequence of a pelvic fracture. No study has stratified PFUI outcomes based on severity of the urethral distraction injury. METHODS: Adult male patients with blunt-trauma-related PFUI were followed prospectively for a minimum of six months at 27 US medical centers from 2015-2020. Patients underwent retrograde cystourethroscopy and retrograde urethrography to determine injury severity and were categorized into three groups: (1) major urethral distraction, (2) minor urethral distraction, and (3) partial urethral injury. Major distraction vs minor distraction was determined by the ability to pass a cystoscope retrograde into the bladder. Simple statistics summarized differences between groups. Multi-variable analyses determined odds ratios for obstruction and urethroplasty controlling for urethral injury type, age, and Injury Severity Score. RESULTS: There were 99 patients included, 72(72%) patients had major, 13(13%) had minor, and 14(14%) had partial urethral injuries. The rate of urethral obstruction differed in patients with major (95.8%), minor (84.6%), and partial injuries (50%) (P < 0.001). Urethroplasty was performed in 90% of major, 66.7% of minor, and 35.7% of partial injuries (P < 0.001). CONCLUSION: In PFUI, a spectrum of severity exists that influences outcomes. While major and minor distraction injuries are associated with a higher risk of developing urethral obstruction and need for urethroplasty, up to 50% of partial PFUI will result in obstruction, and as such need to be closely followed.

Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies.

Across multiple disciplines undertaking airway management globally, preventable episodes of unrecognised oesophageal intubation result in profound hypoxaemia, brain injury and death. These events occur in the hands of both inexperienced and experienced practitioners. Current evidence shows that unrecognised oesophageal intubation occurs sufficiently frequently to be a major concern and to merit a co-ordinated approach to address it. Harm from unrecognised oesophageal intubation is avoidable through reducing the rate of oesophageal intubation, combined with prompt detection and immediate action when it occurs. The detection of 'sustained exhaled carbon dioxide' using waveform capnography is the mainstay for excluding oesophageal placement of an intended tracheal tube. Tube removal should be the default response when sustained exhaled carbon dioxide cannot be detected. If default tube removal is considered dangerous, urgent exclusion of oesophageal intubation using valid alternative techniques is indicated, in parallel with evaluation of other causes of inability to detect carbon dioxide. The tube should be removed if timely restoration of sustained exhaled carbon dioxide cannot be achieved. In addition to technical interventions, strategies are required to address cognitive biases and the deterioration of individual and team performance in stressful situations, to which all practitioners are vulnerable. These guidelines provide recommendations for preventing unrecognised oesophageal intubation that are relevant to all airway practitioners independent of geography, clinical location, discipline or patient type.

First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector.

We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9 MeV≲m_{χ}≲50 MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.

Surgical Complications in the Management of Benign Prostatic Hyperplasia Treatment.

PURPOSE OF REVIEW: There are a variety of treatment options for men with symptomatic benign prostatic hyperplasia (BPH); transurethral resection of the prostate (TURP) remains the gold standard surgical treatment. The field continues to evolve with the introduction of new energy and laser technologies, increasing adoption of enucleation techniques, in addition to the advent of minimally invasive surgical technologies (MIST) that enable office-based treatments. The choice in surgical management has become very nuanced depending on a variety of patient and anatomic factors. There continues to be high success rates for surgical treatment of BPH; however, the risk profiles vary across the various surgical treatments. We sought to evaluate contemporary series and summarize the experience of complications associated with BPH treatment and management of these complications. RECENT FINDINGS: A comprehensive literature review was performed, and identified 79 manuscripts, published between 2005 and 2021 characterizing the diagnosis and management of complications following BPH surgery. Commonly cited issues included bleeding, ureteral orifice injury, bladder neck injury, rectal injury, TURP syndrome, bladder neck contractures, urethral stricture disease, refractory OAB symptoms, and complications unique to new modalities of treatment. The practicing urologist has multiple surgical options to choose from in treating patients with symptomatic BPH. The surgical management of BPH is generally well tolerated with high objective success rates that allow for significant improvement in urinary quality of life. It is critical to understand the potential complications associated with these various treatment options, which will enable trainees and practicing urologists to better counsel patients and manage these potential complications.