Calibration and sensitivity analysis of a novel water flow and pollution model for future city planning: Future Urban Stormwater Simulation (FUSS).

Planning for future urban development and water infrastructure is uncertain due to changing human activities and climate. To quantify these changes, we need adaptable and fast models that can reliably explore scenarios without requiring extensive data and inputs. While such models have been recently considered for urban development, they are lacking for stormwater pollution assessment. This work proposes a novel Future Urban Stormwater Simulation (FUSS) model, utilizing a previously developed urban planning algorithm (UrbanBEATS) to dynamically assess pollution changes in urban catchments. By using minimal input data and adding stochastic point-source pollution to the build-up/wash-off approach, this study highlights calibration and sensitivity analysis of flow and pollution modules, across the range of common stormwater pollutants. The results highlight excellent fit to measured values in a continuous rainfall simulation for the flow model, with one significant calibration parameter. The pollution model was more variable, with TSS, TP and Pb showing high model efficiency, while TN was predicted well only across event-based assessment. The work further explores the framework for the model application in future pollution assessment, and points to the future work aiming to developing land-use dependent model parameter sets, to achieve flexibility for model application across varied urban catchments.

Illicit discharge detection in stormwater drains using an Arduino-based low-cost sensor network.

Illicit discharges in urban stormwater drains are a major environmental concern that deteriorate downstream waterway health. Conventional detection methods such as stormwater drain visual inspection and dye testing have fundamental drawbacks and limitations which can prevent easy location and elimination of illegal discharges in a catchment. We deployed 22 novel low-cost level, temperature and conductivity sensors across an urban catchment in Melbourne for a year to monitor the distributed drainage network, thereby detecting likely illicit discharges ranging from a transitory flow with less than 10 minutes to persistent flows lasting longer than 20 hours. We discuss rapid deployment methods, real-time data collection and online processing. The ensemble analysis of all dry weather flow data across all sites indicates that: (i) large uncertainties are associated with discharge frequency, duration, and variation in water quality within industrial and residential land uses; (ii) most dry weather discharges are intermittent and transient flows which are difficult to detect and not simply due to cross-connections with the sewerage network; (iii) detectable diurnal discharge patterns can support mitigation efforts, including policies and regulatory measures (e.g., enforcement or education) to protect receiving waterways; and, (iv) that it is possible to cost effectively isolate sources of dry weather pollution using a distributed sensor network.

Linking hunting weaponry to attack strategies in sailfish and striped marlin.

Linking morphological differences in foraging adaptations to prey choice and feeding strategies has provided major evolutionary insights across taxa. Here, we combine behavioural and morphological approaches to explore and compare the role of the rostrum (bill) and micro-teeth in the feeding behaviour of sailfish (Istiophorus platypterus) and striped marlin (Kajikia audax) when attacking schooling sardine prey. Behavioural results from high-speed videos showed that sailfish and striped marlin both regularly made rostrum contact with prey but displayed distinct strategies. Marlin used high-speed dashes, breaking schools apart, often contacting prey incidentally or tapping at isolated prey with their rostra; while sailfish used their rostra more frequently and tended to use a slower, less disruptive approach with more horizontal rostral slashes on cohesive prey schools. Capture success per attack was similar between species, but striped marlin had higher capture rates per minute. The rostra of both species are covered with micro-teeth, and micro-CT imaging showed that species did not differ in average micro-tooth length, but sailfish had a higher density of micro-teeth on the dorsal and ventral sides of their rostra and a higher amount of micro-teeth regrowth, suggesting a greater amount of rostrum use is associated with more investment in micro-teeth. Our analysis shows that the rostra of billfish are used in distinct ways and we discuss our results in the broader context of relationships between morphological and behavioural feeding adaptations across species.

Oil gland and oil pores in billfishes: in search of a function.

Billfishes are well known for their distinctive elongated rostra, i.e. bills. The functional significance of billfish rostra has been frequently discussed and the recent discovery of an oil gland (glandula oleofera) at the base of the rostrum in swordfish, Xiphias gladius, has added an interesting facet to this discussion regarding the potential co-evolution of gland and rostra. Here, we investigated the oil gland and oil pores (through which the oil is brought to the skin surface) of four billfish species - swordfish, Atlantic blue marlin (Makaira nigricans), Indo-Pacific sailfish (Istiophorus platypterus) and striped marlin (Kajikia audax) - and provide detailed evidence for the presence of an oil gland in the last three. All four species had a high density of oil pores on the forehead which is consistent with the hypothesis of hydrodynamic benefits of the oil. The extension of the pores onto the front half of the rostrum in sailfish and striped marlin, but not in swordfish or blue marlin, suggests that the oil may have additional functions. One such function could be linked to the antibacterial and anti-inflammatory properties of the oil. However, the available evidence on predatory rostrum use (and hence the likelihood of tissue damage) is only partly consistent with the extension of pores on rostra across species. We conclude that the oil gland probably serves multiple, non-mutually exclusive functions. More detailed information on rostrum use in blue marlin and swordfish is needed to better link behavioural and morphological data with the aim of accomplishing a full comparative analysis.

Methadone Matters: What the United States Can Learn from the Global Effort to Treat Opioid Addiction.

In the midst of an opioid epidemic, mortality related to opioid overdose continues to rise in the US. Medications to treat opioid use disorder, including methadone and buprenorphine, are highly effective in reducing the morbidity and mortality related to illicit opioid use. Despite the efficacy of these life-saving medications, the majority of people with an opioid use disorder lack access to treatment. This paper briefly reviews the evidence to support the use of medications to treat opioid use disorder with a specific focus on methadone. We discuss the current state of methadone therapy for the treatment of opioid use disorder in the US and present logistical barriers that limit its use. Next, we examine three international pharmacy-based models in which methadone dispensing to treat opioid use disorder occurs outside of an opioid treatment facility. We discuss current challenges and opportunities to incorporate similar methods of methadone dispensing for the treatment of opioid use disorder in the US. Finally, we present our vision to integrate pharmacy-based methadone dispensing into routine opioid use disorder treatment through collaboration between clinicians and pharmacies to improve local access to this life-saving medication.

A highly transmissible tuberculosis outbreak: the importance of bars.

The transmission of tuberculosis (TB) in bars is difficult to study. The objective was to describe a large TB outbreak in a company's bar and other leisure settings. A descriptive study of a TB outbreak was carried out. Contacts were studied in the index case's workplace bar (five circles of contacts) and other recreational areas (social network of three bars in the index case's neighbourhood). Chest X-rays were recommended to contacts with positive tuberculin skin tests (TST) (⩾5 mm). The risk of latent tuberculosis infection (LTBI) was determined using an adjusted odds ratio. The dose-response relationship was determined using the chi-square test for linear trend. We studied 316 contacts at the index case's workplace and detected five new cases of TB. The prevalence of LTBI was 57·9% (183/316) and was higher in the first circle, 96·0% (24/25), and lower in the fifth, 46·5% (20/43) (P < 0·0001). Among 58 contacts in the three neighbourhood bars, two TB cases were detected and the LTBI prevalence was 51·7% (30/58). Two children of one secondary TB company patient became ill. Bars may be transmission locations for TB and, as they are popular venues for social events, should be considered as potential areas of exposure.

Norovirus gastroenteritis outbreak transmitted by food and vomit in a high school.

We investigated an outbreak of norovirus that affected students and teachers of a high school in Lleida, Spain through various transmission mechanisms. A case-control epidemiological study of the risk of disease and the relative importance of each mode of transmission was carried out. Cases and controls were selected from a systematic sample of students and teachers present at the school on 28 January. Faecal samples were taken from three food handlers and 16 cases. The influence of each factor was studied using the adjusted odds ratio (aOR) and the estimated population attributable risk (ePAR) with 95% confidence intervals (CI). We interviewed 210 people (42 cases, 168 controls). The proportion of symptoms in these individuals was nausea 78·6%, vomiting 59·5%, diarrhoea 45·2%, and fever 19·0%. The epidemic curve showed transmission for at least 4 days. The risk of disease was associated with exposure to food (aOR 5·8) in 66·1% of cases and vomit (aOR 4·7) in 24·8% of cases. Faecal samples from 11 patients and two food handlers were positive for norovirus GII.12 g. Vomit may co-exist with other modes of transmission in norovirus outbreaks and could explain a large number of cases.

Failed needle decompression of bilateral spontaneous tension pneumothorax.

This case report presents a young male admitted with primary bilateral spontaneous tension pneumothorax and severe respiratory distress. This is an extremely rare condition. The patient was on the verge of hypoxic cardiac arrest and the attempted needle thoracocentesis was unsuccessful. Needle thoracocentesis in the midclavicular line of the second intercostal space is widely used and recommended as first-line treatment of tension pneumothorax. Reviewing the literature, the procedure is not based on solid evidence. It has high failure rates and potentially serious complications. Alternatives to this approach are perhaps more appropriate. Correctly done, needle thoracocentesis has its place in the presence of a diagnosed or suspected tension pneumothorax when no other options are available. If needle thoracocentesis is chosen, then insertion in the mid-anterior axillary line of the 3rd-5th intercostal space is an appropriate alternative site. Otherwise, lateral thoracostomy, with or without chest tube insertion, is a safe procedure with a high success rate. It should be considered as the first-line treatment of tension pneumothorax, particularly in the unstable patient.

Accidental mechanical asphyxia of children in Germany between 2000 and 2008.

Accidents constitute one of the greatest risks to children, yet there are few medical reports that discuss the subject of accidental asphyxia. However, a systematic analysis of all documented cases in Germany over the years 2000-2008 has now been conducted, aiming at identifying patterns of accidental asphyxia, deducing findings, defining avoidance measures and recommending ways of increasing product safety and taking possible precautions. The analysis is based on a detailed retrospective analysis of all 91 relevant autopsy reports from 24 different German forensic institutes. A variety of demographic and morphological data was systematically collected and analysed. In 84 of the 91 cases, the sex of the victim was reported, resulting in a total of 57 boys (68 %) and 27 girls (32 %). The age spread ranged between 1 day and 14 years, with an average of 5.9 years. Most accidents occurred in the first year of life (20 %) or between the ages of 1 and 2 years (13 %). In 46 % of cases, the cause of death was strangulation, with the majority occurring in the home environment. In 31 % of all cases, the cause of death was positional asphyxia, the majority resulting from chest compression. In 23 % of cases, the cause of death was aspiration, mainly of foreign bodies. Today, accidental asphyxiation is a rare cause of death in children in Germany. Nevertheless, the majority of cases could have been avoided. Future incidence can be reduced by implementing two major precautions: increasing product safety and educating parents of potentially fatal risks. Specific recommendations relate to children's beds, toys and food.

Petechial bleedings in sudden infant death.

The autopsy reports of 484 cases of deceased infants (201 females, 283 males) were analysed retrospectively for the existence of external and internal petechial bleedings (PET). The cases were divided into five groups on the basis of the cause of death (sudden infant death syndrome, sepsis, airway infections, asphyxia and trauma). Internal PET (pleural, pericardial, epicardial, thymic and peritoneal) were observed in each group with a lower prevalence in cases of trauma. The highest prevalence of external (cutaneous and conjunctival) PET was detected in cases of asphyxia (38% and 31%, respectively). However, even if with low prevalence, such bleedings were detected in every group. Factors like sex, age, cardiopulmonary resuscitation and its duration did not influence the presence of PET. The detection of external PET at autopsy is a suspicious finding that suggests asphyxia. Because of the possible natural origin of these bleedings, the medicolegal investigation has to be as complete as possible and has to include histology as mandatory.

The development of a novel approach for assessment of the first flush in urban stormwater discharges.

The management of stormwater pollution has placed particular emphasis on the first flush phenomenon. However, definition and current methods of analyses of the phenomena contain serious limitations, the most important being their inability to capture a possible impact of the event size (total event volume) on the first flush. This paper presents the development of a novel approach in defining and assessing the first flush that should overcome these problems. The phenomenon is present in a catchment if the decrease in pollution concentration with the absolute cumulative volume of runoff from the catchment is statistically significant. Using data from seven diverse catchments around Melbourne, Australia, changes in pollutant concentrations for Total Suspended Solids (TSS) and Total Nitrogen (TN) were calculated over the absolute cumulative runoff and aggregated from a collection of different storm events. Due to the discrete nature of the water quality data, each concentration was calculated as a flow-weighted average at 2 mm runoff volume increments. The aggregated concentrations recorded in each increment (termed as a 'slice' of runoff) were statistically compared to each other across the absolute cumulative runoff volume. A first flush is then defined as the volume at which concentrations reach the 'background concentration' (i.e. the statistically significant minimum). Initial results clearly highlight first flush and background concentrations in all but one catchment supporting the validity of this new approach. Future work will need to address factors, which will help assess the first flush's magnitude and volume. Sensitivity testing and correlation with catchment characteristics should also be undertaken.

Gods associated with male fertility and virility.

BACKGROUND: Human fertility has always been a topic of curiosity and devotion. Many cultures consider fertility to be a necessity for the survival and perpetuation of mankind and since early times, myths were created to explain this fabulous process. Fertility gods were ubiquitous in numerous ancient human cultures and were used both to understand fertility and to cope with infertility by means of rituals and offerings. OBJECTIVES: This manuscript aims to catalog and describe the deities associated with male fertility and virility. MATERIAL AND METHODS: We conducted a comprehensive search for the terms "male fertility god" and "male virility god" on the internet using web-based search engines. Based on the information retrieved, we selected those deities directed related to male fertility and/or virility and further deepened the search using Pubmed and Medline databases for peer-reviewed articles as well as books and articles about ancient mythology. RESULTS: We identified several gods linked to male fertility and virility in various cultures from Egypt, Greece, Rome, India, Southwestern United States, France, Colombia and Buthan.. DISCUSSION: Most of these deities were depicted with an erect phallus and with other fertility symbols like snakes. Some deities were also associated with plants and/or animal fertility and their festivals were often held during the harvest period. CONCLUSION: Gods of male fertility and virility played important roles in many ancient cultures. Offerings and rituals to these gods were the only available options to deal with problems of reproduction and demonstrate the lengths to which ancient people would go seeking cures for infertility.

[A primary adenocarcinoma of the seminal vesicles. Case report of a rare malignancy]. / Primäres Adenokarzinom der Samenblasen. Fallbericht einer seltenen onkologischen Entität.

Primary malignancies of the seminal vesicles are extremely rare. They must be strictly differentiated from surrounding malignancies that may infiltrate the seminal vesicles from outside (e.g. prostate, rectum, and bladder carcinoma). MEDLINE and CANCERLIT review showed about 50 documented cases of primary seminal vesicle carcinoma so far worldwide in men between 19 and 90 years of age. Early diagnosis may be difficult due to lack of specific symptoms. Especially with a history of voiding dysfunction, haemospermia and/or haematuria, investigators should consider it. Primary diagnostic steps include digital rectal examination, transrectal ultrasound, and transrectal biopsy of the tumour. Additionally, CT and MRT scans show tumour masses corresponding to the seminal vesicles. Adenocarcinoma of seminal vesicles shows no expression of prostate-specific antigen or prostate-specific acid phosphatase, but there may be expression of carcinoembryonic antigen and cancer antigen 125. Radical surgery including radical prostatectomy and/or cystoprostatectomy including pelvic lymph node dissection offers a curative treatment pathway. Adjuvant or inductive medical treatment is of unproven worth, but a combination of hormonal deprivation and radiotherapy seems to be more effective than any chemotherapy.

Integrated modelling of stormwater treatment systems uptake.

Nature-based solutions provide a variety of benefits in growing cities, ranging from stormwater treatment to amenity provision such as aesthetics. However, the decision-making process involved in the installation of such green infrastructure is not straightforward, as much uncertainty around the location, size, costs and benefits impedes systematic decision-making. We developed a model to simulate decision rules used by local municipalities to install nature-based stormwater treatment systems, namely constructed wetlands, ponds/basins and raingardens. The model was used to test twenty-four scenarios of policy-making, by combining four asset selection, two location selection and three budget constraint decision rules. Based on the case study of a local municipality in Metropolitan Melbourne, Australia, the modelled uptake of stormwater treatment systems was compared with attributes of real-world systems for the simulation period. Results show that the actual budgeted funding is not reliable to predict systems' uptake and that policy-makers are more likely to plan expenditures based on installation costs. The model was able to replicate the cumulative treatment capacity and the location of systems. As such, it offers a novel approach to investigate the impact of using different decision rules to provide environmental services considering biophysical and economic factors.

Evaluation of different protocols for gene transfer into non-obese diabetes/severe combined immunodeficiency disease mouse repopulating cells.

PURPOSE: Although gene transfer with retroviral vectors has shown distinct clinical success in defined settings, efficient genetic manipulation of hematopoietic progenitor cells remains a challenge. To address this issue we have evaluated different transduction protocols and retroviral constructs in the non-obese diabetes (NOD)/severe combined immunodeficiency disease (SCID) xenograft model. METHODS: An extended transduction protocol requiring 144 h of in vitro manipulation was compared to a more conventional protocol requiring 96 h only. RESULT: While pretransplantation analysis of cells transduced with a retroviral vector, expressing the enhanced green fluorescent protein (EGFP) marker gene, demonstrated significantly higher overall transduction rates for the extended protocol (33.6 +/- 2.3 vs. 22.1 +/- 3.8%), EGFP expression in CD34+ cells before transplantation (4.0 +/- 0.9 vs. 11.6 +/- 2.5%), engraftment of human cells in NOD/SCID bone marrow 4 weeks after transplantation (4.5 +/- 1.7 vs. 36.5 +/- 9.4%) and EGFP expression in these cells (0 +/- 0 vs. 11.3 +/- 2.8%) were significantly impaired. When the 96 h protocol was used in combination with the spleen focus forming virus (SFFV)/murine embryonic stem cell (MESV) hybrid vector SFbeta11-EGFP, high transduction rates for CD45+ (41.0 +/- 5.3%) and CD34+ (38.5 +/- 3.7%) cells prior to transplantation, as well as efficient human cell engraftment in NOD/SCID mice 4 weeks after transplantation (32.4 +/- 3.5%), was detected. Transgene expression was observed in B-lymphoid (15.9 +/- 2.0%), myeloid (36.5 +/- 3.5%) and CD34+ cells (10.1 +/- 1.5%). CONCLUSION: Our data show that CD34+ cells maintained in cytokines for multiple days may differentiate and loose their capacity to contribute to the haematological reconstitution of NOD/SCID mice. In addition, the SFFV/MESV hybrid vector SFbeta11-EGFP allows efficient transduction of and gene expression in haematopoietic progenitor cells.

[Retroperitoneal extravasation as the primary symptom of a pancreatic carcinoma]. / Retroperitoneale Extravasation als primäres Symptom eines Pankreaskarzinoms.

Adenocarcinoma of the pancreas has a low 5-year survival rate of approximately 5%. Early diagnostics of pancreatic carcinoma during early tumor stages is made difficult by the lack of symptoms. In particular, individuals suffering from carcinomas located within the pancreatic tail are at high risk of a missed diagnosis. The early symptoms are usually nonspecific (e.g., nonspecific upper abdominal complaints, decrease in weight, loss of appetite, and impaired performance) and are characteristic only in carcinomas of the pancreatic head with painless icterus. If the patient complains of low back pain, a severe infiltration with no chance of a complete surgical resection is found in most cases. An adenocarcinoma of the pancreatic tail was diagnosed in this case report based on a large retroperitoneal extravasation missing further symptoms. The extravasation found represented a primary infiltration of the left ureter which was not diagnosed in primary computed tomography.

[Secondary right-sided diaphragmatic hernia following neonatal group B Streptococcal septicaemia in a preterm infant]. / Hernie diaphragmatique droite à révélation secondaire et septicémie néonatale à Streptocoque B chez un prématuré.

We report on a case of a secondary right-sided diaphragmatic hernia following group B streptococcal (GBS) septicaemia in a very low birth weight infant born at 30 weeks. After initial improvement, the diagnosis of a secondary right-sided diaphragmatic hernia was suspected with the persistent radiological pulmonary right-sided image on the chest x-ray and the clinical degradation. The diagnosis was confirmed by ultrasonography on day 43. The postoperative course was simple. Persistent respiratory distress in a neonate, after a GBS septicaemia associated with a right pulmonary opacity on the chest x-ray, should prompt a careful evaluation. A secondary right-sided diaphragmatic hernia should be considered. Treatment is surgery, the prognosis is good in the absence of pulmonary hypoplasia.

Modelling transitions in urban water systems.

Long term planning of urban water infrastructure requires acknowledgement that transitions in the water system are driven by changes in the urban environment, as well as societal dynamics. Inherent to the complexity of these underlying processes is that the dynamics of a system's evolution cannot be explained by linear cause-effect relationships and cannot be predicted under narrow sets of assumptions. Planning therefore needs to consider the functional behaviour and performance of integrated flexible infrastructure systems under a wide range of future conditions. This paper presents the first step towards a new generation of integrated planning tools that take such an exploratory planning approach. The spatially explicit model, denoted DAnCE4Water, integrates urban development patterns, water infrastructure changes and the dynamics of socio-institutional changes. While the individual components of the DAnCE4Water model (i.e. modules for simulation of urban development, societal dynamics and evolution/performance of water infrastructure) have been developed elsewhere, this paper presents their integration into a single model. We explain the modelling framework of DAnCE4Water, its potential utility and its software implementation. The integrated model is validated for the case study of an urban catchment located in Melbourne, Australia.

Injury-mediated decrease in locomotor performance increases predation risk in schooling fish.

The costs and benefits of group living often depend on the spatial position of individuals within groups and the ability of individuals to occupy preferred positions. For example, models of predation events for moving prey groups predict higher mortality risk for individuals at the periphery and front of groups. We investigated these predictions in sardine (Sardinella aurita) schools under attack from group hunting sailfish (Istiophorus platypterus) in the open ocean. Sailfish approached sardine schools about equally often from the front and rear, but prior to attack there was a chasing period in which sardines attempted to swim away from the predator. Consequently, all sailfish attacks were directed at the rear and peripheral positions of the school, resulting in higher predation risk for individuals at these positions. During attacks, sailfish slash at sardines with their bill causing prey injury including scale removal and tissue damage. Sardines injured in previous attacks were more often found in the rear half of the school than in the front half. Moreover, injured fish had lower tail-beat frequencies and lagged behind uninjured fish. Injuries inflicted by sailfish bills may, therefore, hinder prey swimming speed and drive spatial sorting in prey schools through passive self-assortment. We found only partial support for the theoretical predictions from current predator-prey models, highlighting the importance of incorporating more realistic predator-prey dynamics into these models.This article is part of the themed issue 'Physiological determinants of social behaviour in animals'.

Age and adjuvant chemotherapy use after surgery for stage III colon cancer.

BACKGROUND: Randomized trials have established that 5-fluorouracil-based adjuvant chemotherapy following resection of stage III colon cancer reduces subsequent mortality by as much as 30%. However, the extent to which adjuvant therapy is used outside the clinical trial setting, particularly among the elderly, is unknown. METHODS: A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results/Medicare-linked database identified 6262 patients aged 65 years and older with resected stage III colon cancer. The primary outcome was chemotherapy use within 3 months of surgery, as ascertained from Medicare claims. We examined the extent to which age at diagnosis was associated with adjuvant chemotherapy usage, and we adjusted for potential confounding based on differences in other patient characteristics with the use of multiple logistic regression. All P values were two-sided. RESULTS: Age at diagnosis was the strongest determinant of chemotherapy: 78% of patients aged 65-69 years, 74% of those aged 70-74 years, 58% of those aged 75-79 years, 34% of those aged 80-84 years, and 11% of those aged 85-89 years received postoperative chemotherapy. The age trend remained pronounced after adjustment for potential confounding based on variation in patients' demographic and clinical characteristics and after exclusion of patients with any evident comorbidity (all P values <.001). CONCLUSIONS: Adjuvant chemotherapy for stage III colon cancer is used extensively, especially for patients under the age of 75 years. However, treatment rates decline dramatically with chronologic age. Because patients in their 70s and even 80s have a reasonable life expectancy, further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding this potentially curative treatment.