A large 'Active Magnetic Shield' for a high-precision experiment: nEDM collaboration

We present a novel Active Magnetic Shield (AMS), designed and implemented for the n2EDM experiment at the Paul Scherrer Institute. The experiment will perform a high-sensitivity search for the electric dipole moment of the neutron. Magnetic-field stability and control is of key importance for n2EDM. A large, cubic, 5 m side length, magnetically shielded room (MSR) provides a passive, quasi-static shielding-factor of about 10 5 for its inner sensitive volume. The AMS consists of a system of eight complex, feedback-controlled compensation coils constructed on an irregular grid spanned on a volume of less than 1000 m3 around the MSR. The AMS is designed to provide a stable and uniform magnetic-field environment around the MSR, while being reasonably compact. The system can compensate static and variable magnetic fields up to ± 50 μ T (homogeneous components) and ± 5 μ T/m (first-order gradients), suppressing them to a few μ T in the sub-Hertz frequency range. The presented design concept and implementation of the AMS fulfills the requirements of the n2EDM experiment and can be useful for other applications, where magnetically silent environments are important and spatial constraints inhibit simpler geometrical solutions.

The morphology of ligamentous sacroiliac lesions - challenge to the antero-posterior compression mechanism

AIM

This paper evaluates computer tomographic morphology of partial ligamentous lesions of the sacroiliac joint. We hypothesised that in antero-posterior compression (APC) injuries the anterior superior portion of the sacroiliac joint (SIJ) should open up the most as suggested by the vector forces outlined in the Young and Burgess classification.

METHODS

All patients who underwent operative fixation of a ligamentous APC pelvic injury between July 2009 and December 2015 in a single Level-1 trauma centre were included. Patients were case matched (1:1) to controls without pelvic injury. SIJ width was measured by two independent reviewers at the anterior superior and anterior inferior part of the SIJ. Wilcoxon ranged test was applied for analysis.

RESULTS

70 patients (35 cases, 35 controls) were evaluated. Median inferior and superior SI joint widths were 5.27 (IQR 3.68-7.80) and 4.05 (IQR 3.13-5.31) mm in cases versus 2.24 (IQR 1.83-2.50) and 2.44 (IQR 2.14-2.65) mm in controls, respectively. The difference between the inferior and superior SI width in cases was larger than in controls (p-value < 0.01, median of -0.22 mm in the control group versus 1.51 mm in the cases).

CONCLUSION

Our data suggests that the inferior part of the SIJ opens up after injury more, relative to its superior portion. The vector of the force involved in rotationally unstable pelvic injuries is unlikely to be antero-posterior if the force causes the SI joint to widen up inferiorly first. This should be considered in SIJ fixation and challenges the APC mechanism in pure ligamentous rotationally unstable pelvic ring injuries.

Extremely Weakly Interacting ΔS_{z}=0 and ΔS_{z}=1 Excitations and Evidence for Fractional Quantization in a Magnetization Plateau: CeSb

The plateau at 1/3 of the saturation magnetization M_{s} in the metamagnet CeSb is accompanied by a state of ferromagnetic layers of spins in an up-up-down sequence. We measured M and the specific heat C in the plateau, spin wave analyses of which reveal two distinct branches of excitations. Those with ΔS_{z}=1 as measured by M, coexist with a much larger population of ΔS_{z}=0 excitations measured by C but invisible to M. The large density of ΔS_{z}=0 excitations, their energy gap, and their seeming lack of interaction with ΔS_{z}=1 excitations suggest an analogy with astrophysical dark matter. Additionally, in the middle of the plateau three sharp jumps in M(H) are seen, the size of which, 0.15%M_{s}, is consistent with fractional quantization of magnetization per site in the down-spin layers.

Measurement of the Permanent Electric Dipole Moment of the Neutron

We present the result of an experiment to measure the electric dipole moment (EDM) of the neutron at the Paul Scherrer Institute using Ramsey's method of separated oscillating magnetic fields with ultracold neutrons. Our measurement stands in the long history of EDM experiments probing physics violating time-reversal invariance. The salient features of this experiment were the use of a ^{199}Hg comagnetometer and an array of optically pumped cesium vapor magnetometers to cancel and correct for magnetic-field changes. The statistical analysis was performed on blinded datasets by two separate groups, while the estimation of systematic effects profited from an unprecedented knowledge of the magnetic field. The measured value of the neutron EDM is d_{n}=(0.0±1.1_{stat}±0.2_{sys})×10^{-26}  e.cm.

nEDM experiment at PSI: Data-taking strategy and sensitivity of the dataset

We report on the strategy used to optimize the sensitivity of our search for a neutron electric dipole moment at the Paul Scherrer Institute. Measurements were made upon ultracold neutrons stored within a single chamber at the heart of our apparatus. A mercury cohabiting magnetometer together with an array of cesium magnetometers were used to monitor the magnetic field, which was controlled and shaped by a series of precision field coils. In addition to details of the setup itself, we describe the chosen path to realize an appropriate balance between achieving the highest statistical sensitivity alongside the necessary control on systematic effects. The resulting irreducible sensitivity is better than 1 × 10−26e cm. This contribution summarizes in a single coherent picture the results of the most recent publications of the collaboration.

Statistical sensitivity of the nEDM apparatus at PSI to n − n′ oscillations

The neutron and its hypothetical mirror counterpart, a sterile state degenerate in mass, could spontaneously mix in a process much faster than the neutron β-decay. Two groups have performed a series of experiments in search of neutron – mirror-neutron (n − n′) oscillations. They reported no evidence, thereby setting stringent limits on the oscillation time τnn′. Later, these data sets have been further analyzed by Berezhiani et al.(2009–2017), and signals, compatible with n − n′ oscillations in the presence of mirror magnetic fields, have been reported. The Neutron Electric Dipole Moment Collaboration based at the Paul Scherrer Institute performed a new series of experiments to further test these signals. In this paper, we describe and motivate our choice of run configurations with an optimal filling time of 29 s, storage times of 180 s and 380 s, and applied magnetic fields of 10 μT and 20 μT. The choice of these run configurations ensures a reliable overlap in settings with the previous efforts and also improves the sensitivity to test the signals. We also elaborate on the technique of normalizing the neutron counts, making such a counting experiment at the ultra-cold neutron source at the Paul Scherrer Institute possible. Furthermore, the magnetic field characterization to meet the requirements of this n − n′ oscillation search is demonstrated. Finally, we show that this effort has a statistical sensitivity to n − n′ oscillations comparable to the current leading constraints for B′ = 0.

The n2EDM experiment at the Paul Scherrer Institute

We present the new spectrometer for the neutron electric dipole moment (nEDM) search at the Paul Scherrer Institute (PSI), called n2EDM. The setup is at room temperature in vacuum using ultracold neutrons. n2EDM features a large UCN double storage chamber design with neutron transport adapted to the PSI UCN source. The design builds on experience gained from the previous apparatus operated at PSI until 2017. An order of magnitude increase in sensitivity is calculated for the new baseline setup based on scalable results from the previous apparatus, and the UCN source performance achieved in 2016.

Prenatal microarray comparative genomic hybridization: Experience from the two first years of activity at the Lyon university-hospital

OBJECTIVES

This study aims to describe how microarray comparative genomic hybridization (aCGH) has shifted to become a prenatal diagnosis tool at the Lyon university-hospital.

MATERIALS AND METHODS

This retrospective study included all patients who were referred in the 3 pluridisciplinary centers for prenatal diagnosis of the Lyon university-hospital and who received a prenatal aCGH between June 2013 and June 2015. aCGH was systematically performed in parallel with a karyotype, using the PréCytoNEM array design.

RESULTS

A total of 260 microarrays were performed for the following indications: 249 abnormal ultrasounds (95.8%), 7 characterizations of chromosomal rearrangements (2.7%), and 4 twins with no abnormal ultrasounds (1.5%). With a resolution of 1 mega base, we found 235 normal results (90.4%), 23 abnormal results (8.8%) and 2 non-returns (0.8%). For the chromosomal rearrangements visible on the karyotype, aCGH identified all of the 12 unbalanced rearrangements and did not identify the 2 balanced rearrangements. Among the fetuses with normal karyotypes, 11 showed abnormal microarray results, corresponding to unbalanced cryptic chromosomal rearrangements (4.2%).

CONCLUSION

Transferring aCGH to a prenatal diagnosis at the Lyon university-hospital has increased the detection rate of chromosomal abnormalities by 4.2% compared to the single karyotype.

Lectin staining of cultured CNS microglia

Carbohydrate binding proteins, known as lectins, bind to specific sugar groups on most membranes. We used fluorescent and light microscopy to study the interaction of various lectins with the membranes of microglia cultured from neonatal rat or fetal mouse cerebral cortices. Microglia stained intensely with GS-1, RCA, WGA, and ConA and slightly with DBA, UEA, BPA, and SBA. No staining was seen with GS-2, MPA, or PNA. Staining was specific for microglia in the mixed glial cultures and was dose dependent. In addition, microglial lectin binding could be reduced or blocked by competitive inhibition using specific sugars. Treatment of the microglia with agents such as dimethylsulfoxide (DMSO), interleukin-1 (IL-1), interferon (IFN), or lipopolysaccharide (LPS) did not eliminate lectin staining, although the degree of staining was altered. Positive staining of the microglia was also associated with a functional change for at least one lectin, i.e., ConA. Superoxide anion production by microglia was increased in the presence of ConA. Overall, binding of the lectins GS-1, RCA, WGA, and ConA can be used as an identifying tool for microglia in glial cultures, but intensity of staining varies depending on their functional state.

Recent trends in water quality in an agricultural catchment in Eastern Scotland: elucidating the roles of hydrology and land use

Across the EU, programmes of measures have been introduced as part of river basin management planning as a means of tackling problems of diffuse pollution from agriculture. Evidence is required to demonstrate the effectiveness of these measures and with this overarching objective, monitoring of an agricultural catchment in Eastern Scotland was initiated in 2007. As a precursor to evaluating the effect of new management measures it is essential to understand how other factors, including hydrology and land use changes, could have influenced water quality. This study undertook an analysis of the trends in concentrations and loads of nitrate, soluble reactive phosphorus (SRP), suspended solids (SS) and turbidity measured at six points in the catchment over a six year period. The results identified both differing trends between determinands and differing trends occurring over varying spatial scales. The only direct relationships between land use and water quality that could be identified based on annual data was a positive link between arable cropping and nitrate concentrations. At the sub-catchment scale some temporal changes in land use and management explained short-term trends in nitrate but not in SRP. Lags in the system were identified due to soil adsorption, in-stream/loch processing and groundwater transport making the identification of cause and effect problematic. The results have implications for the demonstration of effectiveness of measures over the shorter term and the timescales of recovery from diffuse pollution. Longer term monitoring at small scales will be important in this regard.

Assessment of the use of sediment fences for control of erosion and sediment phosphorus loss after potato harvesting on sloping land

In humid temperate areas, after harvest of potatoes, it is difficult to prevent soil erosion and diffuse pollution. In some autumn weather conditions, in-field mitigation such as cultivation or sowing are not possible, while edge of field measures can be costly and inflexible. We have assessed the potential of modified sediment fences, widely used on building sites, for erosion mitigation post-harvest of potato crops. Field scale assessments were conducted on fields in the Lunan catchment, eastern Scotland. Sediment retention was estimated by two methods: a topographic survey method using a hand held Real Time Kinematic Global Positioning System (RTK-GPS), and direct measurement of sediment depth using a graduated cane. In the 2010/11 trial the main fence comprised 70 m of entrenched fine mesh (0.25 mm) and coarser mesh (4mm) fabric pinned to a contour fence near the base of the field. This retained an estimated 50.9 m(3) (80.2 tonnes) of sediment, with weighted mean total P (TP) content of 0.09 % in the<2mm soil fraction. In the 2011/12 trial, the main 146 m fence was of intermediate mesh size (1.2mm). The fence was partitioned into nine upslope plots, with 3 replicates of each of 3 cultivation methods: T1 (full grubbing--a light, tined cultivator), T2 (partial grubbing) and T3 (no grubbing). Average plot slopes ranged from 9.9 to 11.0 %. The amounts of TP accumulating as sediment at the fences were: 9.3 (sd = 7.8), 11.8 (sd = 10.2) and 25.7 (sd = 5.8)kg P/ha of upslope plot for the T1, T2 and T3 treatments respectively.

Reprint of: Assessment of the use of sediment fences for control of erosion and sediment phosphorus loss after potato harvesting on sloping land

In humid temperate areas, after harvest of potatoes, it is difficult to prevent soil erosion and diffuse pollution. In some autumn weather conditions, in-field mitigation such as cultivation or sowing are not possible, while edge of field measures can be costly and inflexible. We have assessed the potential of modified sediment fences, widely used on building sites, for erosion mitigation post-harvest of potato crops. Field scale assessments were conducted on fields in the Lunan catchment, eastern Scotland. Sediment retention was estimated by two methods: a topographic survey method using a hand held Real Time Kinematic Global Positioning System (RTK-GPS), and direct measurement of sediment depth using a graduated cane. In the 2010/11 trial the main fence comprised 70 m of entrenched fine mesh (0.25 mm) and coarser mesh (4mm) fabric pinned to a contour fence near the base of the field. This retained an estimated 50.9 m(3) (80.2 tonnes) of sediment, with weighted mean total P (TP) content of 0.09 % in the<2mm soil fraction. In the 2011/12 trial, the main 146 m fence was of intermediate mesh size (1.2mm). The fence was partitioned into nine upslope plots, with 3 replicates of each of 3 cultivation methods: T1 (full grubbing--a light, tined cultivator), T2 (partial grubbing) and T3 (no grubbing). Average plot slopes ranged from 9.9 to 11.0 %. The amounts of TP accumulating as sediment at the fences were: 9.3 (sd=7.8), 11.8 (sd=10.2) and 25.7 (sd=5.8)kg P/ha of upslope plot for the T1, T2 and T3 treatments respectively.

Effect of contralateral pure tone stimulation on distortion emissions suggests a frequency-specific functioning of the efferent cochlear control

Contralateral acoustic stimulation (CAS) with white noise and pure tone stimuli was used to assess frequency specificity of efferent olivocochlear control of cochlear mechanics in the gerbil. Changes of the cochlear amplifier can be monitored by distortion product otoacoustic emissions (DPOAEs), which are a byproduct of the nonlinear amplification by the outer hair cells. We used the quadratic DPOAE f2-f1 as ipsilateral probe, as it is known to be sensitive to efferent olivocochlear activity. White noise CAS, used to evoke efferent activity, had maximal effects on the DPOAE level for f2-stimulus frequencies of 5–7 kHz. The dominant effect during CAS was a DPOAE level increase of up to 13.5 dB. The frequency specificity of the olivocochlear system was evaluated by presenting pure tones (0.5–38 kHz) as contralateral stimuli to evoke efferent activity. Maximal DPOAE level changes were triggered by CAS frequencies close to the frequency of the DPOAE elicitor tones (tested f2 range: 2.5–15 kHz). The effective CAS frequency range covered 1.4–2.4 octaves and was centered 0.42 octaves below the DPOAE elicitor tone f2. The frequency-specific effect of CAS with pure tones suggests a dedicated central control of mechanical adjustments for peripheral frequency processing.

[Trisomy 21 by isochromosome: a case report of true false negative of chorionic villi sampling]

We report a rare case of true false negative of chorionic villi sampling for a child with Down syndrome. A chorionic villi sampling was performed for a nuchal translucency at the first trimester. The karyotype was 46,XX for the short and the long-term culture. Because of facial dysmorphy and cardiopathy to the child, a karytoype was proposed. This postnatal karyotype showed a trisomy 21, by isochromosome 46,XX,i(21)(q10). We expose the mechanism of true false negative of chorionic villi sampling, and particularly the role of isochromosome in this case.

Pre-adolescent gunshot injuries: anatomy of a Jamaican problem

This retrospective analysis explores the apparent increase in gunshot injuries among pre-adolescent Jamaican children. During the five-year study period (2001-2005), 74 children less than 12 years old were treated for gunshot injuries at the Bustamante Hospital for Children. In the last four years of the study, the hospital incidence of such child shootings rose by 155%. Children between six and eleven years of age were seen to be at particular risk. Shootings were likely to occur between 4:00 pm and 10:00 pm in the evening, at or near home, in inner city communities. Affected children were unlikely to have been under direct adult supervision at the time of injury and were reported to be intended targets of the shooting in 49% of cases. Injuries to the limbs occurred most frequently, resulting chiefly in soft tissue injuries and open fractures. Half required operative intervention, most avoiding blood transfusion. Hospital stay was usually less than a week. Though clearly needed, social support services were underutilized A mortality rate of 4% was seen but long-term morbidity was uncommon. Routine social and psychiatric evaluation of victims, organized after school-care, establishment of paediatric paramedical services, establishment of a dedicated paediatric interhospital transfer team and more widespread training in paediatric trauma management are recommended to improve the quality of care given to paediatric victims of firearm injuries.

Behavioral flexibility impairment with negative feedback in refractory temporal lobe epileptic patients with unilateral amygdala and hippocampal resection

INTRODUCTION

Patients with amygdala dysfunction generally have behavioral impairment. Temporal lobe surgery might be a model of study of unilateral amygdala resection. The objective of this study was to evaluate behavioral flexibility in epileptic patients who undergo amygdala resection for epilepsy surgery and evaluate its relationship with their neuropsychiatric symptoms.

MATERIAL AND METHODS

Ten epileptic patients who underwent amygdala and hippocampal resection (6 left and 4 right) matched by age and educational level with 10 healthy controls were tested with an extensive neuropsychological and neuropsychiatric battery. Psychiatric symptomatology was measured with the positive and negative syndrome scale (PANSS) and the Beck depression inventory. To assess behavioral flexibility the emotion-related visual reversal-learning task (O'Doherty et al., 2001) and the gambling task (Bechara et al., 1994) were used.

RESULTS

Patient's mean scores were: Beck: 8 +/- 1.5; PANSS positive: 10 +/- 1.3, and negative: 14.4 +/- 2.2; intellectual quotient (IQ): 101.4 +/- 6.3; category number in Wisconsin card sorting test: 4.6 +/- 2.4. The emotion-related visual reversal-learning task showed significance differences in the number of reversion: healthy controls: 9.3; epileptic patients: 4.23 (p < 0.001); in the number of trials to the first reversion: healthy controls: 5; epileptic patients: 23.42 (p < 0.05). There was no correlation between reversion and depression, PANSS and IQ.

CONCLUSIONS

Patients with epilepsy who undergo unilateral hippocampal and amygdala resection appear to have alterations in the reversion capacity with an emotional component that would explain the lack of behavior flexibility that they sometimes have and that are not related with either the isolated presence of executive alterations or low intellectual quotient.

"Minimal intervention management" for gastroschisis: a preliminary report

The replacement of eviscerated bowel, without anaesthesia, has been performed safely in stable neonates with gastroschisis. This technique, termed "minimal intervention management", was used in three infants treated at the Newborn Special Care Nursery of the University Hospital of the West Indies. Two infants had excellent results but one had bowel perforation during the procedure, necessitating conversion to formal laparotomy under general anaesthesia. In selected patients, advantages of this technique include the ability to be guided by patient response during the procedure in order to avoid excessive intra-abdominal tension, the avoidance of anaesthesia and minimal cost. This technique is proposed for wider use in developing countries.

French multi-centric study of 2000 amniotic fluid interphase FISH analyses from high-risk pregnancies and review of the literature

This prospective and multi-centric study confirms the accuracy and the limitations of interphase FISH and shows that any cytogenetics laboratory can perform this technique. With regard to the technical approach, we think that slides must be examined by two investigators, because the scoring may be subjective. The main problem with the AneuVysion kit concerns the alpha satellite probes, and especially the chromosome 18 probe, which is sometimes very difficult to interpret because of the high variability of the size of the spots, and this may lead to false negative and uninformative cases. The best solution would be to replace these probes by locus-specific probes. Concerning clinical management, we offer interphase FISH only in very high-risk pregnancies or/and at late gestational age because of the cost of the test. We think that an aberrant FISH result can be used for a clinical decision when it is associated with a corresponding abnormal ultrasound scan. In other cases, most of the time, we prefer to wait for the standard karyotype.

Ultrasound appearance of schistosomiasis of the testis

Schistosomiasis of the testis is rare and its ultrasound findings have not previously been documented in the English medical literature. This case report describes the ultrasound appearances of a case of schistosomiasis of the testis in a 33-year-old male who had recently travelled to Egypt. The ultrasound findings are those of a solid testicular mass with a heterogeneous echotexture identical to that of most testicular malignancies.

Histology of the upper pole in complete urinary duplication--does it affect surgical management?

OBJECTIVE

To review the histological change in the upper pole of excised duplex kidneys and assess whether ante-natal diagnosis might predispose to more conservative surgical management of this abnormality.

PATIENTS AND METHODS

Fifty consecutive patients undergoing upper pole hemi-nephroureterectomy for ectopic ureter or ectopic ureterocele between 1980 and 1992 had their histology reviewed and assessed for dysplastic, inflammatory and obstructive change.

RESULTS

Segmental scarring and chronic and acute inflammatory change occurred consistently and the degree of inflammation seemed unaffected by antenatal diagnosis. Dysplasia was seen in 70% of patients with ureterocele and in only 30% of those with ectopic ureter. One patient had normal histology.

CONCLUSION

There was no evidence of reversible histological change in patients with ectopic ureter and ectopic ureterocele who were diagnosed ante-natally. Preservation of the upper pole of the kidney does not seem justified in the light of the histological evidence.

The effect of low dose lofepramine in depressed elderly patients in general medical wards

A double-blind randomised controlled trial of the effect of low dose lofepramine (70 mg once daily) against placebo was carried out on depressed elderly inpatients on general medical wards for the elderly, comparing measures of depression and side-effects between the randomised groups. Patients were identified for the study using the Geriatric Depression Scale (GDS) and the Brief Assessment Schedule Depression Cards (BASDEC). Sixty-three subjects were randomised: 46 patients completed the entire trial of 28 days treatment. BASDEC and GDS were administered on day 8 post-admission, and depressed patients were randomised double-blind to either low dose lofepramine (70 mg daily) (n = 23) or placebo (n = 23). Assessment of changes in depressive states were made using the Montgomery Asberg Depression Rating Scale (MADRS) on days 8, 18 and 36 post-admission. Both groups improved by a similar amount during the trial. Lofepramine tended to be more effective than placebo in those patients who were more depressed (GDS > or = 18). On the other hand, subjects who were less depressed (i.e. GDS < 18) improved more on placebo than lofepramine. Low dose lofepramine may prove useful in moderately or severely depressed patients treated for only 4 weeks. However, low dose lofepramine is not indicated for mild (GDS 15-18) depression.

Transient behaviour of baker's yeast during enforced periodical variation of dissolved oxygen concentration

The aim of the investigation was to find out the influence of the variation of the dissolved oxygen concentration in the microenvironment of yeast cells on their physiological behaviour in small laboratory reactors and estimate their behaviour in large industrial reactors. Since the morphology of the laboratory and industrial yeasts differed considerably, their transient behaviour was investigated and compared. For this purpose, the strain Saccharomyces cerevisiae H620 and an industrial strain were cultivated on synthetic as well as on complex medium in batch operation during periodical variation of the dissolved oxygen concentration, monitoring the most important key parameters. Also the yeast was cultivated in batch as well as in continuous operation, the cell-containing culture medium was recirculated through a nonaerated loop at different recirculation rates (residence times of the cells in the loop), and the key operation variables were monitored. It was found that the transient behaviour of laboratory and industrial yeasts differed slightly. Since cells growing in batch culture are more sensitive to dissolved oxygen concentration variation than cells growing in continuous culture, the transient behavior of cells cultivated in batch operation varied from those in continuous operation. If the anaerobic phase was longer than 1 min, ethanol was produced. However, it was consumed during the aerobiosis again, provided that phase was considerably longer than the anaerobic phase. This means that the yeast cultivation was not influenced by the periodic operation of the dissolved oxygen. Judging from the measurements in large stirred tank and airlift tower loop reactors, in general, the cells would spend more time in the aerobic than in the anaerobic flow region, and they would spend less than 1 min in the anaerobic flow region. Therefore, no considerable effect of the periodically varied dissolved oxygen concentration on the cell cultivation can be expected in large-scale reactors. In the stirred tank-loop-system at high pumping rates/high frequencies of periodically varied dissolved oxygen concentration, unexpectedly, the formation of ethanol was observed, which might be caused by stress imposed on the cells.

Studies on dental aerobiology. II. Microbial splatter discharged from the oral cavity of dental patients

The distribution and bacterial content of splatter particles emanating from a patient's mouth during dental procedures was studied in a controlled environment operatory. Levels of contamination far exceeding those produced by common oral activities were observed. Suction and preoperative oral hygiene procedures are not effective in reducing contamination from bacterial splatters, and the modification of certain procedures and the use of protective shields or glasses is advised.