A new method to compile global multi-hazard event sets

This study presents a new method, the MYRIAD-Hazard Event Sets Algorithm (MYRIAD-HESA), that compiles historically-based multi-hazard event sets. MYRIAD-HESA is a fully open-access method that can create multi-hazard event sets from any hazard events that occur on varying time, space, and intensity scales. In the past, multi-hazards have predominately been studied on a local or continental scale, or have been limited to specific hazard combinations, such as the combination between droughts and heatwaves. Therefore, we exemplify our approach by compiling a global multi-hazard event set database, spanning from 2004 to 2017, which includes eleven hazards from varying hazard classes (e.g. meteorological, geophysical, hydrological and climatological). This global database provides new scientific insights on the frequency of different multi-hazard events and their hotspots. Additionally, we explicitly incorporate a temporal dimension in MYRIAD-HESA, the time-lag. The time-lag, or time between the occurrence of hazards, is used to determine potentially impactful events that occurred in close succession. Varying time-lags have been tested in MYRIAD-HESA, and are analysed using North America as a case study. Alongside the MYRIAD-HESA, the multi-hazard event sets, MYRIAD-HES, is openly available to further increase the understanding of multi-hazard events in the disaster risk community. The open-source nature of MYRIAD-HESA provides flexibility to conduct multi-risk assessments by, for example, incorporating higher resolution data for an area of interest.

Contralateral neck failure in oral tongue cancer: Outcomes from two centers using predefined treatment criteria

BACKGROUND

The objective was to determine the incidence of, and factors associated with contralateral neck failure (CNF) in oral tongue squamous cell carcinoma (OTSCC).

METHODS

Consecutive patients with OTSCC between 2007 and 2016 were included. The predefined policy of the contralateral neck included neck dissection (ND) where the primary tumor extended/crossed midline or the contralateral neck was involved; and elective nodal irradiation (ENI) where the primary tumor was ≤1 cm from midline/2 cm from tip.

RESULTS

This study included 258 patients. ND was ipsilateral 169 (66%) and bilateral 33 (13%). Fifty-five patients (21%) received ENI to the undissected contralateral neck. CNF occurred in 19 patients (7%) and was similar by treatment received. Utilizing this approach, we observed higher rates of CNF with increasing N classification, perineural invasion, extracapsular extension, and depth of invasion ≥6 mm.

CONCLUSIONS

Using our institutional policy of treatment to the contralateral neck, a low rate of CNF (≤10%) was observed.

Impact of histological Oral Tongue Cancer margins on locoregional recurrence: A multi-centre retrospective analysis

OBJECTIVES

To assess the effect of the histological margins (HM) upon locoregional failure (LRF) and overall survival (OS) for oral tongue squamous cell carcinoma (OTSCC).

MATERIALS AND METHODS

We undertook a retrospective review of 258 patients, across two institutions, treated for OTSCC between 2007 and 2016. A Cox-proportional hazards model was used to compare the relative hazard ratio of HM to the accepted standard of 5 mm margins for LRF and OS.

RESULTS

The median follow up period was 4.8 years. The 5 year OS and freedom from LRF were 69% and 75% respectively. The Cox-proportional hazards model adjusted for age, DOI and LVI showed increasing risk of mortality and LRF with decreasing HM widths of <5 mm.

CONCLUSION

HM >5 mm were associated with a risk reduction of both LRF and mortality in OTSCC. This study supports >5 mm HM being the oncologic goal of surgery.

Metabolite secretion in microorganisms: the theory of metabolic overflow put to the test

INTRODUCTION

Microbial cells secrete many metabolites during growth, including important intermediates of the central carbon metabolism. This has not been taken into account by researchers when modeling microbial metabolism for metabolic engineering and systems biology studies.

MATERIALS AND METHODS

The uptake of metabolites by microorganisms is well studied, but our knowledge of how and why they secrete different intracellular compounds is poor. The secretion of metabolites by microbial cells has traditionally been regarded as a consequence of intracellular metabolic overflow.

CONCLUSIONS

Here, we provide evidence based on time-series metabolomics data that microbial cells eliminate some metabolites in response to environmental cues, independent of metabolic overflow. Moreover, we review the different mechanisms of metabolite secretion and explore how this knowledge can benefit metabolic modeling and engineering.

Low-Carbon Fuel and Chemical Production by Anaerobic Gas Fermentation

World energy demand is expected to increase by up to 40% by 2035. Over this period, the global population is also expected to increase by a billion people. A challenge facing the global community is not only to increase the supply of fuel, but also to minimize fossil carbon emissions to safeguard the environment, at the same time as ensuring that food production and supply is not detrimentally impacted. Gas fermentation is a rapidly maturing technology which allows low carbon fuel and commodity chemical synthesis. Unlike traditional biofuel technologies, gas fermentation avoids the use of sugars, relying instead on gas streams rich in carbon monoxide and/or hydrogen and carbon dioxide as sources of carbon and energy for product synthesis by specialized bacteria collectively known as acetogens. Thus, gas fermentation enables access to a diverse array of novel, large volume, and globally available feedstocks including industrial waste gases and syngas produced, for example, via the gasification of municipal waste and biomass. Through the efforts of academic labs and early stage ventures, process scale-up challenges have been surmounted through the development of specialized bioreactors. Furthermore, tools for the genetic improvement of the acetogenic bacteria have been reported, paving the way for the production of a spectrum of ever-more valuable products via this process. As a result of these developments, interest in gas fermentation among both researchers and legislators has grown significantly in the past 5 years to the point that this approach is now considered amongst the mainstream of emerging technology solutions for near-term low-carbon fuel and chemical synthesis.

Laparoscopic evaluation of the argon beam coagulator. Initial report

The objective of this study was to evaluate the safety and hemostatic properties of the argon beam coagulator (ABC) at laparoscopy. The study is composed of two parts: laparoscopic results in five anesthetized animals and a preliminary clinical trial in 35 volunteers undergoing laparoscopy. Animals were evaluated during a laparoscopic cholecystectomy training course. Private patients undergoing operative laparoscopy voluntarily consented to a hospital Investigational Review Board-approved protocol to evaluate the ABC. The pigs were 3-month-old, healthy females. The patients were healthy volunteers undergoing laparoscopy for pain, infertility or cholecystectomy. Both pigs and human volunteers underwent operative laparoscopic use of the ABC for hemostasis and selected tissue electrocoagulation using a prototype 10-mm laparoscopic probe. The safety of the ABC was evaluated in the pigs by continuously monitoring heart rate, oxygen saturation and end-tidal CO2. Patients had similar clinical monitoring during operative laparoscopy, with observation of tissue effects of the ABC for hemostasis and tissue electrocoagulation. Laparoscopic use of the ABC in animals and patients produced no observable anesthetic changes, with both pigs and patients recovering normally. The ABC allowed smokeless, hemostatic tissue electrocoagulation, with a rapid non-touching technique easy to apply laparoscopically. We conclude that the ABC can safely be used laparoscopically with excellent hemostasis and effective controlled tissue electrocoagulation. The lack of smoke and the non-touching technique for delivery allow rapid laparoscopic application. The prototype 10-mm delivery probe is cumbersome, and the argon gas flow rate of 4 L/min with firing requires constant venting of the peritoneum with close monitoring of intraperitoneal pressures.

The efficacy of early pregnancy monitoring with serial chorionic gonadotropin determinations and real-time sonography in an infertility population

Ninety-one pregnancies were monitored prospectively with serial human chorionic gonadotropin (hCG) determinations and real-time sonography. The monitoring process included an initial hCG doubling time (DT) followed by sonographic examination for fetal heart motion at 7 to 8 weeks in the asymptomatic patient. In women with an abnormal DT or who developed symptoms, repeat hCG determinations and/or sonography were performed. A single DT correctly identified 95% of the successful pregnancies (58) and 64% of the abnormal pregnancies (25 abortions and 8 ectopic gestations) in asymptomatic women. With repeat hCG determinations and/or sonography, 88% of the spontaneous abortions (before aborting) and 100% of the ectopic pregnancies (before tubal rupture) were identified. As a result of the early diagnosis, conservative surgery was performed in six of eight women with tubal pregnancies. The presence of fetal heart motion was a reliable indicator that an intrauterine pregnancy will progress to viability in both the symptomatic (89%) and asymptomatic patient (93%). We conclude that the combined use of serial hCG determinations and real-time sonography provides efficacious monitoring of the early high-risk pregnancy.

Reconstruction of the cervical canal after complete postconization obstruction. A case report

Complete cervical canal obstruction is a rare complication of cone biopsy and may result in retrograde menstrual flow, hematometria and infertility. We treated a patient who had postconization obstruction and ultimately a successful pregnancy after combined vaginal and abdominal reconstruction of the cervical canal.

Prevention of acute pelvic inflammatory disease after hysterosalpingography: efficacy of doxycycline prophylaxis

In an attempt to minimize the infectious morbidity of hysterosalpingography, the efficacy of oral doxycycline prophylaxis was examined. The records and hysterosalpingograms of 278 consecutive women (group 1) were reviewed to correlate the radiologic findings and the development of acute pelvic inflammatory disease (PID) after hysterosalpingography. Four women (1.4%) developed PID and all four had tubal dilatation. The overall frequency of PID in women with dilated tubes was 4/35 (11%). Subsequently, 56 of 326 women (group 2) with tubal dilatation received oral doxycycline prophylaxis. No cases of PID were observed in the 56 women who had antibiotic prophylaxis (p less than 0.02) or in group 2 as a whole. The study suggests that the risk of infection after hysterosalpingography is very low when nondilated tubes are present (0/398 women of groups 1 and 2). The relative risk of PID in women with peritubal disease or proximal tubal occlusion, although apparently low, remains to be determined. Furthermore, in the highest-risk group of women with dilated tubes, doxycycline prophylaxis was effective in reducing infection after hysterosalpingography.

Structural anomalies of the X chromosome: personal observation and review of non-mosaic cases

We describe a new case of partial deletion of the long arm of the X chromosome, found in a 24-year-old female with secondary amenorrhea; the karyotype of the proposita is 46,X,del(X)(q22). We take this opportunity to review the previously published descriptions of non-mosaic structural anomalies of the X chromosome (X isochromosomes excepted) with the goal of "testing" the recent hypothesis formulated about: (a) the existence of an X inactivation center (Therman et al. 1974b); (b) the presence of a "b" segment remaining active on Xp (Therman et al. 1976); (c) the potential importance of a critical area on Xq linked to gonadal function (Sarto et al. 1973); and (d) the presence of normal gonadal function despite and Xp terminal deletion (Fraccaro et al. 1977). We conclude that the above-mentioned theories, as well as those concerning phylogenetic evolution of sex chromosome morphology presented by Lyon (1974) and Hoo (1975), receive support from practically all of the 149 cases we compared. Regarding the features of the Turner syndrome, we propose "mapping" of the X chromosome as follows: the genes involved in gonadal function seem to be located on the proximal part of Xp and on the distal part of Xq, whereas the genes whose absence is responsible for somatic features of the syndrome may be distributed along the length of Xp and the middle section of Xq(q21-q26). Furthermore, we note some interesting analogies between the evolutional model proposed by Hoo (1975) and the map we visualize.

Catamenial pneumothorax in sisters

Two sisters had documented pelvic endometriosis and catamenial pneumothoraxes. Both were typical of the 54 reported cases of catamenial pneumothorax in that pneumothoraxes were always on the right and occurred only at menses with onset in the fourth decade. One patient was asymptomatic during 11 months of menstrual suppression with hormones but subsequently required surgery where diaphragmatic perforations were found. The other patient was treated with isoxazole ethisterone with no pneumothoraxes while under suppression. These patients are unlike any of the previously reported cases of familial pneumothoraxes. We have not found a previous report of a familial catamenial pneumothorax.