Long-lasting, deep effect of Saturn's giant storms.

Planetary-scale giant storms erupt on Saturn quasiperiodically. There have been at least six recorded occurrences of past eruptions, and the most recent one was in 2010, with its whole life span captured by the Cassini mission. In 2015, we used the Very Large Array to probe the deep response of Saturn's troposphere to the giant storms. In addition to the remnant effect of the storm in 2010, we have found long-lasting signatures of all mid-latitude giant storms, a mixture of equatorial storms up to hundreds of years old, and potentially an unreported older storm at 70°N. We derive an ammonia anomaly map that shows an extended meridional migration of the storm's aftermath and vertical transport of ammonia vapor by storm dynamics. Intriguingly, the last storm in 2010 splits into two distinct components that propagate in opposite meridional directions, leaving a gap at 43°N planetographic latitude.

Perception of infant sleep problems: the role of negative affectivity and maternal depression.

STUDY OBJECTIVES: To investigate whether the interaction between infant negative affectivity and maternal depressive symptoms is associated with the degree to which mothers perceive infant sleep to be problematic at 6 months postpartum, independent of infant sleep and sociodemographic factors. METHODS: Infant negative affectivity and maternal depressive symptoms were assessed in a sample of 59 mother-infant dyads at 6 months postpartum using standardized measures. Mothers reported the degree to which they perceived their infant's sleep to be problematic via an item composite of the Sleep Practices Questionnaire. Nocturnal infant sleep variables (duration, number of awakenings) were retrieved from a 2-week infant sleep diary (maternal report). RESULTS: There was a significant interaction between infant negative affectivity and maternal depressive symptoms in predicting mothers' perceived extent of infant sleep problems. Simple slope analysis showed that high levels of depression were related to higher maternal perception of infant sleep problem scores only among mothers of infants with high levels of negative affectivity. Moreover, infant negative affectivity and maternal depressive symptoms positively predicted perception scores after adjustment for infant sleep, maternal age, and parity (P < .05). CONCLUSIONS: The current study provides evidence that high levels of maternal depression combined with high levels of infant negative affectivity may contribute to mothers' perceptions of infant sleep problems, independent of infant sleep duration and awakenings. These findings highlight the importance for pediatricians and other health professionals to consider infant temperament in conjunction with mothers' depressive symptoms when addressing mothers' concerns about infant sleep problems.

Primary squamous cell carcinoma at ileostomy site. Two case reports and review of literature.

SCC at ileostomy is rare, early diagnosis by sampling abnormal tissue around ileostomy is vital.

Sleep Difficulties in Preschoolers with Psychiatric Diagnoses.

Background: Sleep problems among preschoolers are highly prevalent. Given the impact of poor sleep quality on development, this relationship is particularly relevant in vulnerable populations but is less documented. This study aims to document parental perception of sleep problems in preschoolers assessed in a psychiatric clinic, as a function of diagnosis type. Methods: Children (14-71 months, n = 228) were evaluated by a psychiatrist, and diagnoses were pooled into four categories: behavioral disorders, relational disorders/psychosocial problems, developmental coordination disorder (DCD), and communication disorders. Sleep problems were measured using the Child Behavior Checklist (CBCL). Results: In this clinical sample of preschoolers, 21.6% of children were identified as having a sleep problem by their parents. Behavioral disorders and communication disorders were associated with increased parental report of sleep problems (respectively, trouble falling asleep and nighttime awakenings), while DCD was associated with lower parental report of sleep problems (fewer nighttime awakenings and less difficulty falling asleep) (p < 0.05). Relational disorders were not associated with parental reports of sleep difficulties (p > 0.05). Moreover, some psychiatric categories were associated with specific sleep symptoms (such as difficulty falling asleep and night awakenings). Conclusion: Parents of preschoolers with behavioral disorders and communication disorders are more likely to report sleep problems in their children than parents of preschoolers with DCD and relational disorders. Since different categories of psychiatric disorders are associated with specific types of sleep complaints, screening, and treatment should be adapted accordingly.

Successful management of Halyomorpha halys (Hemiptera: Pentatomidae) in commercial apple orchards with an attract-and-kill strategy.

BACKGROUND: Introduction of Halyomorpha halys (Stål) in the USA has disrupted many established integrated pest management programs for specialty crops, especially apple. While current management heavily relies on insecticides, one potential alternative tactic is attract-and-kill (AK), whereby large numbers of H. halys are attracted to and retained in a circumscribed area using attractive semiochemicals and removed from the foraging population with an insecticide. The goal of this study was to evaluate if AK implementation in commercial apple orchards can result in levels of H. halys damage that are equal to or less than those from grower standard management programs. RESULTS: Over 2 years at farms in five Mid-Atlantic USA states, we found that the use of AK resulted in 2-7 times less damage compared with grower standard plots, depending on year and period. At selected trees on which AK was implemented, over 10,000 H. halys individuals were killed in two growing seasons, and the use of AK reduced the crop area treated with insecticide against H. halys by 97%. Using AK had no impact on the natural enemy or secondary pest community over the same period. CONCLUSIONS: Overall, the use of AK was effective at managing low to moderate H. halys populations in apple orchards, but must be optimized to increase economic feasibility for grower adoption. © 2018 Society of Chemical Industry.

Peering through Jupiter's clouds with radio spectral imaging.

Radio wavelengths can probe altitudes in Jupiter's atmosphere below its visible cloud layers. We used the Very Large Array to map this unexplored region down to ~8 bar, ~100 kilometers below the visible clouds. Our maps reveal a dynamically active planet at pressures less than 2 to 3 bar. A radio-hot belt exists, consisting of relatively transparent regions (a low ammonia concentration, NH3 being the dominant source of opacity) probing depths to over ~8 bar; these regions probably coincide with 5-micrometer hot spots. Just to the south we distinguish an equatorial wave, bringing up ammonia gas from Jupiter's deep atmosphere. This wave has been theorized to produce the 5-micrometer hot spots; we observed the predicted radio counterpart of such hot spots.

Hand-Assisted Laparoscopic (HAL) Multiple Segmental Colorectal Resections: Are They Feasible and Safe?

The objective of this study was to evaluate the short-term outcomes of synchronous hand-assisted laparoscopic (HAL) segmental colorectal resections. The surgical options for synchronous colonic pathology include extensive colonic resection with single anastomosis, multiple synchronous segmental resections with multiple anastomoses, or staged resections. Traditionally, multiple open, synchronous, segmental resections have been performed. There is a lack of data on HAL multiple segmental colorectal resections. A retrospective chart review was compiled on all patients who underwent HAL synchronous segmental colorectal resections by all the colorectal surgeons from our Group during the period of 1999 to 2014. Demographics, operative details, and short-term outcomes are reported. During the period, 9 patients underwent HAL synchronous multiple segmental colorectal resections. There were 5 women and 4 men, with median age of 54 (24-83) years and median BMI of 24 (19.8-38.7) kg/m(2). Two patients were on long-term corticosteroid therapy. The median operative time was 210 (120-330) minutes and median operative blood loss was 200 (75-300) mLs. The median duration for return of bowel function was 2 days and the median length of stay was 3.5 days. We had 2 minor wound infections. There were no deaths. Synchronous segmental colorectal resections with anastomoses using the hand-assisted laparoscopic technique are safe. Early conversion to open and use of stomas are advisable in challenging cases.

Spatial Distribution of Brown Marmorated Stink Bug (Hemiptera: Pentatomidae) Injury at Harvest in Mid-Atlantic Apple Orchards.

Brown marmorated stink bug, Halyomorpha halys (Stål), injury to late-season apple cultivars was measured at harvest in 2011 and 2012 in commercial orchards in four mid-Atlantic states. In each orchard block, a border zone (adjacent to woods), an interior zone (near orchard center), and an intermediate zone (between border and interior zones) comprised 1-3 tree rows per zone, depending on block size. Just before commercial harvest, 10 fruit were sampled from the upper, middle, and lower third of the canopy from five trees in each zone. After 3-5 wk in cold storage, fruit were examined for external and internal injury, and severity of internal injury (number of injury sites per fruit) from H. halys. A zero-inflated negative binomial model accounted for significant variation among the orchards and showed that apples from the upper canopy of border zone trees had the highest probability of experiencing external and internal injury. A minor interaction was detected among the orchards and zones for injury prevalence and severity, but there was no evidence of an orchard showing less expected injury in the border zone compared with other zones. Adjusting for orchard-to-orchard variation, differences in injury distributions among the zones and canopies were primarily due to injury prevalence rather than expected injury severity. The implications of these results to scouting and managing H. halys in eastern apple orchards are discussed.

Results of the repair of acute rotator cuff tears is not influenced by tear retraction.

PURPOSE: This study evaluated retraction in the setting of acute rotator cuff tears and determined its effects on patient outcomes and tendon repair integrity. MATERIALS AND METHODS: A total of 22 patients had surgery within 6 weeks or less from the time of injury. Fifteen of these patients were prospectively followed at a minimum of 2 years; average 40.5 months (range 24-69). Pre-operative objective and subjective outcomes were compared. Tendon repair integrity was assessed with ultrasound at a minimum of 1 year from surgery. The population was stratified into Group 1 (8 patients) with minimal intra-operative medial tendon retraction to the mid-line level of the humeral head and Group 2 (7 patients) with a large medial tendon retraction to the glenohumeral joint or greater. RESULTS: The average time to surgery from the onset of symptoms was 27 days (range, 6-42). Post-operative motion increased significantly for external rotation and forward elevation, 77% of patients were pain free, 80% were completely satisfied, and 100% would have the surgery again. Group 1 (small retraction) versus Group 2 (large retraction) showed that post-operative pain levels, satisfaction, range of motion, strength, subjective shoulder value (95.4% vs. 92.3%), Constant Score (80.8 vs. 78.1), and American Society of Shoulder and Elbow Surgeons (96.2 vs. 93.5) scores were not statistically different. Ultrasound showed a tendon repair integrity rate of 87%. 2 patients who did have a re-tear were in Group 2, yet had comparative outcomes. CONCLUSION: In acute rotator cuff tears, equal patient satisfaction, pain scores, range of motion, strength, and outcome measures should be expected with surgical repair despite the level of retraction. LEVEL OF EVIDENCE: Therapeutic level IV.

Teaching professionalism through virtual means.

OBJECTIVES: Virtual patients are used across a variety of clinical disciplines for both teaching and assessment, but are they an appropriate environment in which to develop professional skills? This study aimed to evaluate students' perceived effectiveness of an online interactive virtual patient developed to augment a personal professional development curriculum, and to identify factors that would maximise the associated educational benefits. METHODS: Student focus group discussions were conducted to explore students' views on the usefulness and acceptability of the virtual patient as an educational tool to teach professionalism, and to identify factors for improvement. A thematic content analysis was used to capture content and synthesise the range of opinions expressed. RESULTS: Overall there was a positive response to the virtual patient. The students recognised the need to teach and assess professionalism throughout their curriculum, and viewed the virtual patient as a potentially engaging and valuable addition to their curriculum. We identified factors for improvement to guide the development of future virtual patients. CONCLUSION: It is possible to improve approaches to teaching and learning professionalism by exploring students' views on innovative teaching developments designed to augment personal professional development curricula.