Comparing the effect of different sample conditions and spectral libraries on the prediction accuracy of soil properties from near- and mid-infrared spectra at the field-scale.

The prediction accuracy of soil properties by proximal soil sensing has made their application more practical. However, in order to gain sufficient accuracy, samples are typically air-dried and milled before spectral measurements are made. Calibration of the spectra is usually achieved by making wet chemistry measurements on a subset of the field samples and local regression models fitted to aid subsequent prediction. Both sample handling and wet chemistry can be labour and resource intensive. This study aims to quantify the uncertainty associated with soil property estimates from different methods to reduce effort of field-scale calibrations of soil spectra. We consider two approaches to reduce these expenses for predictions made from visible-near-infrared ((V)NIR), mid-infrared (MIR) spectra and their combination. First, we considered reducing the level of processing of the samples by comparing the effect of different sample conditions (in-situ, unprocessed, air-dried and milled). Second, we explored the use of existing spectral libraries to inform calibrations (based on milled samples from the UK National Soil Inventory) with and without 'spiking' the spectral libraries with a small subset of samples from the study fields. Prediction accuracy of soil organic carbon, pH, clay, available P and K for each of these approaches was evaluated on samples from agricultural fields in the UK. Available P and K could only be moderately predicted with the field-scale dataset where samples were milled. Therefore this study found no evidence to suggest that there is scope to reduce costs associated with sample processing or field-scale calibration for available P and K. However, the results showed that there is potential to reduce time and cost implications of using (V)NIR and MIR spectra to predict soil organic carbon, clay and pH. Compared to field-scale calibrations from milled samples, we found that reduced sample processing lowered the ratio of performance to inter-quartile range (RPIQ) between 0% and 76%. The use of spectral libraries reduced the RPIQ of predictions relative to field-scale calibrations from milled samples between 54% and 82% and the RPIQ was reduced between 29% and 70% for predictions when spectral libraries were spiked. The increase in uncertainty was specific to the combination of soil property and sensor analysed. We conclude that there is always a trade-off between prediction accuracy and the costs associated with soil sampling, sample processing and wet chemical analysis. Therefore the relative merits of each approach will depend on the specific case in question.

Trauma-Focused Cognitive Behavioral Therapy in 13 Urban Public Schools: Mixed Methods Results of Barriers, Facilitators, and Implementation Outcomes.

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based intervention to treat Post-traumatic Stress Disorder among youth ages 3-18 years. In this pilot study, 31 clinicians in 13 urban public schools received TF-CBT training to improve access to a high-quality trauma treatment for youth in need. A mixed methods design was used to assess implementation barriers, facilitators and outcomes to examine initial feasibility, acceptability, and appropriateness of TF-CBT delivered in school settings. Although 70% of clinicians reported confidence in the evidence-base of TF-CBT and its potential to support their students who have a very high prevalence of lifetime trauma exposure, implementation practice outcomes suggest a wide range of TF-CBT use (Range = 0 to 11 students enrolled per clinician, Mean = 1.4 students) with 23 clinicians implementing the TF-CBT model with at least one case. Results point to the potential value of training school mental health clinicians in TF-CBT based on its compatibility with student needs. Yet, by connecting focus group results to top-rated barriers and facilitators, we identify several adjustments that should be made to improve intervention-setting fit in future studies. Specifically, school setting-specific intervention adaptations, school-tailored implementation support and thoughtful consideration of school-based clinicians' roles and responsibilities are needed to enhance future implementation success.

Epidural anaesthesia and analgesia for liver resection.

Although epidural analgesia is routinely used in many institutions for patients undergoing hepatic resection, there are unresolved issues regarding its safety and efficacy in this setting. We performed a review of papers published in the area of anaesthesia and analgesia for liver resection surgery and selected four areas of current controversy for the focus of this review: the safety of epidural catheters with respect to postoperative coagulopathy, a common feature of this type of surgery; analgesic efficacy; associated peri-operative fluid administration; and the role of epidural analgesia in enhanced recovery protocols. In all four areas, issues are raised that question whether epidural anaesthesia is always the best choice for these patients. Unfortunately, the evidence available is insufficient to provide definitive answers, and it is clear that there are a number of areas of controversy that would benefit from high-quality clinical trials.

Late-onset deep prosthetic infection following mesh repair of inguinal hernia.

BACKGROUND: The use of prosthetic biomaterials for the primary repair of inguinal hernias is now commonplace. Late-onset deep-seated prosthetic infection can be an unexpected complication. METHODS: The literature from a Medline search relating to the biology of mesh in the setting of hernia repair is discussed. CONCLUSIONS: The use of a foreign body for hernia repair does not appear to alter the incidence of superficial wound infection. Late-onset deep graft infection has been rarely reported, and the true incidence is yet to be established. With the more widespread use of mesh materials, this complication may become increasingly evident.

Anaerobic septicemia secondary to Fusobacterium mortiferum.

A case of anaerobic sepsis associated with Fusobacterium mortiferum is reported. Blood cultures from a 60-year-old man with type II diabetes mellitus, hypertension, severe atherosclerotic cardiovascular disease, and renal insufficiency revealed on a gramstained smear highly pleomorphic gram-negative bacilli with bizarre forms and round bodies. Growth of the organism on nonselective anaerobic media and analysis of its pattern produced results characteristic of Fusobacterium mortiferum.

Influence of earphone-cushion center-hole diameter on the acoustic output of audiometric earphones.

Although the dimensions of the MX-41/AR earphone cushion are specified in ANSI S3.6--1969, nonstandard MX--41/AR cushions are still found on some audiometers. Variations in the diameter of the cushion's center hole are shown to affect the coupler calibration of the earphone and also hearing threshold measurements at high audiometric frequencies.

Edwardsiella tarda associated with osteomyelitis.

A case of osteomyelitis associated with Edwardsiella tarda is reported. Specimens from a wound exudate of a 58-year-old female with osteomyelitis revealed on a direct gram-stained smear, pleomorphic, gram-negative rods. Growth of the organism on differential media and analysis of its Analytab (API)(*) patterns produced results consistent with E. tarda. The identification of the organism was confirmed by the Center for Disease Control, Atlanta. This represents the first reported case of a wound infection attributable to this organism.