Patient's posteroanterior chest radiographs are routinely displayed at different sizes on PACS: Cause and prevalence.

OBJECTIVE: Sequential posteroanterior chest radiographs (CXRs) on any one patient are commonly displayed at different sizes on PACS monitors. The purpose of this study was to determine the cause of these differences, the percentage of radiographs affected, the relative change in magnification seen and if radiologists were aware of this display difference. METHODS: Differences in routine radiographer collimation pre-acquisition and image cropping (shuttering) post acquisition were noted. From three different hospitals, 300 posteroanterior (PA) erect CXRs with prior comparative studies were viewed side-by-side on a standard landscape display monitor. Variation in display size was calculated using the number of detector elements in the autofitted axis of the radiograph, when compared with the prior study. Correlation between patient gender and extent of magnification between images was recorded. Following this, a national survey was circulated to see if radiologists were aware of this phenomenon. RESULTS: Large variations in display size were noted. The mean extent of magnification between sequential PA chest radiographs was ±6.8% (range 0-21.6%). 98% of CXRs had some degree of variability in display size. There was no significant difference in the extent of variation in magnification based on age or gender. 86% of the radiologists who responded to the survey (n = 132) were unaware of any display size variability. CONCLUSION: Sequential DR acquired chest radiographs are routinely displayed with varying degrees of magnification on PACS monitors due to differences in radiographer practice and auto-fit display settings. Most radiologists surveyed were unaware of these differences and their causation.

Plant-parasitic nematodes on turfgrass in Queensland, Australia, and biosecurity issues associated with the interstate transfer and eradication of southern sting nematode (Ibipora lolii).

Southern sting nematode (Ibipora lolii), by far the most damaging nematode pest of turfgrass in Australia, was first reported from the Newcastle area of New South Wales in 1979 and is now widely distributed in the Central Coast region of NSW; is causing severe damage to sportsgrounds in Perth, Western Australia; and has been reported from a few locations in other states. This paper reports a recent example of interstate transfer, as small rolls of turf transferred from a turf nursery in Victoria to the Brisbane Cricket Ground (the Gabba) for the Australian Football League Grand Final in October 2020 were found to be infested with I. lolii. Despite this transfer, evidence is provided to suggest that Queensland should be considered provisionally free of I. lolii. First, in the period from 2006 to 2021, 744 turfgrass samples from 160 Queensland locations were processed by two diagnostic laboratories and I. lolii was never detected. Second, I. lolii was not found at the two Queensland locations reported in 2010 as being infested. Third, an action plan designed to eliminate I. lolii from the Gabba (removal and disposal of the infested turf; fumigation of the sites where the infested turf had been laid; and application of nematicides to the fumigated areas and the whole oval) appears to have been successful, as I. lolii was not detected in a post-treatment monitoring program. The paper concludes by arguing that Queensland biosecurity authorities should list I. lolii as one of its priority pests, establish a surveillance program for the nematode, and develop strategies to minimise the risk of I. lolii being transferred into and within the state.

Challenges and outlook for convection-permitting climate modelling.

Climate projections at very high resolution (kilometre-scale grid spacing) are becoming affordable. These 'convection-permitting' models (CPMs), commonly used for weather forecasting, better represent land-surface characteristics and small-scale processes in the atmosphere such as convection. They provide a step change in our understanding of future changes at local scales and for extreme weather events. For short-duration precipitation extremes, this includes capturing local storm feedbacks, which may modify future increases. Despite the major advance CPMs offer, there are still key challenges and outstanding science issues. Heavy rainfall tends to be too intense; there are challenges in representing land-surface processes; sub-kilometre scale processes still need to be parametrized, with existing parametrization schemes often requiring development for use in CPMs; CPMs rely on the quality of lateral boundary forcing and typically do not include ocean-coupling; large CPM ensembles that comprehensively sample future uncertainties are costly. Significant progress is expected over the next few years: scale-aware schemes may improve the representation of unresolved convective updrafts; work is underway to improve the modelling of complex land-surface fluxes; CPM ensemble experiments are underway and methods to synthesize this information with larger coarser-resolution model ensembles will lead to local-scale predictions with more comprehensive uncertainty context for user application. Large-domain (continental or tropics-wide) CPM climate simulations, potentially with additional earth-system processes such as ocean and wave coupling and terrestrial hydrology, are an exciting prospect, allowing not just improved representation of local processes but also of remote teleconnections. This article is part of a discussion meeting issue 'Intensification of short-duration rainfall extremes and implications for flash flood risks'.

The Mesostigmatid Mite Protogamasellus mica, an Effective Predator of Free-Living and Plant-Parasitic Nematodes.

Protogamasellus mica was extracted from a sugarcane field in Australia and cultured on bacterial-feeding nematodes. Studies with various nematodes in laboratory arenas showed that one mite and its progeny reduced nematode numbers by between 26 and 50 nematodes/day. A bacterivore (Mesorhabditis sp.), a fungivore (Aphelenchus avenae), and two plant parasites (root-knot nematode, Meloidogyne javanica and root-lesion nematode, Pratylenchus zeae) were all reduced at much the same rate despite the fact that the nematodes are quite different in size and motility and belong to different trophic groups. When sugarcane was grown in the greenhouse for 8 wk, stunt nematode (Tylenchorhynchus annulatus), a plant parasite that feeds ectoparasitically on roots, was almost eliminated from pots inoculated with the mite, and numbers of microbivores and root-lesion nematode were markedly reduced. Huge reductions in nematode populations were also observed when mites were added to microcosms containing small quantities of defaunated soil. These results show that P. mica multiplies rapidly when nematodes are available as a food source and has the capacity to play a role in regulating populations of both plant-parasitic and free-living nematodes. Future research should focus on understanding the crop and soil management practices required to enable this mite and other predatory species to thrive.

Ring-shaped variation of the coeliac trunk branches.

Aberrant arterial variations in the branching pattern of the coeliac trunk are of great interest to surgeons and radiologists. We report on a rare arterial variation found in a 79-year-old cadaver during educational dissection. Specifically, the coeliac axis formed a unique incomplete trunk termed the hepato-hepatic trunk. The splenic artery arose separately from the anterior aspect of the abdominal aorta. On the right side, there was a right hepatic artery giving rise to a gastroduodenal but an absence of the left hepatic. On the left side, there was a branch coursing towards the porta hepatis; the left hepatic artery, dividing into the left gastric, an accessory left gastric, and a branch to the distal oesophagus. The hepato-hepatic trunk formed a ring-shaped vascular structure around the caudate lobe of the liver. Precise mapping and observation of the extrahepatic arteries and bile duct branches is essential in a variety of hepato-biliary laparoscopic procedures of the liver and gallbladder. Other operative procedures requiring, a comprehensive kno-wledge of the varied coeliac trunk patterns are liver transplantation and arterial embolism for hepatic tumour therapy.

Supraclavicularis proprius muscle associated with supraclavicular nerve entrapment.

Entrapment neuropathy of the supraclavicular nerve is rare and, when it occurs, is usually attributable to branching of the nerve into narrow bony clavicular canals. We describe another mechanism for entrapment of this nerve with the aberrant muscle; supraclavicularis being found during the routine dissection of an embalmed 82-year-old cadaver. Our report details a unique location for this rare muscular variation whereby the muscle fibres originated posteriorly on the medial aspect of the clavicle before forming a muscular arch over the supraclavicular nerve and passing laterally towards the trapezius and acromion. We recommend that in clinical instances of otherwise unexplained unilateral clavicular pain or tenderness, nerve compression from the supraclavicularis muscle must be borne in mind.

Imaging appearances and clinical outcome following sacrectomy and ilio-lumbar reconstruction for sacral neoplasia.

OBJECTIVE: Sacrectomy and ilio-lumbar reconstruction is an uncommonly performed complex surgical procedure for the treatment of sacral neoplasia. There are many challenges in the post-operative period including the potential for tumor recurrence, infection, and construct failure. We present our experience of this patient cohort and describe the complications and imaging appearances that can be encountered during the follow-up period. MATERIALS AND METHODS: Retrospective review of our Orthopaedic Oncology database was undertaken which has been collected over a 30-year period to identify patients that had undergone sacrectomy and ilio-lumbar reconstruction. Pre and post-operative imaging including radiographs, CT, and MRI was reviewed. These were viewed by two experienced musculoskeletal radiologists with consensus opinion if there was disagreement over the imaging findings. Data regarding patient demographics, tumor type, and dimensions was collected. Serial review of radiographs, CT, and MRI was performed to assess implant position and integrity, strut graft position and union, and for the presence of recurrence within the surgical bed. RESULTS: Five male and two female patients (mean age 36 years, age range 15-54 years) were treated with this procedure. Histological diagnoses included chordoma, chondrosarcoma, osteosarcoma, and spindle cell sarcoma. Mean maximal tumor size on pre-operative imaging was 10.7 cm (range, 6-16 cm). Post-operative follow-up ranged from 10-46 months. A total of 76 imaging studies were reviewed. Commonly identified complications included vertical rod and cross-connector fracture and screw loosening. Fibula strut graft non-union and fracture was also evident on imaging review. Two patients demonstrated disease recurrence during the follow-up period. CONCLUSIONS: This study demonstrates the spectrum and frequency of complications that can occur following sacrectomy and ilio-lumbar reconstruction for sacral neoplasia.

Data acquisition in a high-speed rotating frame for New Mexico Institute of Mining and Technology liquid sodium αω dynamo experiment.

New Mexico Institute of Mining and Technology liquid sodium αω-dynamo experiment models the magnetic field generation in the universe as discussed in detail by Colgate, Li, and Pariev [Phys. Plasmas 8, 2425 (2001)]. To obtain a quasi-laminar flow with magnetic Reynolds number R(m) ~ 120, the dynamo experiment consists of two co-axial cylinders of 30.5 cm and 61 cm in diameter spinning up to 70 Hz and 17.5 Hz, respectively. During the experiment, the temperature of the cylinders must be maintained to 110 °C to ensure that the sodium remains fluid. This presents a challenge to implement a data acquisition (DAQ) system in such high temperature, high-speed rotating frame, in which the sensors (including 18 Hall sensors, 5 pressure sensors, and 5 temperature sensors, etc.) are under the centrifugal acceleration up to 376g. In addition, the data must be transmitted and stored in a computer 100 ft away for safety. The analog signals are digitized, converted to serial signals by an analog-to-digital converter and a field-programmable gate array. Power is provided through brush/ring sets. The serial signals are sent through ring/shoe sets capacitively, then reshaped with cross-talk noises removed. A microcontroller-based interface circuit is used to decode the serial signals and communicate with the data acquisition computer. The DAQ accommodates pressure up to 1000 psi, temperature up to more than 130 °C, and magnetic field up to 1000 G. First physics results have been analyzed and published. The next stage of the αω-dynamo experiment includes the DAQ system upgrade.

Giant cell tumour with a lipoma of the sacrum.

We report the case of a 58-year old female who presented with insidious low back pain radiating to the buttock and thigh. Magnetic resonance imaging revealed a heterogenous high-signal (on T2-weighting) in the midline of the sacrum. Within this mass was a distinct area of low-signal intensity. Computed tomography revealed a lytic lesion within the sacrum. Biopsy confirmed the presence of a lipoma that contained within it a giant cell tumour. The patient proceeded to have surgical excision and bone graft augmentation.

Are there atomic orbitals in a molecule?

Effective atomic orbitals (AOs) have been calculated by the method of the "fuzzy atoms" analysis by using the numerical molecular orbitals (MOs) obtained from plane-wave DFT calculation, i.e., without introducing any atom-centered functions. The results show that in the case of nonhypervalent atoms there are as many effective AOs with non-negligible occupation numbers, as many orbitals are in the classical minimal basis set of the given atom. This means that, for nonhypervalent systems, it is possible to present the MOs as sums of effective atomic orbitals that resemble very much the atomic minimal basis orbitals of the individual atoms (or their hybrids). For hypervalent atoms some additional orbitals basically of d-type are also of some importance; they are necessary to describe the back-donation to these positive atoms. It appears that the d-type orbitals play a similar role also for strongly positive carbon atoms. The method employed here is also useful to decide whether the use of polarization functions of a given type is a matter of conceptual importance or has only a numerical effect.

High magnetic shear gain in a liquid sodium stable Couette flow experiment: a prelude to an α-Ω dynamo.

The Ω phase of the liquid sodium α-Ω dynamo experiment at New Mexico Institute of Mining and Technology in cooperation with Los Alamos National Laboratory has demonstrated a high toroidal field B(ϕ) that is ≃8×B(r), where B(r) is the radial component of an applied poloidal magnetic field. This enhanced toroidal field is produced by the rotational shear in stable Couette flow within liquid sodium at a magnetic Reynolds number Rm≃120. Small turbulence in stable Taylor-Couette flow is caused by Ekman flow at the end walls, which causes an estimated turbulence energy fraction of (δv/v)(2)∼10(-3).

Factors associated with the suppressiveness of sugarcane soils to plant-parasitic nematodes.

Observations in three Australian sugarcane fields suggested that the soil just under the trash blanket (the covering of crop residue that remains on the soil surface after crops are harvested) was suppressive to plant-parasitic nematodes. Roots were concentrated in this upper layer of soil but plant-parasitic nematode populations were relatively low and roots showed few signs of nematode damage. Root biomass was much lower 15 cm further down the soil profile, where root health was poor and populations of plant-parasitic nematodes were 3-5 times higher than near the soil surface. A bioassay in which Radopholus similis (a nematode that does not occur in sugarcane soils) was inoculated into heat-sterilized and untreated soils, confirmed that biological factors were limiting nematode populations in some of the soils, with soil from 0-2 cm much more suppressive than soil from 15-17 cm. Surface soil from one site was highly suppressive, as only 16% of R. similis recoverable from heated soil were retrieved from this soil after 8 days. Numerous soil chemical, biochemical, and biological properties were measured, and non-linear regression analysis identified two major groups of factors that were significantly associated with suppressiveness. One group reflected the amount of organic matter in soil (total C, total N, and labile C) and the other was associated with the size of the free-living nematode community (total numbers of free-living nematodes, and numbers of plant associates, bacterial feeders, fungal feeders, and carnivores). These results suggested that suppressiveness was biologically mediated and was sustained by C inputs from crop residues and roots. Since nematode-trapping fungi in the test soils could not be quantified using traditional dilution plating methods, their possible role as suppressive agents was assessed by generating TRFLP profiles with Orbiliales-specific primers, and by sequencing cloned PCR products. Although the molecular data were obtained from a limited number of samples, the level of suppression was significantly correlated to the number of Orbiliales clone groups and was also related to the number of Orbiliales species and TRFs, suggesting that this group of fungi may have been one of the suppressive factors operating in the test soils.

Giant cell tumour of the sacrum: a suggested algorithm for treatment.

To investigate the outcome of our management of patients with giant cell tumour of the sacrum and draw lessons from this. A retrospective review of medical records and scans for all patients treated at our unit over the past 20 years with a giant cell tumour of the sacrum. Of the 517 patients treated at our unit for giant cell tumour over the past 20 years, only 9 (1.7%) had a giant cell tumour in the sacrum. Six were female, three male with a mean age of 34 (range 15-52). All, but two tumours involved the entire sacrum and there was only one purely distal to S3. The mean size was 10 cm and the most common symptom was back or buttock pain. Five had abnormal neurology at diagnosis, but only one presented with cauda equina syndrome. The first four patients were treated by curettage alone, but two patients had intraoperative cardiac arrests and although both survived all subsequent curettages were preceded by embolisation of the feeding vessels. Of the seven patients who had curettage, three developed local recurrence, but all were controlled with a combination of further embolisation, surgery or radiotherapy. One patient elected for treatment with radiotherapy and another had excision of the tumour distal to S3. All the patients are alive and only two patients have worse neurology than at presentation, one being impotent and one with stress incontinence. Three patients required spinopelvic fusion for sacral collapse. All patients are mobile and active at a follow-up between 2 and 21 years. Giant cell tumour of the sacrum can be controlled with conservative surgery rather than subtotal sacrectomy. The excision of small distal tumours is the preferred option, but for larger and more extensive tumours conservative management may well avoid morbidity whilst still controlling the tumour. Embolisation and curettage are the preferred first option with radiotherapy as a possible adjunct. Spinopelvic fusion may be needed when the sacrum collapses.

An outbreak of infection with Bacillus anthracis in injecting drug users in Scotland.

An investigation is currently underway to explore and control an outbreak of Bacillus anthracis among drug users (mainly injecting) in Scotland. Contaminated heroin or a contaminated cutting agent mixed with the heroin is considered to be the most likely source and vehicle of infection. Heroin users have been advised of the risk. The risk to the general public is regarded as very low.

Definition and constituents of maltreatment in sport: establishing a conceptual framework for research practitioners.

There has recently been an increased emergence of research on the maltreatment of athletes in sport. It is suggested that research may play a particularly salient role with respect to athlete protection initiatives. However, as it stands, current research in this area is limited by a lack of consistency in definitions. The purpose of the paper, therefore, is to propose a conceptual framework of maltreatment in sport to be used among research practitioners. More specifically, a conceptual model of the different categories, constructs and constituents of maltreatment in sport is proposed. Sport-specific examples of the various maltreatments are outlined. Current literature is reviewed, and recommendations are made for future research.

The effect of mesalazine therapy on quality of life in patients with mildly and moderately active ulcerative colitis.

BACKGROUND: Ulcerative colitis (UC) has a major impact on the quality of life (QoL) of affected patients. Patient-reported outcomes have not been thoroughly evaluated in patients with UC receiving oral mesalazine (mesalamine). AIM: To examine the effect of mesalazine on QoL of patients with mildly and moderately active UC and assess the time course of change, baseline disease severity, mesalazine dose and responder status on QoL parameters. METHODS: Inflammatory Bowel Disease Questionnaire (IBDQ) data were combined from two double-blind, randomized, multicentre, active-controlled trials assessing 2.4 and 4.8 g/day oral delayed-release mesalazine in 687 patients. Mean score changes from baseline were compared at 3 and 6 weeks and effects of baseline severity, mesalazine dose and response to therapy were examined. RESULTS: Mesalazine significantly improved IBDQ scores at 3 and 6 weeks (mean increase, 29.6 and 39.7 points, respectively; P < 0.0001 for both). Improvement was greater for patients with moderate disease. Greater week 6 changes occurred in clinical responders than nonresponders (50.1 vs. 23.6 points, respectively; P < 0.0001). CONCLUSIONS: Delayed-release oral mesalazine produces significant clinical and statistical improvements in QoL of patients with UC by 3 weeks, with further improvement at 6 weeks.

Triple therapy in early active rheumatoid arthritis: a randomized, single-blind, controlled trial comparing step-up and parallel treatment strategies.

OBJECTIVE: The Tight Control of Rheumatoid Arthritis study previously demonstrated that an intensive step-up disease-modifying antirheumatic drug (DMARD) treatment strategy targeting persistent disease activity was superior to routine care in the management of early rheumatoid arthritis (RA). We undertook this study to test the hypothesis that early parallel triple therapy achieves better outcomes than step-up therapy within an intensive disease management regimen. METHODS: Ninety-six patients with early RA (mean disease duration 11.5 months) were randomized to receive step-up therapy (sulfasalazine [SSZ] monotherapy, then after 3 months, methotrexate [MTX] was added, and when the maximum tolerated dosage of MTX was reached, hydroxychloroquine [HCQ] was added) or parallel triple therapy (SSZ/MTX/HCQ). All patients were assessed monthly for 12 months. If their disease activity score in 28 joints (DAS28) was > or =3.2, the dosage of DMARDs was increased according to protocol, and swollen joints were injected with triamcinolone acetonide (maximum dosage 80 mg per month). A metrologist who was blinded to the treatment allocation performed assessments every 3 months. The primary outcome measure was the mean decrease in the DAS28 score at 12 months. RESULTS: Both groups showed substantial improvements in disease activity and functional outcome. At 12 months, the mean decrease in the DAS28 score was -4.0 (step-up therapy group) versus -3.3 (parallel therapy group) (P = 0.163). No significant differences in the percentages of patients with DAS28 remission (step-up therapy group 45% versus parallel triple therapy group 33%), DAS28 good response (60% versus 41%, respectively), or American College of Rheumatology criteria for 20% improvement (ACR20) (77% versus 76%, respectively), ACR50 (60% versus 51%, respectively), or ACR70 (30% versus 20%, respectively) responses were seen. Radiologic progression was similar in both groups. CONCLUSION: This study confirms that highly effective control of disease activity can be achieved using conventional DMARDs as part of an intensive disease management strategy. Within this setting, step-up therapy is at least as effective as parallel triple therapy.