What are the risk factors for complications after combined injury of the pelvic ring and acetabulum?

PURPOSE: Combined acetabular and pelvic ring injuries represent a unique subset of pelvic trauma and little is known regarding their complications and outcomes. We sought to further evaluate these injury patterns and quantify their outcomes. METHODS: A retrospective review at a single level 1 trauma center was performed on all patients with operatively treated combined ring and acetabulum injuries during a seven-year period. Main outcome measurements include all-cause complication including residual neurologic deficit, deep infection, conversion to total hip arthroplasty, deep venous thrombosis and mortality. RESULTS: Seventy operatively treated combined ring and acetabulum patients with one-year follow-up were reviewed. The overall complication rate was 44%. Hip dislocation occurred in 40% of the cohort and was significantly associated with residual neurologic deficit and all-cause complication. Angiography with embolization was not associated with an increased rate of deep infection. Open acetabular approaches had a significantly higher complication rate compared to percutaneous procedures. Delay to definitive fixation greater than 36 h trended toward but did not reach association with all complications. CONCLUSION: Combined injuries to the acetabulum and pelvic ring have high rates of complications. No individual fracture patterns were identified as risk factors, but hip dislocation was associated with an increased rate of complications. When possible, percutaneous reduction and fixation of acetabular fractures and early definitive fracture fixation lead to lower rates of complications. Use of angiography with embolization appears to be safe and does not increase the risk of infection or other complications.

A Review of GNSS/GPS in Hydrogeodesy: Hydrologic Loading Applications and Their Implications for Water Resource Research.

Hydrogeodesy, a relatively new field within the earth sciences, is the analysis of the distribution and movement of terrestrial water at Earth's surface using measurements of Earth's shape, orientation, and gravitational field. In this paper, we review the current state of hydrogeodesy with a specific focus on Global Navigation Satellite System (GNSS)/Global Positioning System measurements of hydrologic loading. As water cycles through the hydrosphere, GNSS stations anchored to Earth's crust measure the associated movement of the land surface under the weight of changing hydrologic loads. Recent advances in GNSS-based hydrogeodesy have led to exciting applications of hydrologic loading and subsequent terrestrial water storage (TWS) estimates. We describe how GNSS position time series respond to climatic drivers, can be used to estimate TWS across temporal scales, and can improve drought characterization. We aim to facilitate hydrologists' use of GNSS-observed surface deformation as an emerging tool for investigating and quantifying water resources, propose methods to further strengthen collaborative research and exchange between geodesists and hydrologists, and offer ideas about pressing questions in hydrology that GNSS may help to answer.

Geographic variation in the frequency and potency of postoperative opioid prescriptions for extremity fracture surgery. A retrospective cohort study.

Introduction: There is increasing evidence that the prescription opioid crisis is spreading internationally. However, there is scarce literature comparing contemporary prescribing practices between units in different countries, particularly in the context of this evolving international problem. We sought to determine the patterns of postoperative opioid prescribing in three hospitals from geographically distinct regions. Methods: This is a retrospective cohort study involving patients from three hospitals: XXX, Maine, USA; XXX, Scotland; and XXX, Australia. The health records, surgical details, and frequency and potency of discharge prescriptions were analyzed for 350 patients receiving surgery for isolated wrist or ankle fractures. Regression analysis was used to identify independent predictors of prescription opioid provision. Results: Following ankle fracture surgery, Aberdeen patients (OR 6.0, 95% CI 3.0-11.5) and Adelaide patients (11.8, 95% CI 4.1-39.6) were significantly more likely to receive a prescription for opioids than those in Augusta (p < 0.001). For distal radius fractures, this was also the case (Aberdeen OR 21.2, 95% CI 7.2-79.3, Adelaide OR 21.6, 95% CI 7.3-81.3). For both fracture groups, the potency of prescription provided (measured in morphine milligram equivalents) was not significantly different. When opioids were included in the discharge prescription, Adelaide prescribers favored strong opioids, Aberdeen prescribers selected weak opioids, and prescribers in Augusta chose an even distribution of both types (p < 0.001). Multivariate analysis demonstrated that the odds of receiving prescription opioids were significantly influenced by geographic location and decreased by advancing patient age. Conclusions: Geographic location is a key factor influencing the provision of postoperative opioids. We found no association with fracture type, patient demographic factors or intra-operative practices. Prescriber culture is likely an influential determinant of postoperative opioid provision. Emphasis on patient and prescriber education regarding the risks of prescription opioids and their potential long-term sequelae is key if we wish to change modifiable prescriber behavior.

Spinal epidural abscesses - The role for non-operative management: A systematic review.

BACKGROUND: Spinal Epidural Abscesses (SEAs) are traditionally seen as a surgical emergency. However, SEAs can be discovered in entirely asymptomatic patients. This presents a dilemma for the attending clinician as to whether to subject these patients to significant surgery. This systematic review updates the evidence surrounding the efficacy of non-operative SEA management by means of intravenous antibiotics ± radiologically-guided aspiration. AIMS: 1. To assess failure rates of medical therapy for SEA. The absolute definition of 'failure' used by the study was recorded, and comparisons made. 2. To review of risk factors for success/failure of medical treatment for SEA. METHODS: A database search with the MESH term 'epidural abscess' and keywords ['treatment' OR 'management'] were used. RESULTS: 14 studies were included. The number of SEA patients managed non-operatively ranged from 19 to 142. There was significant heterogeneity across the studies. Pooled Failure of Medical Therapy (FMT) (defined as any poor outcome) was 29.40%. When FMT = mortality the pooled rate was 11.49%. Commonly cited risk factors for FMT included acute neurological compromise, diabetes mellitus, increasing age and Staphylococcus aureus. CONCLUSION: SEA will always be a condition mostly managed surgically. Despite this, there is growing evidence that non-operative management can be possible in the correct patients. The key is in patient selection - patients with any of the above-mentioned risk factors have the potential to deteriorate further on medical treatment and have a worse outcome than if they had undergone emergency surgery straight away. Ongoing research will hopefully further investigate this crucial step.

Natural and anthropogenic processes affecting radon releases during mining and early stage reclamation activities, Pinenut uranium mine, Arizona, USA.

Radon (Rnair) was monitored in open air in publicly accessible areas surrounding the Pinenut uranium (U) mine during mining and reclamation activities in 2015-16 to address concerns about mining related effects to areas surrounding Grand Canyon National Park (GCNP) in Arizona, USA. During July 2015, Rnair concentrations associated with the ore storage pile monitoring site were larger than those at the mine vent monitoring site and likely resulted from the relatively large amount of ore stored on site during this period. Higher wind velocities at the ore pile monitoring site generally resulted in lower Rnair concentrations; however, wind velocity did not appear to be an important factor in controlling Rnair concentrations at the mine vent monitoring site. Physical disturbances of the ore pile by heavy equipment did not coincide with elevated Rnair concentrations at the ore storage pile or mine vent monitoring sites. The relative size of the ore storage pile showed a positive trend with the daily mean Rnair concentration measured at the ore pile monitoring site. Principal component analysis (PCA) was applied to the ore pile and mine vent multivariate data sets for simultaneous comparison of all measured variables during 230 days of the study period. A significant positive coefficient for Rnair was associated with a significant negative coefficient for wind speed for principal component (PC) 2ore pile. Significant, positive PC2mine vent coefficients included Rnair, wind direction, and relative ore pile size indicating that Rnair variations at the mine vent monitoring site may be affected by Rn sourced from the ore pile. The ore pile is located about 200 m south of the mine vent Rn monitor with the prevalent wind direction coming from the south. All data generated during the field study and laboratory verification tests were published by Naftz et al. (2018) and are available online at: https://doi.org/10.5066/F79Z946T.

Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data.

PURPOSE: Major depression is a leading cause of morbidity in military populations. However, due to a lack of longitudinal data, little is known about the rate at which military personnel experience the onset of new episodes of major depression. We used a new source of clinical and administrative data to estimate the incidence of major depression diagnoses in Canadian Armed Forces (CAF) personnel, and to compare incidence rates between demographic and occupational factors. METHODS: We extracted all data recorded in the electronic medical records of CAF Regular Force personnel, at every primary care and mental health clinical encounter since 2016. Using a 12-month lookback period, we linked data over time, and identified all patients with incident diagnoses of major depression. We then linked clinical data to CAF administrative records, and estimated incidence rates. We used multivariate Poisson regression to compare adjusted incidence rates between demographic and occupational factors. RESULTS: From January to December 2017, CAF Regular Force personnel were diagnosed with major depression at a rate of 29.2 new cases per 1000 person-years at risk. Female sex, age 30 years and older, and non-officer ranks were associated with significantly higher incidence rates. CONCLUSIONS: We completed the largest study to date on diagnoses of major depression in the Canadian military, and have provided the first estimates of incidence rates in CAF personnel. Our results can inform future mental health resource allocation, and ongoing major depression prevention efforts within the Canadian Armed Forces and other military organizations.

Atmospheric ammonia (NH3) emanations from Lake Natron's saline mudflats.

In a recent global analysis of satellite-derived atmospheric NH3 data, a hotspot was observed in the vicinity of Lake Natron, Tanzania. The lake is in the centre of an endorheic (limited drainage) basin and has shallow, saline-alkaline waters. Its remote location and the absence of nearby large anthropogenic sources suggest that the observed NH3 is mainly of natural origin. Here we explore 10 years of IASI NH3 satellite data and other publicly available datasets over the area to characterize the natural NH3 emissions in this unique ecosystem. Temporal analysis reveals that the emissions are episodic and linked with the lake's surface area. The largest NH3 column loadings generally occur at the end of the dry season in September-November over Lake Natron's largest mudflat, that is exposed with receding water levels. The timing is different from the agricultural dominated NH3 emissions in the wider Natron area, which peak early in the year, after the first wet season. The likely source of NH3 at Lake Natron is decomposition of organic material, either from rivers and springs or produced in the lake (plankton, bird excreta). High temperatures and alkalinity are known to promote NH3 losses from soda lakes. We formulate six processes that may explain why the largest losses are observed specifically over concentrated brines and/or exposed sediments. As a by-product, we also show that hyperspectral infrared sounders such as IASI are capable of mapping different types of evaporative minerals such as trona and thermonatrite.

Seasonal Population Dynamics of Megacopta cribraria (Hemiptera: Plataspidae) in Kudzu and Soybean, and Implication for Insecticidal Management in Soybean.

Megacopta cribraria (F.), an invasive species introduced from Asia in 2009, is now prolific in the southeastern United States. Megacopta cribraria develops primarily on kudzu and soybean completing two generations. It is not well understood how this economic pest is affected by changes in geographic distribution in the United States or how population levels have changed since its establishment. The effect of insecticide application timing on field populations of M. cribraria is not well documented. These studies seek to understand how population dynamics of M. cribraria vary with geographic regions in Georgia. Effect of application timing on populations throughout the growing season was also examined. Weekly from 2012 to 2013, all life stages were enumerated from kudzu and soybean environments at several locations throughout Georgia from sweeps samples and flight intercept captures. Coordinates were recorded for locations, and classified as belonging to the Piedmont or Coastal Plain region of the state. Single spray trials were conducted from 2011-2014, and applications were made to soybean at intervals throughout the season. From 2012 to 2015, two kudzu patches near Griffin, GA, were monitored to detect population changes. Differences in population dynamics from locations around the state were found, but no clear effect of latitude, longitude, or region was observed. Insecticide applications applied in July suppressed nymph populations significantly better than treatments made earlier or later. Megacopta cribraria populations declined in 2014 and 2015 compared with 2012 and 2013. These studies provide the critical information for M. cribraria management in soybean in the southeastern United States.

Biotic and abiotic controls on co-occurring nitrogen cycling processes in shallow Arctic shelf sediments.

The processes that convert bioavailable inorganic nitrogen to inert nitrogen gas are prominent in continental shelf sediments and represent a critical global sink, yet little is known of these pathways in the Arctic where 18% of the world's continental shelves are located. Moreover, few data from the Arctic exist that separate loss processes like denitrification and anaerobic ammonium oxidation (anammox) from recycling pathways like dissimilatory nitrate reduction to ammonium (DNRA) or source pathways like nitrogen fixation. Here we present measurements of these co-occurring processes using 15N tracers. Denitrification was heterogeneous among stations and an order of magnitude greater than anammox and DNRA, while nitrogen fixation was undetectable. No abiotic factors correlated with interstation variability in biogeochemical rates; however, bioturbation potential explained most of the variation. Fauna-enhanced denitrification is a potentially important but overlooked process on Arctic shelves and highlights the role of the Arctic as a significant global nitrogen sink.

Improving mental health care transitions for children and youth: a protocol to implement and evaluate an emergency department clinical pathway.

BACKGROUND: While the emergency department (ED) is often a first point of entry for children and youth with mental health (MH) concerns, there is a limited capacity to respond to MH needs in this setting. Child MH systems are typically fragmented among multiple ministries, organizations, and providers. Communication among these groups is often poor, resulting in gaps, particularly in transitions of care, for this vulnerable population. The evidence-based Emergency Department Mental Health Clinical Pathway (EDMHCP) was created with two main goals: (1) to guide risk assessment and disposition decision-making for children and youth presenting to the ED with MH concerns and (2) to provide a streamlined transition to follow-up services with community MH agencies (CMHAs) and other providers. The purpose of this paper is to describe our study protocol to implement and evaluate the EDMHCP. METHODS/DESIGN: This mixed methods health services research project will involve implementation and evaluation of the EDMHCP in four exemplar ED-CMHA dyads. The Theoretical Domains Framework will be used to develop a tailored intervention strategy to implement the EDMHCP. A multiple baseline study design and interrupted time-series analysis will be used to determine if the EDMHCP has improved health care utilization, medical management of the MH problems, and health sector coordination. The primary process outcome will be the proportion of patients with MH-specific recommendations documented in the health record. The primary service outcome will be the proportion of patients receiving the EDMHCP-recommended follow-up at 24-h or at 7 days. Data sources will include qualitative interviews, health record audits, administrative databases, and patient surveys. A concurrent process evaluation will be conducted to assess the degree of variability and fidelity in implementation across the sites. DISCUSSION: This paper presents a novel model for measuring the effects of the EDMHCP. Our development process will identify how the EDMHCP is best implemented among partner organizations to deliver evidence-based risk management of children and youth presenting with MH concerns. More broadly, it will contribute to the body of evidence supporting clinical pathway implementation within novel partnerships. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT02590302 ).

Tracking groundwater discharge to a large river using tracers and geophysics.

Few studies have investigated large reaches of rivers in which multiple sources of groundwater are responsible for maintaining baseflow. This paper builds upon previous work undertaken along the Fitzroy River, one of the largest perennial river systems in north-western Australia. Synoptic regional-scale sampling of both river water and groundwater for a suite of environmental tracers ((4) He, (87) Sr/(86) Sr, (222) Rn and major ions), and subsequent modeling of tracer behavior in the river, has enabled definition and quantification of groundwater input from at least three different sources. We show unambiguous evidence of both shallow "local" groundwater, possibly recharged to alluvial aquifers beneath the adjacent floodplain during recent high-flow events, and old "regional" groundwater introduced via artesian flow from deep confined aquifers. We also invoke hyporheic exchange and either bank return flow or parafluvial flow to account for background (222) Rn activities and anomalous chloride trends along river reaches where there is no evidence of the local or regional groundwater inputs. Vertical conductivity sections acquired through an airborne electromagnetic (AEM) survey provide insights to the architecture of the aquifers associated with these sources and general groundwater quality characteristics. These data indicate fresh groundwater from about 300 m below ground preferentially discharging to the river, at locations consistent with those inferred from tracer data. The results demonstrate how sampling rivers for multiple environmental tracers of different types-including stable and radioactive isotopes, dissolved gases and major ions-can significantly improve conceptualization of groundwater-surface water interaction processes, particularly when coupled with geophysical techniques in complex hydrogeological settings.

Discovery of blood transcriptomic markers for depression in animal models and pilot validation in subjects with early-onset major depression.

Early-onset major depressive disorder (MDD) is a serious and prevalent psychiatric illness in adolescents and young adults. Current treatments are not optimally effective. Biological markers of early-onset MDD could increase diagnostic specificity, but no such biomarker exists. Our innovative approach to biomarker discovery for early-onset MDD combined results from genome-wide transcriptomic profiles in the blood of two animal models of depression, representing the genetic and the environmental, stress-related, etiology of MDD. We carried out unbiased analyses of this combined set of 26 candidate blood transcriptomic markers in a sample of 15-19-year-old subjects with MDD (N=14) and subjects with no disorder (ND, N=14). A panel of 11 blood markers differentiated participants with early-onset MDD from the ND group. Additionally, a separate but partially overlapping panel of 18 transcripts distinguished subjects with MDD with or without comorbid anxiety. Four transcripts, discovered from the chronic stress animal model, correlated with maltreatment scores in youths. These pilot data suggest that our approach can lead to clinically valid diagnostic panels of blood transcripts for early-onset MDD, which could reduce diagnostic heterogeneity in this population and has the potential to advance individualized treatment strategies.

An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations.

OBJECTIVE: Bronchopulmonary dysplasia (BPD) is a pulmonary disease associated with poor neurodevelopmental and medical outcomes. Patients with BPD are medically fragile, at high risk for complications and require interdisciplinary care. We tested the hypothesis that a chronic care approach for BPD would improve neurodevelopmental outcomes relative to the National Institute of Child and Human Development Neonatal Research Network (NICHD NRN) and reduce medical complications. STUDY DESIGN: Infants were followed as inpatients and outpatients. Bayley developmental exams were carried out at 18-24 months of age and compared with the NICHD NRN report. Finally, rates of readmission (a proxy for medical complications) were compared before and after implementation of the Comprehensive Center for BPD (CCBPD). RESULT: Developmental scores obtained in 2007 and 2008 show that 12 and 10% of patients with moderate BPD (n=61) had Bayley Scores <70 for mental and motor indices respectively, whereas corresponding national rates were 35 and 26%. For patients with severe BPD (n=46), 15 and 11% of patients within the CCBPD vs 50 and 42% of national patients scored <70 for mental and motor indices, respectively. Finally, readmission rates dropped from 29% in the year before the implementation of the CCPD (n=269) to 5% thereafter (n=866, P<0.0001). CONCLUSION: The encouraging neurodevelopmental outcomes and readmission rates associated with a chronic care approach to BPD suggest these infants may be best served by a comprehensive interdisciplinary approach to care that focuses on neurodevelopment throughout the hospital stay.

Telehealth practice recommendations for diabetic retinopathy, second edition.

Ocular telemedicine and telehealth have the potential to decrease vision loss from DR. Planning, execution, and follow-up are key factors for success. Telemedicine is complex, requiring the services of expert teams working collaboratively to provide care matching the quality of conventional clinical settings. Improving access and outcomes, however, makes telemedicine a valuable tool for our diabetic patients. Programs that focus on patient needs, consider available resources, define clear goals, promote informed expectations, appropriately train personnel, and adhere to regulatory and statutory requirements have the highest chance of achieving success.

Aberrant expression of chromogranin A, miR-146a, and miR-146b-5p in prostate structures with focally disrupted basal cell layers: an early sign of invasion and hormone-refractory cancer?

Our recent studies have suggested that prostate tumor invasion is triggered by autoimmunoreactions induced focal basal cell layer disruptions (FBCLD) that selectively favor monoclonal proliferation of the overlying progenitors or of a biologically more aggressive cell clone. As circulating chromogranin-A (CgA) levels are found to correlate with tumor progression and the status of hormone refractoriness, our current study attempted to assess whether CgA-positive cells would be preferentially distributed in epithelial structures with FBCLD. Paraffin-embedded specimens from 50 patients with organ-confined prostate cancer were subjected to double immunohistochemical analysis with monoclonal antibodies to basal cells and CgA. From each case, 3-5 randomly selected fields were digitally photographed and the photos were magnified 400% and the numbers of CgA-positive cells in epithelial structures with non-disrupted, focally disrupted, and lost basal cell layer were separately counted. The averaged number of cell for each category was statistically compared with the Pearson's Chi-square test. In addition, morphologically similar structures with and without CgA-positive cell clusters were microdissected from four selected cases and subjected to a comparison of differential micro-RNA expression levels. Our study revealed that, although isolated CgA-positive cells were seen in both the basal cell layer and the luminal cell population in all cases, only 8 cases (16%) harbored large clusters of CgA-positive cells that were concentrated in a given area, in which all or nearly all cells appeared to share a similar morphological and immunohistochemical profile. Microdissected epithelial structures with CgA-positive cell clusters exhibited a more than 5- and 7-fold lower expression of miR-146a and miR-146b-5p than their CgA-negative counterparts. As focal basal cell layer disruptions and the reduction or loss of miR-146a and miR-146b-5p has been documented to correlate with prostate tumor invasion and hormone refractoriness, our findings suggest that aberrant CgA expression in epithelial structures with FBCLD may represent an early sign of these events.

Influence of dental esthetics on social perceptions of adolescents judged by peers.

INTRODUCTION: The relationship between physical appearance and social attractiveness is well established in the literature. The purpose of this study was to determine whether dental esthetics influenced the perceptions of teens when judging a peer's athletic, social, leadership, and academic abilities. METHODS: The frontal-face smiling photographs of 10 teenage volunteers were each altered to create 1 image with an ideal arrangement of teeth and 1 with a nonideal arrangement. Two parallel surveys were constructed with 1 photo displaying either an ideal or a nonideal smile image of each subject. If the ideal smile image appeared in 1 survey, then the nonideal smile appeared in the other. Two hundred twenty-one peer evaluators successfully rated the pictures in 1 of the surveys by indicating their perception of each subject's athletic, social, leadership, and academic abilities. RESULTS: The subjects' photographs with ideal smile esthetics were consistently rated higher on average than the same subjects' images with nonideal smile esthetics. The differences in ratings between ideal and nonideal smiles were significant for perceptions of athletic performance (P = 0.0141), popularity (P <0.0001), and leadership ability (P <0.0001), but not for academic performance (P = 0.0548). CONCLUSIONS: On average, ratings for the ideal smiles in perceived athletic, social, and leadership skills were about 10% higher than those given for images with nonideal smiles. Based on these findings, it would be expected that orthodontic treatment resulting in improved smile esthetics can provide modest social benefits for adolescent patients.

Activity of bifenthrin, chlorfenapyr, fipronil, and thiamethoxam against red imported fire ants (Hymenoptera: Formicidae).

Bifenthrin, chlorfenapyr, fipronil, and thiamethoxam were evaluated for activity against the red imported fire ant, Solenopsis invicta Buren (Hymenoptera: Formicidae). Mobility impairment and lethal times were determined after topical treatments. Both immobilization and mortality occurred most quickly with bifenthrin, followed by thiamethoxam, chlorfenapyr, and fipronil. Mortality due to horizontal exposure was evaluated at 10, 20, or 30 degrees C, with three ratios of topically treated donor ant corpses to live recipients (5, 10, or 20% donors). Bifenthrin had the greatest horizontal activity of the chemicals tested. For chlorfenapyr, the only treatments having higher mortality than controls were the highest percentage donors at either 10 or 30 degrees C. Horizontal activity of fipronil was temperature dependent only with the highest proportion of donors and was lower than that ofbifenthrin but higher than that of chlorfenapyr or thiamethoxam. Mean mortality due to thiamethoxam was similar to that with chlorfenapyr. Significant mortality occurred in all of the 20 and 30 degrees C thiamethoxam treatments, but none of the 10 degrees C treatments. Effectiveness as a barrier was evaluated by providing a choice between bridges treated with insecticide or water. Although bifenthrin did not provide an impenetrable barrier, it was the only treatment having fewer ants than its paired control bridge. Mortality data suggest that a reduction in recruitment rather than repellency account for this result.

Activity of bifenthrin, chlorfenapyr, fipronil, and thiamethoxam against Argentine ants (Hymenoptera: Formicidae).

Bifenthrin, chlorfenapyr, fipronil, and thiamethoxam were evaluated for activity against the Argentine ant, Linepithema humile (Mayr) (Hymenoptera: Formicidae). Mobility impairment and lethal times were determined after topical treatments. Ants were immobilized most quickly by bifenthrin, followed by chlorfenapyr and thiamethoxam. After 2 h, the number of fipronil-treated ants unable to walk out of test arenas did not differ from control ants. Median lethal time (LT50) after topical treatment was lowest in the bifenthrin treatment, followed by thiamethoxam, chlorfenapyr, and then fipronil. Mortality due to horizontal exposure was evaluated at 10, 20, or 30 degrees C, with topically treated ant corpses serving as donors. There was low to moderate horizontal activity in bifenthrin and chlorfenapyr treatments, with no temperature effect in bifenthrin treatments and a positive temperature effect in chlorfenapyr treatments. Mortality in the fipronil treatments was highest and was positively correlated with temperature. Thiamethoxam treatments did not differ from controls at 10 degrees C, but mortality increased with temperature. To evaluate contact activity, either all of 20% of the ants in a cohort were exposed to insecticide-treated pine needles. In both tests, mortality was highest in fipronil and bifenthrin treatments, followed by thiamethoxam, with lowest mortality in chlorfenapyr treatments. Effectiveness as a barrier was evaluated by providing a choice between bridges treated with insecticide or water. Although bifenthrin did not provide an impenetrable barrier, it was the only treatment having fewer ants than its paired control. Mortality data suggest that lack of recruitment rather than repellency account for this result.

Personality disorders and nonfatal unintentional injuries among US adults.

OBJECTIVE: To investigate the association between personality disorders and nonfatal unintentional injuries in a representative sample of US adults. METHODS: Data on self-reported nonfatal unintentional injuries during the 12 months before the interview were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed; 43,093 adults > or = 18 years participated in the NESARC wave I survey in 2001-02. Personality disorders were determined using the NIAAA Alcohol Use Disorders and Associated Disabilities Interview Schedule-DSM-IV. RESULTS: Individuals with at least one personality disorder had a significantly higher 12-month incidence of injuries than people without any personality disorder (p<0.001). After accounting for sociodemographic characteristics or other mental disorders, OR was 1.54 (95% CI 1.39 to 1.71) for individuals with one personality disorder and 1.80 (95% CI 1.58 to 2.05) for individuals with two or more personality disorders compared with people with no personality disorder. CONCLUSION: Personality disorders were associated with a significantly increased risk of unintentional injuries. This information has important implications for the treatment of patients with these disorders.

The decomposition of wood products in landfills in Sydney, Australia.

Three landfill sites that had been closed for 19, 29 and 46 years and had been operated under different management systems were excavated in Sydney. The mean moisture content of the wood samples ranged from 41.6% to 66.8%. The wood products recovered were identified to species, and their carbon, cellulose, hemicellulose and lignin concentration were determined and compared to those of matched samples of the same species. No significant loss of dry mass was measured in wood products buried for 19 and 29 years, but where refuse had been buried for 46 years, the measured loss of carbon (as a percentage of dry biomass) was 8.7% for hardwoods and 9.1% for softwoods, equating to 18% and 17% of their original carbon content, respectively. The results indicate that published decomposition factors based on laboratory research significantly overestimate the decomposition of wood products in landfill.