Litter behaviour on Mediterranean cobble beaches, SE Spain.

Despite the large research effort on reporting quantities of coastal litter, the dynamics of this litter is not yet sufficiently understood. Litter inputs in five cobble beaches located in the Mediterranean (Spain) were studied over three months during winter by biweekly litter tagging. Plastic represented the dominant material that reached the beaches (77%). In remote and narrow beaches, storms constituted the main driver in litter dynamics, favouring the accumulation of floating items such as plastic bottles and wood fragments as well as the largest but contrasting effects, increasing litter inputs and outputs from the beach, respectively. In rural beaches, beach users, mainly fisher people, but also tourists, contributed to a notable input of litter to the beach. Burial and exhumation of litter were reported as common occurring processes. Better management actions are required to improve beach environmental quality.

Beach litter distribution along the western Mediterranean coast of Spain.

The amount and composition of beach litter was assessed, during spring 2018, at 56 sites along the coast of Alicante Province, on the western Mediterranean Sea. Selected sites covered "natural" (19), "village" (17) and "urban" (20) bathing areas and a total of 10,101 litter items was counted in an area of 201,686 m2. Plastic represented the dominant material with 8345 items, i.e. 82.6% of all debris; paper and cardboard numbered 566 items (i.e. 5.6%); pottery and ceramics 348 (3.4%); metal 325 (3.2%); cloth 231 (2.3%); glass 147 (1.5%); rubber 64 (0.6%); wood 46 (0.5%) and other materials summed 29 items, i.e. 0.3% of all debris. Cigarette butts, 45.6% of total items, were observed at different coastal sites: i.e. 1028 units at natural, 1148 at village and 2431 at urban sites. Despite the efforts of local administrations, which enforced cleaning operations at most sites, litter items were essentially related to beachgoers followed by wastewater discharges and fishing activities.

Beach litter sourcing: A trawl along the Northern Ireland coastline.

Fourteen non-recreational coastal locations in Northern Ireland were investigated as to whether beach litter deposition was related to seasonal or site specific factors. Litter items were counted in 100m width transects and 1km strand-line surveys over a five-season period (autumn to autumn). Survey sites comprised fishing ports; estuarine areas, north (high energy) and east coast (low energy) beaches. Fishing ports accumulated the most litter. In the 100m beach surveys, plastics, string and cord, bottle caps, food items, rope, and drink containers dominated. In strand-line surveys, large plastic pieces were dominant, followed by rope, string and cord, strapping bands (absent on beach surveys), cloth, wood (mainly pallets, fish boxes) and metal items. Multivariate analyses revealed major litter category differences between the ports and all other sites, with a lesser distinction between exposed and estuarine sites. There was no simple coastline trend and no apparent effect of seasonality between samples.

Litter assessment on 99 Cuban beaches: A baseline to identify sources of pollution and impacts for tourism and recreation.

Litter presence was assessed on the entire Cuban coastline, and includes 99 beaches from all Cuban regions, during field work carried out in 2012 and 2015. A standard method verified in several countries was applied, which classified beaches for nine types of litter into four grades (A-excellent to D-poor). Almost half of the Cuban beaches obtained excellent cleanliness scores, although many needed to be better managed. In this baseline, the most common types of residue were general litter (8% grade D and 35% grades B/C) and potentially harmful litter (<68% with grade A). Resort beaches and those with international visitors showed the best litter management. Tourism Impacts seems to be related to visitor origin therefore choices to develop sustainable tourism in rural and village beaches (64%) appears low, if beach cleaning gross investment is focused on resort beaches (24%). Finally, this paper highlights geographical distribution and types of litter patterns.

The benefit of silicone stents in primary endonasal dacryocystorhinostomy: a systematic review and meta-analysis.

OBJECTIVE: To critically evaluate the evidence comparing success rates of endonasal dacryocystorhinostomy (EN-DCR) with and without silicone tubing and to thus determine whether silicone intubation is beneficial in primary EN-DCR. DESIGN: Systematic review and meta-analysis. SEARCH STRATEGY: A literature search was performed on AMED, EMBASE, HMIC, MEDLINE, PsycINFO, BNI, CINAHL, HEALTH BUSINESS ELITE, CENTRAL and Cochrane Ear, Nose and Throat disorders groups trials register using a combination of various MeSH. The date of last search was January 2016. This review was limited to randomised controlled trials (RCTs) in English language. Risk of bias was assessed using the Cochrane Collaboration's risk of bias tool. Chi-square and I2 statistics were calculated to determine the presence and extent of statistical heterogeneity. EVALUATION METHOD: Study selection, data extraction and risk of bias scoring were performed independently by two authors in concordance with the PRISMA statement. RESULTS: Five RCTs (447 primary EN-DCR procedures in 426 patients) were included for analysis. Moderate interstudy statistical heterogeneity was demonstrated (Chi2 = 6.18; d.f. = 4; I2 = 35%). Bicanalicular silicone stents were used in 229 and not used in 218 procedures. The overall success rate of EN-DCR was 92.8% (415/447). The success rate of EN-DCR was 93.4% (214/229) with silicone tubing and 92.2% (201/218) without silicone tubing. Meta-analysis using a random-effects model showed no statistically significant difference in outcomes between the two groups (P = 0.63; RR = 0.79; 95% CI = 0.3-2.06). CONCLUSIONS: Our review and meta-analysis did not demonstrate an additional advantage of silicone stenting. A high-quality well-powered prospective multicentre RCT is needed to further clarify on the benefit of silicone stents.

Incidence of neoplasia in patients with clinically suspicious nasal lesions and the value of computed tomography imaging in diagnosis.

BACKGROUND: There is no consensus as to whether all routine bilateral polypectomy specimens should be sent for formal histopathological diagnosis to exclude underlying neoplastic pathology. This study assessed the necessity for histopathological investigation as routine practice in cases of bilateral and unilateral nasal lesions by estimating the incidence of unexpected pathologies. It also evaluated the ability of computed tomography to predict histopathological diagnosis in patients with unilateral nasal lesions. METHODS: A retrospective analysis was conducted of 98 patients undergoing nasal polypectomy over a 12-month period. RESULTS: Five of 23 patients with a unilateral lesion on nasendoscopy had inverted papillomas on histopathological examination. None of the 75 patients with clinically bilateral lesions on nasendoscopy showed evidence of neoplasia on histopathological examination. Patients with inverted papillomas had significantly lower total Lund-Mackay scores than those with bilateral polyps. Asymmetry scores of inverted papilloma patients were significantly higher compared to both bilateral and unilateral polyps patients. CONCLUSION: The results suggest that histopathological diagnosis is only necessary in unilateral lesion patients as no unexpected histopathological diagnoses were made in bilateral lesion patients. Computed tomography imaging may have a role in predicting histopathological diagnosis by demonstrating asymmetry and less overall sinus opacification in patients with neoplastic lesions.

From a millennium base line to 2012: beach litter changes in Wales.

Forty-five beaches at 41 bathing area locations in Wales were analysed for litter in 2000 and 2012, via a standard seven category checklist. Fourteen resorts, 2 urban, 11 village, 15 rural 3 remote, were graded, A to D. A grade beach numbers changed from 5 to19; B, 27 to 24; C, 9 to 2; D, 4 to 0, many beaches maintaining their current status. Assuming trend continuance within the next 12 years, the A:B grade ratio would approach equilibrium of 44:56, with no grade C or D beaches. Recreational litter was ubiquitous; fishing materials prevalent along Cardigan Bay. New water treatment plant investment reduced sewage related debris. Despite apparent increased awareness of beach litter, improving visitor behaviour through information/education should be a future priority. Removing a few gross items could improve beach grades at little cost to local authorities and benefits to the Welsh economy.

Desalination impacts on the coastal environment: Ash Shuqayq, Saudi Arabia.

Ash Shuqayq (Saudi Red Sea coast) is approximately 28km long and characterised by narrow rocky headlands with intermittent pocket beaches. Fifty-two sediment samples from six different environments (beach, dune, sabkha, tidal/lagoon, offshore and wadi) were analysed. Testing showed that beach and dune sands are mainly medium to fine grained, with some very coarse sand (MZ=-0.59ø). Both beach and dune sands are moderately well to moderately sorted, although some are poorly sorted due to an influx of wadi sediments. Sediment source together with littoral reworking contributed to grain size variation. Carbonate content varied between 1.5% and 23%, whilst the organic content varied between 1.1% and 13%. Spatial analysis showed increasing southward carbonate and organic content, with both correlated (r=0.57). Sabkha sediments had significantly higher carbonate percentages (t=2.898; df=18; p<0.01) and results suggested origins are similar for both UAE Arabian Sea and Saudi Arabian Red Sea coasts. X-ray diffractions show beach and dune sediments are mainly composed of detrital quartz and plagioclase feldspar with uncommon amounts of chlorites. Analysis of sediment characteristics, composition and shoreline distribution alongside coastal processes, indicate that high chlorite levels are probably caused by desalination processes. Due to human and ecosystem health consequences and the likely increased demand for desalination plants, similar analyses should be undertaken elsewhere, e.g. the Mediterranean.

A review of the impact of climate change on future nitrate concentrations in groundwater of the UK.

This paper reviews the potential impacts of climate change on nitrate concentrations in groundwater of the UK using a Source-Pathway-Receptor framework. Changes in temperature, precipitation quantity and distribution, and atmospheric carbon dioxide concentrations will affect the agricultural nitrate source term through changes in both soil processes and agricultural productivity. Non-agricultural source terms, such as urban areas and atmospheric deposition, are also expected to be affected. The implications for the rate of nitrate leaching to groundwater as a result of these changes are not yet fully understood but predictions suggest that leaching rate may increase under future climate scenarios. Climate change will affect the hydrological cycle with changes to recharge, groundwater levels and resources and flow processes. These changes will impact on concentrations of nitrate in abstracted water and other receptors, such as surface water and groundwater-fed wetlands. The implications for nitrate leaching to groundwater as a result of climate changes are not yet well enough understood to be able to make useful predictions without more site-specific data. The few studies which address the whole cycle show likely changes in nitrate leaching ranging from limited increases to a possible doubling of aquifer concentrations by 2100. These changes may be masked by nitrate reductions from improved agricultural practices, but a range of adaption measures need to be identified. Future impact may also be driven by economic responses to climate change.

A tracer methodology for identifying ambient flows in boreholes.

Identifying flows into, out of, and across boreholes is important for characterizing aquifers, determining the depth at which water enters boreholes, and determining the locations and rates of outflow. This study demonstrates how Single Borehole Dilution Tests (SBDTs) carried out under natural head conditions provide a simple and cheap method of identifying vertical flow within boreholes and determining the location of in-flowing, out-flowing, and cross-flowing fractures. Computer simulations were used to investigate the patterns in tracer profiles that arise from different combinations of flows. Field tracer tests were carried out using emplacements of a saline tracer throughout the saturated length of boreholes and also point emplacements at specific horizons. Results demonstrated that SBDTs can be used to identify flowing fractures at the top and bottom of sections of vertical flow, where there is a change in vertical flow rate within a borehole, and also where there are consistent decreases in tracer concentration at a particular depth. The technique enables identification of fractures that might be undetected by temperature and electrical conductance logging, and is a simple field test that can be carried out without pumping the borehole.

Intrauterine tobacco smoke exposure and hyaline membrane disease amongst triplets.

We assessed the association between prenatal smoking and respiratory distress syndrome (RDS) among triplets using a population-based retrospective cohort of 12,169 triplet live births in the United States between 1995 and 1997. Analysis was conducted using the generalised estimating equation framework to adjust for intra-cluster correlations. A total of 938 cases of RDS were reported comprising 35 among smoking (7.2%) and 903 among non-smoking gravidas (7.7%). The likelihood of RDS was comparable in both smoking categories [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.65-1.32]. The risk for RDS due to smoking diminished with declining birth weight albeit non-significantly: low birth weight (OR = 0.99; 95% CI = 0.40-2.42), very low birth weight (OR = 0.85; 95% CI = 0.39-1.86), and extremely low birth weight (OR = 0.69; 95% CI = 0.30-1.58). In conclusion, among triplet neonates, smoking during pregnancy was not associated with respiratory distress syndrome.

The development of targeted chemotherapy for CNS lymphoma-a pilot study of the IDARAM regimen.

PURPOSE: We have developed and evaluated a CNS-targeted chemotherapy regimen based on the pharmacokinetic properties of the individual drugs in the combination. PATIENTS AND METHODS: In a twin-track study, 16 patients with secondary CNS lymphoma (SCNSL) and 8 with primary CNS lymphoma (PCNSL) were treated with IDARAM which comprised idarubicin 10 mg/m(2) i.v., days 1 and 2; dexamethasone 100 mg, 12-h infusion, days 1, 2 and 3; cytosine arabinoside (ARA-C) 1.0 g/m(2), 1-h infusion, days 1 and 2; methotrexate 2.0 g/m(2), 6-h infusion, day 3 (with folinic acid rescue); and cytosine arabinoside 70 mg plus methotrexate 12 mg, intrathecally, days 1 and 8. Two cycles were delivered at 3-weekly intervals. After response assessment, patients received adjuvant cranial radiotherapy (40 Gy over 20 fractions). RESULTS: The series comprised 24 patients, 11 male and 13 female. Their median age was 53 years (range 21 to 73 years). Grade 4 neutropenia and thrombocytopenia occurred in the majority of patients treated. Of the eight PCNSL patients, seven achieved complete remission (CR). Four remained in CR at the time of this report with a median duration of follow-up of 25 months (range 11 to 42 months). Of the 16 SCNSL patients, 12 achieved CR. Seven patients remained in CR at the time of this report with a median duration of follow-up of 24 months (range 18 to 57 months). CONCLUSION: This study suggests that IDARAM is an effective regimen in both PCNSL and SCNSL and is suitable for further development and evaluation.

Pathologists' views on consent for autopsy.

Consent to autopsy is usually obtained by a doctor other than the one who will perform the procedure. There is an argument that, for proper informed consent, a pathologist should participate. We ascertained the views of consultant pathologists in south-east England. 53 (87%) of 61 consultants responded, of whom 50 currently do autopsies. Only 2 at present participate directly in obtaining consent, and 10 of the remaining 48 expressed willingness to do so. The general view was that consent is best obtained by a senior clinician from the team that has looked after the patient. Pathologists see their primary role as to provide guidance to clinicians. Few see it as their function to obtain consent for autopsy.