The relation of preoperative coagulation findings to diagnosis, blood usage, and survival in adult liver transplantation

A group of 70 adults with end-stage liver disease received 87 homologous liver transplants from 7/11/81 and 7/11/83. The recipients fell into the following diagnostic categories: Postnecrotic cirrhosis (PNC) in 22, primary biliary cirrhosis (PBC) in 18, cancer or neoplasia (CA) in 11, sclerosing cholangitis (SC) in 8 and miscellaneous (MISC) in 11. Survival for six months or longer was 46%: Survival by group was PBC=67%, CA=55%, PNC=45%, SC=25%, and MISC=18%. Preoperative coagulation profiles were evaluated on 64 of the 70 first transplant patients by assigning a score derived from one point per abnormality in each of 8 tests. Mean coagulation abnormality scores (CAS) were strikingly elevated in the PNC and MISC groups. Mean intraoperative blood product usage was 43 units of RBCs, 40 units of fresh frozen plasma (FFP), 21 units of platelets, and 9 bags of cryoprecipitate. Direct correlations were found between CAS and RBC usage (+0.454, P=001), CAS, and survival of 6 months or longer (-0.281, P=.02), and RBC usage and survival (-0.408, P=.001). These findings indicate that the degree of coagulation abnormality and the type of liver disease may be predictive of intraoperative blood usage and survival in liver transplantation in adults. © 1985 by The Williams & Wilkins Co

How manipulating task constraints in small-sided and conditioned games shapes emergence of individual and collective tactical behaviours in football: A systematic review

Background: Small-Sided and Conditioned Games are characterised by modifications of field dimensions, number of players, rules of the game, manipulations used to shape the key task constraints that performers need to satisfy in practice. Evidence has already demonstrated the importance of designing practice to enhance understanding of tactical behaviours in football, but there is a lack of information about how coaches can manipulate task constraints to support tactical learning. Objective: To investigate which task constraints have been most often manipulated in studies of SSCGs; and what impact each manipulation had on emerging tactical behaviours, technical–tactical actions, and positional relationships between players. Methods: PubMed, Web of Science, Scielo, and Academic Google databases were searched for relevant reports without time limits. The criteria adopted for inclusion were: a) studies performed with football players; b) studies that included SSCGs as an evaluation method; c) studies that investigated tactical behaviours in SSCGs; and d), articles in English and Portuguese. Results: The electronic database search included 24 articles in the review. Of these, five manipulated field dimensions, six manipulated number of players involved, five manipulated field dimensions and number of players, five used different scoring targets, two altered the number of players and scoring target, and one manipulated the number of players, field dimension, and scoring target. Conclusion: Among the task constraints analyzed in this systematic review, manipulation of number of players and playing field dimensions concomitantly occurred most frequentl

How manipulating task constraints in small-sided and conditioned games shapes emergence of individual and collective tactical behaviours in football: A systematic review

Background: Small-Sided and Conditioned Games are characterised by modifications of field dimensions, number of players, rules of the game, manipulations used to shape the key task constraints that performers need to satisfy in practice. Evidence has already demonstrated the importance of designing practice to enhance understanding of tactical behaviours in football, but there is a lack of information about how coaches can manipulate task constraints to support tactical learning. Objective: To investigate which task constraints have been most often manipulated in studies of SSCGs; and what impact each manipulation had on emerging tactical behaviours, technical–tactical actions, and positional relationships between players. Methods: PubMed, Web of Science, Scielo, and Academic Google databases were searched for relevant reports without time limits. The criteria adopted for inclusion were: a) studies performed with football players; b) studies that included SSCGs as an evaluation method; c) studies that investigated tactical behaviours in SSCGs; and d), articles in English and Portuguese. Results: The electronic database search included 24 articles in the review. Of these, five manipulated field dimensions, six manipulated number of players involved, five manipulated field dimensions and number of players, five used different scoring targets, two altered the number of players and scoring target, and one manipulated the number of players, field dimension, and scoring target. Conclusion: Among the task constraints analyzed in this systematic review, manipulation of number of players and playing field dimensions concomitantly occurred most frequentl

Hydrogeological modelling of the Atlantis aquifer for management support to the Atlantis Water Supply Scheme

The Atlantis Water Supply Scheme (AWSS, Western Cape, South Africa) has been in operation for about 40 years as a means to supply and augment drinking water to the town of Atlantis via managed aquifer recharge (MAR). In this study, the numerical model MODFLOW for groundwater flow and contaminant transport was used in support of the management of the AWSS. The aims were: (i) to calibrate the MODFLOW model for the MAR site at Atlantis; (ii) to run realistic scenarios that cannot be replicated through experiments; and (iii) to make recommendations in support of efficient and sustainable management of the aquifer. MODFLOW was calibrated through comparison of observed and simulated groundwater levels (R2 between 0.663 and 0.995). Scenario simulations indicated possible drawdowns between < 5 m (low groundwater abstraction and low artificial recharge of groundwater through infiltration basins) and > 20 m (high abstraction and high artificial recharge) at localized areas of the Witzand wellfield. At Silwerstroom, large drawdown levels were not predicted to occur, so this wellfield could be exploited more without affecting the sustainability of the groundwater resource. Groundwater moves from the infiltration basins towards the Witzand wellfield at a rate of 120–150 m·a-1. The modelling results supported recommendations for balancing groundwater abstraction and artificial recharge volumes, monitoring the water balance components of the system, the potential risks of groundwater contamination and the delineation of groundwater protection zones.Keywords: Groundwater abstraction; managed aquifer recharge; MODFLOW; particle tracking; scenario modellin

f(R) theories

Over the past decade, f(R) theories have been extensively studied as one of the simplest modifications to General Relativity. In this article we review various applications of f(R) theories to cosmology and gravity - such as inflation, dark energy, local gravity constraints, cosmological perturbations, and spherically symmetric solutions in weak and strong gravitational backgrounds. We present a number of ways to distinguish those theories from General Relativity observationally and experimentally. We also discuss the extension to other modified gravity theories such as Brans-Dicke theory and Gauss-Bonnet gravity, and address models that can satisfy both cosmological and local gravity constraints.Comment: 156 pages, 14 figures, Invited review article in Living Reviews in Relativity, Published version, Comments are welcom

Spectroscopic identification of r-process nucleosynthesis in a double neutron-star merger.

The merger of two neutron stars is predicted to give rise to three major detectable phenomena: a short burst of γ-rays, a gravitational-wave signal, and a transient optical-near-infrared source powered by the synthesis of large amounts of very heavy elements via rapid neutron capture (the r-process). Such transients, named 'macronovae' or 'kilonovae', are believed to be centres of production of rare elements such as gold and platinum. The most compelling evidence so far for a kilonova was a very faint near-infrared rebrightening in the afterglow of a short γ-ray burst at redshift z = 0.356, although findings indicating bluer events have been reported. Here we report the spectral identification and describe the physical properties of a bright kilonova associated with the gravitational-wave source GW170817 and γ-ray burst GRB 170817A associated with a galaxy at a distance of 40 megaparsecs from Earth. Using a series of spectra from ground-based observatories covering the wavelength range from the ultraviolet to the near-infrared, we find that the kilonova is characterized by rapidly expanding ejecta with spectral features similar to those predicted by current models. The ejecta is optically thick early on, with a velocity of about 0.2 times light speed, and reaches a radius of about 50 astronomical units in only 1.5 days. As the ejecta expands, broad absorption-like lines appear on the spectral continuum, indicating atomic species produced by nucleosynthesis that occurs in the post-merger fast-moving dynamical ejecta and in two slower (0.05 times light speed) wind regions. Comparison with spectral models suggests that the merger ejected 0.03 to 0.05 solar masses of material, including high-opacity lanthanides

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Effect of simulated dawn on quality of sleep – a community-based trial

BACKGROUND: Morning light exposure administered as simulated dawn looks a promising method to treat Seasonal Affective Disorder, but it may moreover help with resetting the inaccurate organisation of body clock functions relative to sleep occurring in winter among people in general. Disturbances in sleep patterns are common and may compromise wellbeing even in the short term. Our hypothesis was that simulated dawn could improve the subjective quality of sleep during winter. METHODS: A community-based trial with 100 volunteer subjects provided with dawn simulators. Study period lasted for eight weeks, and subjects used the dawn simulators for two weeks at a time, each subject acting as his own control (ABAB-design). Main outcome measure was subjective quality of sleep recorded each morning with Groningen Sleep Quality Scale. RESULTS: 77 subjects completed the trial. Quality of sleep improved while subjects were using dawn simulator-devices (p = 0.001). The treatment became beneficial after six days' use of dawn simulator, but the effect did not last after the use was ceased. CONCLUSION: Dawn simulation may help to improve the subjective quality of sleep, but the benefits are modest. Further research is needed to verify these findings and to elucidate the mechanism by which dawn simulation acts on the sleep-wake pattern