The International Maritime Organization (IMO) has moved to address the health and climate impact of the emissions from the combustion of low-quality residual fuels within the commercial shipping ...industry. Fuel sulfur content (FS) limits and an efficiency design index for future ships are examples of such IMO actions. The impacts of black carbon (BC) emissions from shipping are now under review by the IMO, with a particular focus on the potential impacts of future Arctic shipping. Recognizing that associating impacts with BC emissions requires both ambient and onboard observations, we provide recommendations for the measurement of BC. We also evaluate current insights regarding the effect of ship speed (engine load), fuel quality and exhaust gas scrubbing on BC emissions from ships. Observations demonstrate that BC emission factors (EFBC) increases 3 to 6 times at very low engine loads (<25% compared to EFBC at 85–100% load); absolute BC emissions (per nautical mile of travel) also increase up to 100% depending on engine load, even with reduced load fuel savings. If fleets were required to operate at lower maximum engine loads, presumably associated with reduced speeds, then engines could be re-tuned, which would reduce BC emissions. Ships operating in the Arctic are likely running at highly variable engine loads (25–100%) depending on ice conditions and ice breaking requirements. The ships operating at low load may be emitting up to 50% more BC than they would at their rated load. Such variable load conditions make it difficult to assess the likely emissions rate of BC. Current fuel sulfur regulations have the effect of reducing EFBC by an average of 30% and potentially up to 80% regardless of engine load; a removal rate similar to that of scrubbers. Uncertainties among current observations demonstrate there is a need for more information on a) the impact of fuel quality on EFBC using robust measurement methods and b) the efficacy of scrubbers for the removal of particulate matter by size and composition.
This paper presents 5 km×5 km Arctic emissions inventories of important greenhouse gases, black carbon and other pollutants under existing and future (2050) scenarios that account for growth of ...shipping in the region, potential diversion traffic through emerging routes, and possible emissions control measures. These high-resolution, geospatial emissions inventories for shipping can be used to evaluate Arctic climate sensitivity to black carbon (a short-lived climate forcing pollutant especially effective in accelerating the melting of ice and snow), aerosols, and gaseous emissions including carbon dioxide. We quantify ship emissions scenarios which are expected to increase as declining sea ice coverage due to climate change allows for increased shipping activity in the Arctic. A first-order calculation of global warming potential due to 2030 emissions in the high-growth scenario suggests that short-lived forcing of ~4.5 gigagrams of black carbon from Arctic shipping may increase global warming potential due to Arctic ships' CO2 emissions (~42 000 gigagrams) by some 17% to 78%. The paper also presents maximum feasible reduction scenarios for black carbon in particular. These emissions reduction scenarios will enable scientists and policymakers to evaluate the efficacy and benefits of technological controls for black carbon, and other pollutants from ships.
Over the 75‐year lifetime of the British Pharmacological Society there has been an enormous expansion in our understanding of how opioid drugs act on the nervous system, with much of this effort ...aimed at developing powerful analgesic drugs devoid of the side effects associated with morphine – the Holy Grail of opioid research. At the molecular and cellular level multiple opioid receptors have been cloned and characterised, their potential for oligomerisation determined, a large family of endogenous opioid agonists has been discovered, multiple second messengers identified and our understanding of the adaptive changes to prolonged exposure to opioid drugs (tolerance and physical dependence) enhanced. In addition, we now have greater understanding of the processes by which opioids produce the euphoria that gives rise to the intense craving for these drugs in opioid addicts. In this article, we review the historical pathway of opioid research that has led to our current state of knowledge.
British Journal of Pharmacology (2006) 147, S153–S162. doi:10.1038/sj.bjp.0706435
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Summary Objective To compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis. Design Systematic review with network ...meta-analysis, to allow comparison of treatments within a coherent framework. Comprehensive searches were undertaken up to January 2013 to identify randomised controlled trials in patients with osteoarthritis of the knee, which reported pain. Results Of 156 eligible studies, 114 trials (covering 22 treatments and 9,709 patients) provided data suitable for analysis. Most trials studied short-term effects and many were classed as being of poor quality with high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that eight interventions: interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise produced a statistically significant reduction in pain when compared with standard care. In a sensitivity analysis of satisfactory and good quality studies, most studies were of acupuncture (11 trials) or muscle-strengthening exercise (9 trials); both interventions were statistically significantly better than standard care, with acupuncture being statistically significantly better than muscle-strengthening exercise (standardised mean difference: 0.49, 95% credible interval 0.00–0.98). Conclusions As a summary of the current available research, the network meta-analysis results indicate that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. However, much of the evidence in this area of research is of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The reproductive microbiome is becoming increasingly recognised for its influence on fertility. While there has been much work to investigate the treatment of bacterial vaginosis and disordered ...microbiomes in optimizing outcomes in Assisted Reproductive Technology (ART), the role of routinely prescribed probiotics is yet to be established. The therapeutic potential of probiotic therapy remains an exciting opportunity in ART and this review endeavours to summarise its evidence to date.
A systematic review of MEDLINE (Pubmed), Allied Health Literature (CINAHL), EMBASE, Web of Science and the Cochrane database was performed on 7th May 2019, and repeated on 26th August 2019. The search was built using the terms ‘subfertility;’ ‘probiotic therapy;’ ‘clinical pregnancy rate’ and ‘assisted reproductive outcomes.’ The primary outcome was change in clinical pregnancy rate. Secondary outcomes included improvements in male and female fertility parameters and microbial assessment.
The initial search found 882 articles, of which 26 full manuscripts were reviewed. Four articles were eligible for inclusion. Of the two studies that reported the primary outcome, only one study found probiotics increased the clinical pregnancy rate non-significantly (48.0%–58.8%, p = 0.47). It also found higher miscarriage rate (30 % vs 16.6 %, p = 0.47) in the group treated with probiotics. Both studies on males with oral probiotic found significantly improved sperm motility.
While benefit in sperm motility has been observed with male probiotic therapy, there is conflicting evidence on the efficacy of probiotic therapy for women undergoing assisted reproduction. High quality randomized studies are needed to definitively examine probiotic therapy and establish its benefit for couples undergoing assisted reproduction.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The use of radiofrequency ablation (RFA) for complete eradication of Barrett's esophagus has shown promise in trials conducted at predominantly tertiary academic centers; however less is known ...regarding outcomes in the community. We evaluated the safety and efficacy of RFA for Barrett's esophagus delivered in a community practice setting.
This was a multicenter registry conducted in community-based gastroenterology practices. Patients had confirmed intestinal metaplasia with or without dysplasia on biopsy of a Barrett's esophagus. Intervention was step-wise RFA with follow-up esophageal biopsies. Endpoints were histology-based; complete response was defined as all biopsies at most recent endoscopy negative for intestinal metaplasia (CR-IM) or dysplasia (CR-D). Three cohorts were reported: 1) safety cohort, all patients; 2) efficacy cohort A, patients with at least one biopsy session after initial treatment; 3) efficacy cohort B, patients with at least one biopsy session > or = 1 year after initial treatment.
The safety cohort included 429 patients (71 % men, median age 59 years, median Barrett's segment 3.0 cm). There were no serious adverse events (bleeding, perforation, death), and a stricture occurred after 1.1 % of cases (2.1 % of patients). In efficacy cohort A (n = 338), CR-IM and CR-D were achieved in 72 % and 89 % of patients, respectively (median follow-up 9 months). In efficacy cohort B (n = 137), CR-IM and CR-D were achieved in 77 % and 100 % of patients, respectively (median follow-up 20 months).
In this multicenter registry conducted at four community-based practices, the observed safety and efficacy outcomes associated with RFA for Barrett's esophagus are comparable to those previously reported in multicenter trials from predominantly tertiary academic centers.
SETTING: South African gold mines.OBJECTIVE: To determine the prevalence of latent tuberculosis infection (LTBI) and risk factors for a positive tuberculin skin test (TST) among gold miners.DESIGN: ...Cross-sectional survey. Human immunodeficiency virus (HIV) status was determined
by self-report and medical records. TST positivity was defined by the mirror method to estimate the prevalence of LTBI, and by the US Centers for Disease Control and Prevention definitions to explore risk factors at the individual level.RESULTS: Among 429 participants (105/130 subjects
aged <30 years, 324/390 ≥30 years), the estimated prevalence of LTBI was 89%; 45.5% of HIV-positive participants had a zero TST response compared to respectively 13% and 13.5% in the HIV-negative and status unknown participants. In participants with TST > 0, there was no significant
difference between size of response by HIV status: the mean (standard deviation) widths for HIV-positive, HIV-negative and HIV status unknown were respectively 11.84 (2.75), 12.03 (2.75) and 12.52 mm (3.04) (analysis of variance P = 0.28). Factors independently associated with
a TST < 10 mm were positive HIV status (aOR 0.41, 95%CI 0.17-0.96) and not working underground (aOR 0.25, 95%CI 0.09-0.71).CONCLUSIONS: The prevalence of LTBI is very high in gold miners in South Africa. HIV-infected individuals are more likely to have a negative TST, but
HIV infection does not affect the size of TST response.
Transmission of a 73.7 Tb/s (96 x 3 x 256-Gb/s) DP-16QAM mode-division-multiplexed signal over 119 km of few-mode fiber transmission line incorporating an inline multi mode EDFA and a phase plate ...based mode (de-)multiplexer is demonstrated. Data-aided 6 x 6 MIMO digital signal processing was used to demodulate the signal. The total demonstrated net capacity, taking into account 20% of FEC-overhead and 7.5% additional overhead (Ethernet and training sequences), is 57.6 Tb/s, corresponding to a spectral efficiency of 12 bits/s/Hz.
The estuaries of Tampa Bay, Sarasota Bay, Lemon Bay, and Upper Charlotte Harbor are contiguous waterbodies located within the subtropical environment of Southwest Florida. Based on an examination of ...rainfall data over the period of record (1916–2001) within the watersheds of these estuaries, there is no evidence for spatial differences (at the watershed level) or monotonic trends in annual rainfall. During the 1980s, nitrogen loads into Tampa Bay and Sarasota Bay (generated primarily by domestic wastewater treatment facilities) were reduced by 57% and 46%, respectively. In response, both Tampa Bay and Sarasota Bay have lower phytoplankton concentrations, greater water clarity and more extensive seagrass coverage in 2002 than in the early 1980s. As there is no evidence of a concurrent trend in rainfall during the period of 1982–2001, it is unlikely that variation in rainfall can account for the observed increase in seagrass coverage in these two bays. In contrast, seagrass coverage has remained relatively constant since the mid 1980s in Lemon Bay and Charlotte Harbor. Domestic wastewater treatment facilities are minor sources of nitrogen to Lemon Bay, and water clarity in Charlotte Harbor varies mostly as a function of dissolved organic matter and non-chlorophyll associated turbidity, not phytoplankton levels. Even in estuaries that share boundaries and are within 100
km of each other, varied responses to anthropogenic changes and natural phenomena were observed in water quality and associated seagrass extent. Resource management strategies must take into account system-specific factors—not all strategies will result in similar results in different systems.
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