The posterior malleolus component of a fracture of the ankle is important, yet often overlooked. Pre-operative CT scans to identify and classify the pattern of the fracture are not used enough. ...Posterior malleolus fractures are not difficult to fix. After reduction and fixation of the posterior malleolus, the articular surface of the tibia is restored; the fibula is out to length; the syndesmosis is more stable and the patient can rehabilitate faster. There is therefore considerable merit in fixing most posterior malleolus fractures. An early post-operative CT scan to ensure that accurate reduction has been achieved should also be considered. Cite this article:
2017;99-B:1413-19.
The use of khat (Catha edulis) is a major public health and social problem that is believed to be growing globally. The khat chewing habit is prevalent in all areas of the Jazan region, Kingdom of ...Saudi Arabia (KSA). However, few studies have been conducted at the community level to investigate the khat chewing habits in this area. This study was conducted with the aim of assessing the prevalence and predictors of khat chewing among the Jazan community population. A cross-sectional study was conducted with a sample (n = 4,500) of the Jizani population who attended primary heath care centers in Jazan region. The participants were selected using a two-stage cluster random sampling. A structured questionnaire was used for data collection. The overall lifetime prevalence of khat chewing was 33.2% (95% CI 31.8-34.7) and was significantly higher for males 42.2% (95% CI 40.4-43.9) than for females 11.3% (95% CI 9.6-13.1) (P < 0.001). Current khat chewers accounted for 28.7% (95% CI 27.4-30.1) of the population sampled; 36.9% (95% CI 35.2-38.6) of whom were males, which is a significantly higher percentage than the 8.7% (95% CI 7.3-10.4) of current khat chewers who were females (P < 0.001). The multivariate logistic regression analysis suggests that the most important independent predictors of khat chewing were having a friend who chewed khat (OR = 20.1, P < 0.001), participant's smoking status (OR) = 3.9, P < 0.001), friend's smoking status (OR = 2.2, P < 0.001), gender (OR = 2.2, P < 0.001) and educational level (OR = 1.5, P < 0.05). A large proportion of the Jizani populations chew khat. Government and non-governmental organizations NGOs should design and strengthen community prevention programs to curb the high prevalence of khat use.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Whilst there is a wealth of empirical studies that indicate negative ecosystem consequences of biodiversity loss, much debate remains over the existence, strength and importance of the same patterns ...in natural systems. We used a gradient of organic enrichment as a means of defining non-random species loss in the marine benthos and, using partial linear regression, determined the relative importance of macrofaunal biodiversity and the abiotic environment in affecting a benthic ecosystem process (bioturbation intensity; indicated by sediment mixing depth), that is important in mediating benthic functioning. Of the abiotic and biotic variables tested (n = 8), species richness and sediment total organic carbon (TOC) content together explained 65% of the variability in this ecosystem process, with more than half of this variability explained solely by species richness. Importantly, the relative importance of biodiversity decreased at low levels of species richness and/or high levels of TOC. These results have profound implications for manipulative field experiments, where environmental factors are likely to dominate ecosystem processes, because the extent and importance of biological mediation could be underestimated. Our results also revealed that a large proportion of the explained variability in the ecosystem process is explained by the underlying reciprocal relationship (shared variability) between biodiversity and sediment TOC, highlighting the importance of species–environment interactions. If we are to fully appreciate the role of biodiversity in natural systems, our findings suggest that the intimate relationship between species and their environment needs to be more prominently featured in future studies that consider the ecosystem consequences of biodiversity loss.
Changes in community structure concurrent with environmental forcing often form a precursor to changes in species diversity, and can have substantive consequences for ecosystem functioning. Here, we ...assess the effects of altered levels of evenness that are representative of different levels of eutrophication and changes in salinity associated with altered precipitation patterns, on the mediation of nutrient release by sediment-dwelling invertebrate communities. We find that an adjustment towards a more even distribution of species corresponds with an increase in sediment particle reworking that, in general, translates to increased levels of nutrient release. This response, however, is dependent on the functional role of each species in the community and is influenced by concomitant changes in salinity, especially when salinity extends beyond the range typically experienced by the community. Overall, our findings highlight the dynamic nature of species contributions to functioning and reinforce the importance of understanding when, and how, the mechanistic basis of species-environment interactions are modified as the influence of abiotic and biotic factors flex under periods of directional forcing.
•The effect of benthic communities' altered evenness and salinity change was evaluated.•Higher evenness generally led to an increase in bioturbation and nutrient release.•Results were highly dependent on each species functional role in the community.•Salinity levels beyond those typical encountered alter evenness-function relations.•The magnitude and direction of changes in functioning is context dependent.
Much of what we know about the role of biodiversity in mediating ecosystem processes and function stems from manipulative experiments, which have largely been performed in isolated, homogeneous ...environments that do not incorporate habitat structure or allow natural community dynamics to develop. Here, we use a range of habitat configurations in a model marine benthic system to investigate the effects of species composition, resource heterogeneity and patch connectivity on ecosystem properties at both the patch (bioturbation intensity) and multi-patch (nutrient concentration) scale. We show that allowing fauna to move and preferentially select patches alters local species composition and density distributions, which has negative effects on ecosystem processes (bioturbation intensity) at the patch scale, but overall positive effects on ecosystem functioning (nutrient concentration) at the multi-patch scale. Our findings provide important evidence that community dynamics alter in response to localized resource heterogeneity and that these small-scale variations in habitat structure influence species contributions to ecosystem properties at larger scales. We conclude that habitat complexity forms an important buffer against disturbance and that contemporary estimates of the level of biodiversity required for maintaining future multi-functional systems may need to be revised.
The importance of individual species in mediating ecosystem process and functioning is generally accepted, but categorical descriptors that summarize species-specific contributions to ecosystems tend ...to reference a limited number of biological traits and underestimate the importance of how organisms interact with their environment. Here, we show how three functionally contrasting sediment-dwelling marine invertebrates affect fluid and particle transport - important processes in mediating nutrient cycling - and use high-resolution reconstructions of burrow geometry to determine the extent and nature of biogenic modification. We find that individual functional effect descriptors fall short of being able to adequately characterize how species mediate the stocks and flows of important ecosystem properties and that, in contrary to common practice and understanding, they are not substitutable with one another because they emphasize different aspects of species activity and behavior. When information derived from these metrics is combined with knowledge of how species behave and modify their environment, however, detailed mechanistic information emerges that increases the likelihood that a species functional standing will be appropriately summarized. Our study provides evidence that more comprehensive functional effect descriptors are required if they are to be of value to those tasked with projecting how altered biodiversity will influence future ecosystems.
Using baited camera landers, the first images of living fishes were recorded in the hadal zone (6000-11 000 m) in the Pacific Ocean. The widespread abyssal macrourid Coryphaenoides yaquinae was ...observed at a new depth record of approximately 7000 m in the Japan Trench. Two endemic species of liparid were observed at similar depths: Pseudoliparis amblystomopsis in the Japan Trench and Notoliparis kermadecensis in the Kermadec Trench. From these observations, we have documented swimming and feeding behaviour of these species and derived the first estimates of hadal fish abundance. The liparids intercepted bait within 100-200 min but were observed to preferentially feed on scavenging amphipods. Notoliparis kermadecensis act as top predators in the hadal food web, exhibiting up to nine suction-feeding events per minute. Both species showed distinctive swimming gaits: P. amblystomopsis (mean length 22.5 cm) displayed a mean tail-beat frequency of 0.47 Hz and mean caudal : pectoral frequency ratio of 0.76, whereas N. kermadecensis (mean length 31.5 cm) displayed respective values of 1.04 and 2.08 Hz. Despite living at extreme depths, these endemic liparids exhibit similar activity levels compared with shallow-water liparids.
In Saudi Arabia many studies have addressed cigarette smoking from various perspectives. Most of these studies, however, were conducted among males and confined to Riyadh, the capital city. Such ...limitations have enhanced the need for community-based epidemiological studies that include both genders and various age groups and socio-demographic features, as well as different regions.
This cross-sectional study aims to assess the prevalence of cigarette smoking and to discuss the association between cigarette smoking habits and socio-demographic factors among community members of the Jazan area in southwest Saudi Arabia.
A pre-coded questionnaire was designed and tested for data consistency. A well-trained health team was assigned to gather the data from the 30 primary healthcare centers distributed across eight provinces. The response rate was 92.8% (4,326 respondents ≥13 years old). The associations among the subjects' socio-demographic characteristics were examined by the chi-square test. A multiple logistic regression and odds ratios were calculated as well.
A total of 1,017 (23.5%), 1,042 (24.1%), and 3,284 (75.9%) respondents were, respectively, current smokers (TCS), ever-smokers (TES), and non-smokers (TNS). Though current smokers seem to be more prevalent in urban populations (13.8%) than in rural populations (9.7%), the association of urbanization with a current smoking habit is insignificant.
Having fun, relieving stress, and the influence of parents, particularly of mothers, were the main motives that encouraged participants' cigarette-smoking habits. This situation was worsened by the fact that accessing cigarettes was either very easy or easy for over 90% of the respondents.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The importance of bioturbation in mediating biogeochemical processes in the upper centimetres of oceanic sediments provides a compelling reason for wanting to quantify in situ rates of bioturbation. ...Whilst several approaches can be used for estimating the rate and extent of bioturbation, most often it is characterized by calculating an intensity coefficient (Db) and/or a mixed layer depth (L). Using measures of Db (n = 447) and L (n = 784) collated largely from peer-reviewed literature, we have assembled a global database and examined patterns of both L and Db. At the broadest level, this database reveals that there are considerable gaps in our knowledge of bioturbation for all major oceans other than the North Atlantic, and almost universally for the deep ocean. Similarly, there is an appreciable bias towards observations in the Northern Hemisphere, particularly along the coastal regions of North America and Europe. For the assembled dataset, we find large discrepancies in estimations of L and Db that reflect differences in boundary conditions and reaction properties of the methods used. Tracers with longer half-lives tend to give lower Db estimates and deeper mixing depths than tracers with shorter half-lives. Estimates of L based on sediment profile imaging are significantly lower than estimates based on tracer methods. Estimations of L, but not Db, differ between biogeographical realms at the global level and, at least for the Temperate Northern Atlantic realm, also at the regional level. There are significant effects of season irrespective of location, with higher activities (Db) observed during summer and deeper mixing depths (L) observed during autumn. Our evaluation demonstrates that we have reasonable estimates of bioturbation for only a limited set of conditions and regions of the world. For these data, and based on a conservative global mean (cSD) L of 5.75 c 5.67 cm (n = 791), we calculate the global volume of bioturbated sediment to be >20 700 km3. Whilst it is clear that the role of benthic invertebrates in mediating global ecosystem processes is substantial, the level of uncertainty at the regional level is unacceptably high for much of the globe.
The relative contributions that species assemblages, abiotic variables, and their interactions with one another make to ecosystem properties are recognised but are seldom considered simultaneously, ...within context, and at the appropriate spatio-temporal scales. Here, we combine fluorescent time-lapse sediment profile imaging (f-SPI) and diffusion gradient thin gels (DGT) to examine, in situ, the link between an important benthic ecosystem process (bioturbation) and the availability (profiles) of Fe and Mn. Whilst the combination of these methodologies (fg-SPI) was successful in gathering high-resolution in situ data of bioturbation activity and Fe/Mn profiles simultaneously, we show that the mechanistic basis of how the infaunal community mediate Fe and Mn is difficult to reconcile because of the spatio-temporal differences between particle and porewater mixing. This mismatch means that the consideration of these mechanistic processes in isolation is likely to limit our interpretative capacity of how infaunal communities mediate various biogeochemical processes in the natural environment. Moreover, the combination of multiple technologies, process based simulation modelling and generalised additive statistical modelling achieved here, emphasises the importance of simultaneously considering additional factors that influence benthic chemistry, in particular bioirrigation and tidal flushing of the sediment profile. Our findings highlight a pressing need to determine how the relative importance of multiple abiotic and biotic factors act in concert to alter major biogeochemical pathways across a variety of contexts and habitats.
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