With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. Infertility ...is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address fertility issues is before the onset of therapy for the underlying disease; however, fertility preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in fertility preservation. In vitro fertilization (IVF) and embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking are acceptable methods for fertility preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to fertility preservation in HCT recipients may include the perception of lack of time to preserve fertility given an urgency to move ahead with transplant, lack of patient-physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for fertility preservation. There is a need to raise awareness in the medical community about fertility preservation in HCT recipients.
Detailed measurements of the electron densities, temperatures, and ionization states of compressed CH shells approaching pressures of 50 Mbar are achieved with spectrally resolved x-ray scattering. ...Laser-produced 9 keV x-rays probe the plasma during the transient state of three-shock coalescence. High signal-to-noise x-ray scattering spectra show direct evidence of continuum depression in highly degenerate warm dense matter states with electron densities ne>1024 cm-3. The measured densities and temperatures agree well with radiation-hydrodynamic modeling when accounting for continuum lowering in calculations that employ detailed configuration accounting.
In the Southern Ocean, the at‐sea distributions of most predators of Antarctic krill are poorly known, primarily because tracking studies have only been undertaken on a restricted set of species, and ...then only at a limited number of sites. For chinstrap penguins, one of the most abundant krill predators breeding across the Antarctic Peninsula, we show that habitat models developed utilizing the distance from the colony and the bearing to the shelf‐edge, adjusting for the at‐sea density of Pygoscelis penguins from other colonies, can be used to predict, with a high level of confidence, the at‐sea distribution of chinstrap penguins from untracked colonies during the breeding season. Comparison of predicted penguin distributions with outputs from a high‐resolution oceanographic model shows that chinstrap penguins prefer nearshore habitats, over shallow bathymetry, with slow‐flowing waters, but that they sometimes also travel to areas beyond the edge of the continental shelf where the faster‐flowing waters of the Coastal Current or the fronts of the Antarctic Circumpolar Current occur. In the slow‐moving shelf waters, large penguin colonies may lead to krill depletion during incubation and chick‐rearing periods when penguins are acting as central place foragers. The habitats used by chinstrap penguins are also locations preferentially used by the commercial krill fishery, one of the last under‐developed marine capture fisheries anywhere on the planet. As it develops, this fishery has the potential to compete with chinstrap penguins and other natural krill predators. Scaling our habitat models by chinstrap penguin population data demonstrates where overlap with the fishery is likely to be most important. Our results suggest that a better understanding of krill retention and krill depletion in areas used by natural predators and by the krill fishery are needed, and that risk management strategies for the fishery should include assessment of how krill movement can satisfy the demands of both natural predators and the fishery across a range of spatial and temporal scales. Such information will help regional management authorities better understand how plausible ecosystem‐based management frameworks could be developed to ensure sustainable co‐existence of the fishery and competing natural predators.
Physician practice variation may be a barrier to informing hematopoietic cell transplant (HCT) recipients about fertility preservation (FP) options. We surveyed HCT physicians in the United States to ...evaluate FP knowledge, practices, perceptions and barriers. Of the 1035 physicians invited, 185 completed a 29-item web-survey. Most respondents demonstrated knowledge of FP issues and discussed and felt comfortable discussing FP. However, only 55% referred patients to an infertility specialist. Most did not provide educational materials to patients and only 35% felt that available materials were relevant for HCT. Notable barriers to discussing FP included perception that patients were too ill to delay transplant (63%), patients were already infertile from prior therapy (92%) and time constraints (41%). Pediatric HCT physicians and physicians with access to an infertility specialist were more likely to discuss FP and to discuss FP even when prognosis was poor. On analyses that considered physician demographics, knowledge and perceptions as predictors of referral for FP, access to an infertility specialist and belief that patients were interested in FP were observed to be significant. We highlight variation in HCT physician perceptions and practices regarding FP. Physicians are generally interested in discussing fertility issues with their patients but lack educational materials.
Airborne and ground-based measurements of methane (CH4), carbon dioxide (CO2) and boundary layer thermodynamics were recorded over the Fennoscandian landscape (67–69.5° N, 20–28° E) in July 2012 as ...part of the MAMM (Methane and other greenhouse gases in the Arctic: Measurements, process studies and Modelling) field campaign. Employing these airborne measurements and a simple boundary layer box model, net regional-scale (~ 100 km) fluxes were calculated to be 1.2 ± 0.5 mg CH4 h−1 m−2 and −350 ± 143 mg CO2 h−1 m−2. These airborne fluxes were found to be relatively consistent with seasonally averaged surface chamber (1.3 ± 1.0 mg CH4 h−1 m−2) and eddy covariance (1.3 ± 0.3 mg CH4 h−1 m−2 and −309 ± 306 mg CO2 h−1 m−2) flux measurements in the local area. The internal consistency of the aircraft-derived fluxes across a wide swath of Fennoscandia coupled with an excellent statistical comparison with local seasonally averaged ground-based measurements demonstrates the potential scalability of such localised measurements to regional-scale representativeness. Comparisons were also made to longer-term regional CH4 climatologies from the JULES (Joint UK Land Environment Simulator) and HYBRID8 land surface models within the area of the MAMM campaign. The average hourly emission flux output for the summer period (July–August) for the year 2012 was 0.084 mg CH4 h−1 m−2 (minimum 0.0 and maximum 0.21 mg CH4 h−1 m−2) for the JULES model and 0.088 mg CH4 h−1 m−2 (minimum 0.0008 and maximum 1.53 mg CH4 h−1 m−2) for HYBRID8. Based on these observations both models were found to significantly underestimate the CH4 emission flux in this region, which was linked to the under-prediction of the wetland extents generated by the models.
Tracking individual marine predators can provide vital information to aid the identification of important activity (foraging, commuting, rafting, resting, etc.) hotspots and therefore also to ...delineate priority sites for conservation. However, in certain locations (e.g. Antarctica) many marine mammal or seabird colonies remain untracked due to logistical constraints, and the colonies that are studied may not be the most important in terms of conservation priorities. Using data for one of the most abundant seabirds in the Antarctic as a case study (the Chinstrap Penguin
Pygoscelis antarcticus
), we tested the use of correlative habitat models (used to predict distribution around untracked colonies) to overcome this limitation, and to enable the identification of important areas at-sea for colonies where tracking data are not available. First, marine Important Bird and Biodiversity Areas (IBA) were identified using a standardised, published approach using empirical data from birds tracked from colonies located in the South Orkney Islands. Subsequently, novel approaches using predicted distributions of Chinstrap Penguins derived from correlative habitat models were applied to identify important marine areas, and the results compared with the IBAs. Data were collected from four colonies over 4 years and during different stages of the breeding season. Results showed a high degree of overlap between the areas identified as important by observed data (IBAs) and by predicted distributions, revealing that habitat preference models can be used to identify marine IBAs for these penguins. We provide a new method for designating a network of marine IBAs for penguins in Antarctic waters, based on outputs from correlative habitat models when tracking data are not available. This can contribute to an evidence-based and precautionary approach to aid the management framework for Antarctic fisheries and for the protection of birds.
Background
Surgery has had low priority in global health planning, so the delivery of surgical care in low‐ and middle‐income countries is often poorly resourced. A recent Lancet Commission on Global ...Surgery has highlighted the need for change.
Methods
A consensus view of the problems and solutions was identified by individual surgeons from high‐income countries, familiar with surgical care in remote and poorer environments, based on recent publications related to global surgery.
Results
The major issues identified were: the perceived unimportance of surgery, shortage of personnel, lack of appropriate training and failure to establish surgical standards, failure to appreciate local needs and poor coordination of service delivery.
Conclusion
Surgery deserves a higher priority in global health resource allocation. Lessons learned from participation in humanitarian crises should be considered in surgical developments.
Global value of surgery needs to be realized
Vanadium dioxide is a thermochromic material that undergoes a semiconductor to metal transitions at a critical temperature of 68°C. This phase change from a low temperature monoclinic structure to a ...higher temperature rutile structure is accompanied by a marked change in infrared reflectivity and change in resistivity. This ability to have a temperature-modulated film that can limit solar heat gain makes vanadium dioxide an ideal candidate for thermochromic energy efficient glazing. In this review we detail the current challenges to such glazing becoming a commercial reality and describe the key chemical vapour deposition technologies being employed in the latest research.
Schematic demonstration of the effect of thermochromic glazing on solar radiation (red arrow represents IR radiation, black arrow represents all other solar radiation). Display omitted
•Vanadium dioxide thin films for energy efficient glazing.•Reviews chemical vapour deposition techniques.•Latest results for thin film deposition for vanadium dioxide.
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