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We sought to define the prevalence of echocardiographic abnormalities in long-term survivors of paediatric hematopoietic stem cell transplantation and determine the utility of screening in asymptomatic patients. We analysed echocardiograms performed on survivors who underwent hematopoietic stem cell transplantation from 1982 to 2006. A total of 389 patients were alive in 2017, with 114 having an echocardiogram obtained ⩾5 years post-infusion. A total of 95 patients had echocardiogram performed for routine surveillance. The mean time post-hematopoietic stem cell transplantation was 13 years. Of 95 patients, 77 (82.1%) had ejection fraction measured, and 10/77 (13.0%) had ejection fraction z-scores ⩽−2.0, which is abnormally low. Those patients with abnormal ejection fraction were significantly more likely to have been exposed to anthracyclines or total body irradiation. Among individuals who received neither anthracyclines nor total body irradiation, only 1/31 (3.2%) was found to have an abnormal ejection fraction of 51.4%, z-score −2.73. In the cohort of 77 patients, the negative predictive value of having a normal ejection fraction given no exposure to total body irradiation or anthracyclines was 96.7% at 95% confidence interval (83.3–99.8%). Systolic dysfunction is relatively common in long-term survivors of paediatric hematopoietic stem cell transplantation who have received anthracyclines or total body irradiation. Survivors who are asymptomatic and did not receive radiation or anthracyclines likely do not require surveillance echocardiograms, unless otherwise indicated.

The genus Clinostomoides Dollfus, 1950 was erected to accommodate a single worm from Ardea goliath sampled in the Belgian Congo. The specimen was distinguished from other clinostomids by its large size and posterior genitalia. In the following years, metacercariae of Clinostomoides brieni, have been described in Clarias spp. in southern and western Africa. A few authors have referred to Clinostomum brieni, but all such usages appear to be lapsus calami, and the validity of Clinostomoides remains widely accepted. In this study our aim was: position C. brieni among the growing clinostomids molecular database, and redescribe the species with emphasis on characters that have emerged as important in recent work. We sequenced two nuclear (partial 18S and ITS) and one mitochondrial marker (partial cytochrome c oxidase I) and studied morphology in metacercariae from hosts and localities likely to harbour the type species (Clarias spp., Democratic Republic of the Congo, South Africa). Phylogenetic analysis shows C. brieni belongs within Clinostomum Leidy, 1856. We therefore transfer C. brieni to Clinostomum, amend the diagnosis for the genus Clinostomum and provide a critical analysis of other species in Clinostomoides, all of which we consider species inquirendae, as they rest on comparisons of different developmental stages.

Through an intensive examination of the development and diffusion of a new legal device—the shareholder rights' plan or poison pill—this article demonstrates the entrepreneurial, lawmaking role of corporate lawyers. This study case suggests that corporate lawyers may act as legal entrepreneurs, developing and promoting new legal devices and strategies on behalf of actual and potential clients. If affirmed by the courts, these devices or techniques are rapidly diffused thereby contributing to the creation of new legal knowledge. The creation and successful defense of the shareholder rights' plan led to both new caselaw and statute law. In this way, corporate practitioners contribute to the creation of new legal knowledge, suggesting a bottom-up approach to knowledge creation rather than the conventional top-down view. It is suggested that legal innovations like the shareholder rights' plan are more likely to be developed in newer firms than in established firms and in specialized firms than general service law firms.

Lawyer-discipline systems underwent substantial reorganization in a majority of states during the 1970s, with responsibility for their operation moving from the bar associations in which they had been located for almost a century to agencies of the state supreme courts. While this transfer of the locus of lawyer discipline resulted in a diminution of the power of the organized bar, it encouraged the professionalization of the process. In this paper the reasons for the willingness of the bar associations in Illinois to cede control over such a central component of professional regulation are examined and their implications for the sociology of the legal profession discussed. Unable to maintain the status quo in the face of extensive criticism, the Illinois bar associations chose not to meet the high costs of upgrading the discipline process but rather to divest themselves of a function that, although at one time central to their identity and authority, had become inconvenient and damaging to their image. It is suggested that the bar associations were willing to countenance such a divestiture because their positions as collective representatives of the profession in Illinois were secure and the major parameters of lawyer discipline well established. Whereas immediate control over self-regulation processes may be necessary during the developmental phase of professionalism, it is not so important once the profession has achieved a dominant market position.

Mountain pine beetle (Dendroctonus ponderosae Hopkins; Coleoptera: Curculionidae) is a major disturbance agent in pine (Pinus Linnaeus; Pinaceae) ecosystems of western North America. Adaptation to local climates has resulted in primarily univoltine generation time across a thermally diverse latitudinal gradient. We hypothesised that voltinism patterns have been shaped by selection for slower developmental rates in southern populations inhabiting warmer climates. To investigate traits responsible for latitudinal differences we measured lifestage-specific development of southern mountain pine beetle eggs, larvae, and pupae across a range of temperatures. Developmental rate curves were fit using maximum posterior likelihood estimation with a Bayesian prior to improve fit stability. When compared to previously published data for a northern population, optimal development of southern individuals occurred at higher temperatures, with higher development thresholds, as compared with northern individuals. Observed developmental rates of the southern and northern populations were similar across studied lifestages at 20 °C, and southern lifestages were generally faster at temperature extremes (10 °C, 27 °C). At 25 °C southern fourth instars were significantly slower than northern fourth instars. Our results suggest that evolved traits in the fourth instar and remaining unstudied lifestage, teneral (i.e., preemergent) adult, likely influence latitudinal differences in mountain pine beetle generation time.

Introduction: Emergency Department Overcrowding (EDOC) is a multifactorial issue that leads to Access Block for patients needing emergency care. Identified as a national problem, patients presenting to a Canadian Emergency Department (ED) at a time of overcrowding have higher rates of admission to hospital and increased seven-day mortality. Using the well accepted input-throughput-output model to study EDOC, current research has focused on throughput as a measure of patient flow, reported as ED length of stay (LOS). In fact, ED LOS and ED beds occupied by inpatients are two “extremely important indicators of EDOC identified by a 2005 survey of Canadian ED directors. One proposed solution to improve ED throughput is to utilize a physician at triage (PAT) to rapidly assess newly arriving patients. In 2017, a pilot PAT program was trialed at Kelowna General Hospital (KGH), a tertiary care hospital, as part of a PDSA cycle. The aim was to mitigate EDOC by improving ED throughput by the end of 2018, to meet the national targets for ED LOS suggested in the 2013 CAEP position statement. Methods: During the fiscal periods 1-6 (April 1 to September 7, 2017) a PAT shift occurred daily from 1000-2200, over four long weekends. ED LOS, time to inpatient bed, time to physician initial assessment (PIA), number of British Columbia Ambulance Service (BCAS) offload delays, and number of patients who left without being seen (LWBS) were extracted from an administrative database. Results were retrospectively analyzed and compared to data from 1000-2200 of non-PAT trial days during the trial periods. Results: Median ED LOS decreased from 3.8 to 3.4 hours for high-acuity patients (CTAS 1-3), from 2.1 to 1.8 hours for low-acuity patients (CTAS 4-5), and from 9.3 to 8.0 hours for all admitted patients. During PAT trial weekends, there was a decrease in the average time to PIA by 65% (from 73 to 26 minutes for CTAS 2-5), average number of daily BCAS offload delays by 39% (from 2.3 to 1.4 delays per day), and number of patients who LWBS from 2.4% to 1.7%. Conclusion: The implementation of PAT was associated with improvements in all five measures of ED throughput, providing a potential solution for EDOC at KGH. ED LOS was reduced compared to non-PAT control days, successfully meeting the suggested national targets. PAT could improve efficiency, resulting in the ability to see more patients in the ED, and increase the quality and safety of ED practice. Next, we hope to prospectively evaluate PAT, continuing to analyze these process measures, perform a cost-benefit analysis, and formally assess ED staff and patient perceptions of the program.

Following the evolution of the “Two Pasture System” of hill sheep management by the Hill Farming Research Organisation (HFRO) at their Sourhope and Lephinmore stations, the model was adopted by the Agricultural Development and Advisory Service at Redesdale experimental husbandry farm (EHF) and by the Scottish Agricultural Colleges at the West College Hill Farm of Kirkton in West Perthshire. At the time, the ADAS Pwllpeiran EHF in mid-Wales was engaged in an exercise based on the traditional Welsh management system in which ewes are kept on enclosed better grazings from tupping until after lambing and then ewes and lambs are summered on the hill.

The paper describes the developments at Sourhope, Redesdale, Kirkton and Pwllpeiran from the mid/late 1960's until the present time (1980 for Kirkton). The four farms differ considerably in climate, topography, soil type, vegetation and size. In all cases, however, between 20-30% of the total resource was subjected to some degree of pasture improvement over the course of the development. In the case of Kirkton and Sourhope, 9% of the resource was reseeded, whilst at Redesdale the corresponding figure was 17%. At Pwllpeiran, most of the improvement involved surface treatment but of a fairly costly nature almost equal to that of reseeding.

In all cases, the improved pasture was used to provide ewe and lamb grazing during lactation and ewe grazing around mating and lambing. Supplementary feed inputs per ewe during late pregnancy increased significantly on all farms. There was an increase in ewe numbers carried, being 99, 139, 42 and 3% greater for Sourhope, Redesdale, Kirkton and Pwllpeiran, respectively. Weaning percentages (lambs weaned per 100 ewes put to the ram) also increased, by 26, 48, 48 and 36% for Sourhope, Redesdale, Kirkton and Pwllpeiran, respectively. Taken together, there was a significant corresponding increase in the number of lambs weaned of the order of 121, 297, 129 and 47%.

Lamb weaning weights were improved in all cases in spite of increased twinning. This weight increase was most significant at Pwllpeiran where a major effort had been made to change breed type with the specific purpose of producing a heavier lamb.

Gross margin data were available for Sourhope, Redesdale and Kirkton and when plotted on a per ewe and per hectare basis follow remarkably similar pathways over the development for the three centres. The gross margin figures per ewe, when discounted to base, show no significant increase and in some cases were reduced up until the introduction of the EEC sheep meat regime in 1981, after which time significant real increases occurred for those developments still in progress (Sourhope and Redesdale). The real increase there occurred as a result of increased stocking rate. On Pwllpeiran, however, where stocking rate increase was low, it is still considered that the exercise was profitable as measured by Internal Rate of Return.

The various increases confirm that investment in land improvement, coupled with an enlightened approach to sheep management, has improved the overall efficiency of pasture utilisation and economic viability.

In sub-Saharan Africa (SSA), the association of crops and livestock in mixed farming systems generally benefits both enterprises. This paper focuses on the main contributions of livestock to crop production: the use of manure and animal draught power to produce crops and the investment of income from livestock into technologies that benefit crop production. In low-input, grazing-based feeding operations, manure is a vital soil fertility amendment. In these systems, penning livestock overnight on fields, fallow between cropping periods, returns both manure and urine to the soil and results in much higher crop yields than if manure only is gathered from stalls and spread onto fields. However, most farmers have insufficient manure to sustain food production. Nutrient harvests often exceed nutrient inputs, requiring a much greater use of fertilizers to arrest soil nutrient depletion. The opposite may be true for mixed farming where livestock are given food in confinement. In these emerging systems, the continuous importation of food (and fertilizer) can result in nutrient surpluses with subsequent soil nutrient build-up and loss. The contribution of animal power to crop production is relatively new in Africa. Animal power affects the amount of land cultivated by farmers, crop selection, the yield per farm and per ha, and on the participation and work load of people (family members and outside labour) involved in crop production and its associated activities. In addition to the impacts of manure and draught power on crop production, income derived from livestock is often invested in inputs that enhance crop production. At the ‘micro’ level, livestock income influences crop production (1) directly by allowing households to invest in productive inputs such as fertilizer, hired labour, and carts and (2) indirectly by allowing poor households to improve their nutritional status and, therefore, the productivity of their most important resource, their own labour. At the ‘macro’ level, increased livestock exports have a large stimulating effect on the demand for locally produced goods and services, particularly basic food crops. Thus, increasing the productivity of the livestock sector, including an emphasis on the policy and institutional environment influencing marketing and trade, is an important element of a development strategy focused on stimulating economic growth and alleviating poverty.

This work reports the synthesis of undoped and alkali metal doped thermochromic vanadium dioxide thin films by sol-gel spin coating and subsequent low-temperature annealing at 450 °C in N2-H2 atmosphere. The effect of sodium and potassium on the phase transition temperature as well as on the solar modulations were investigated. A dopant concentration of 0.3 at% resulted in a reduction of the critical transition temperature (Tc) from 62 °C to 57 °C and 47 °C for the sodium and potassium doped films, respectively. Moreover, both dopants improved the solar modulations (ΔTsol) of the undoped VO2 films from 3.81 to 9.44 and 5.43 %, respectively.

The utilization of taphonomic information to formulate biostratinomic models for modern and ancient assemblages has become a potentially powerful tool in paleoecologic analysis. The division of fossil assemblages into discrete suites of taphonomically-similar material adds an extra dimension to the interpretation of depositional setting and paleoecologic structure (Brett and Baird, 1986; Speyer and Brett, 1986, 1988; Speyer, 1987). This approach uses the hypothesis that taphonomic alteration varies in a predictable way with depositional setting. In other words, each specific environment (e.g., low-salinity muddy bay, storm-dominated clastic shelf) is characterized by a unique suite of physical, chemical and biological processes: these processes imprint a unique and predictable “taphonomic signature” on the death assemblage.

On 2 March 2016, several small en échelon tabular icebergs calved from the seaward front of the McMurdo Ice Shelf, and a previously inactive rift widened and propagated by ~3 km, ~25% of its previous length, setting the stage for the future calving of a ~14 km2 iceberg. Within 24 h of these events, all remaining land-fast sea ice that had been stabilizing the ice shelf broke-up. The events were witnessed by time-lapse cameras at nearby Scott Base, and put into context using nearby seismic and automatic weather station data, satellite imagery and subsequent ground observation. Although the exact trigger of calving and rifting cannot be identified definitively, seismic records reveal superimposed sets of both long-period (>10 s) sea swell propagating into McMurdo Sound from storm sources beyond Antarctica, and high-energy, locally-sourced, short-period (<10 s) sea swell, in the 4 days before the fast ice break-up and associated ice-shelf calving and rifting. This suggests that sea swell should be studied further as a proximal cause of ice-shelf calving and rifting; if proven, it suggests that ice-shelf stability is tele-connected with far-field storm conditions at lower latitudes, adding a global dimension to the physics of ice-shelf break-up.

The genus Clinostomum Leidy, 1856 (Digenea: Clinostomidae) has been reported in all ecozones of the world and a clear separation between the species of the ‘Old World’ and ‘New World’ has been recognized based on molecular studies. Recent works on Afrotropical species include redescriptions of C. cutaneum and C. phalacrocoracis, while C. tilapiae has yet to be studied using modern taxonomic approaches. In the present research, morphological redescription of C. tilapiae metacercariae from a new host, Synodontis batensoda sampled at Anambra River Basin, Nigeria, together with molecular analysis of nuclear internal transcribed spacer rDNA and cytochrome c oxidase 1 mtDNA are reported. We also provide morphological and molecular data from four further putative species of Clinostomum (morphotypes 1–4) from different areas of Africa, as well as the first report of C. phalacrocoracis in South Africa.

Leprocaulon calcicola is described as new from walls in SE England; it is leprose, pale to mid blue-grey, and contains zeorin and usnic acid. It differs from L. knudsenii from North America in its habitat on mortared walls rather than non-calcareous rock and in its ITS sequence. ‘Lecanora’ ecorticata differs in the yellower colour, and the presence of unidentified fatty acids and traces of unknown terpenoids (but not zeorin) by thin-layer chromatography. Leprose lichens with usnic acid are still poorly known and sequencing must be used to support morphological and chemical studies.