Characteristics of drowning deaths in an inner city river

A study was undertaken of all drowning deaths that occurred over a 30-year period from 1988 to 2017 in the urban section of the River Torrens, Adelaide, South Australia, an augmented waterway that runs through the central business district. Autopsy records from Forensic Science South Australia (FSSA) were reviewed. There were 34 drownings (0–5 cases/yr) with 28 males and 6 females (M;F = 4.6:1), with an age range for males of 18-76yrs (mean 42.0; SD 18.0) and for females of 20-84yrs (mean 69.3; SD 24.5). There were 15 (44%) accidents, 11 (32%) suicides, 1 (3%) homicide and 7 (21%) undetermined. Of the 22 cases during or after 1994 with complete toxicology reports, 10 (45%) had a blood alcohol concentration (BAC) of greater than 0.05% (g/100 mL) with an illicit substance detected in 4 (18%) cases: (MDMA (3,4-methylenedioxymethamphetamine), methylamphetamine and THC (delta-9-tetrahydrocannabinol) acid). The presence of various therapeutic drugs was also detected in 10 cases (45%) including temazepam, fluoxetine, diazepam, olanzapine, amitriptyline, carbamazepine, codeine, citalopram and valproate. Although the numbers of cases were not high, the urban portion of the River Torrens had a much higher number of drowning events per kilometre compared to other inland waterways in South Australia such as the Murray River. This is most likely due to the vulnerability that exists for intoxicated individuals in the city from falls into the water and to the availability of the river as a means of suicide to members of the adjacent urban population.     

产学研合作模式下长三角生物医药产业一体化协同创新发展研究——基于专利合作及基金项目合作

长三角一体化上升并发展为国家战略后，国内鲜有探讨长三角地区生物医药产业一体化协同发展的研究，长三角作为我国生物医药产业的重要地区，已初步形成产业集群的发展模式。本研究基于专利及基金项目合作的产学研模式，利用社会网络分析方法（SNA）对长三角地区生物医药产业中专利和国家自然科学基金重大项目合作进行分析研究。研究表明，长三角地区生物医药领域的产学研合作还处于发展阶段，一体化程度也有待提高；高校及科研院所更倾向于与企业合作开展发明专利，与高校合作开展基金项目研究。长三角地区三省一市间的生物医药产业发展也存在一定差距，建议长三角地区采取产学研深度融合模式，相关龙头科研机构建立开放式创新平台，医药类高校借助学科优势培养创新型人才，采取“揭榜挂帅”等方式进行关键核心技术攻关。     

长三角一体化背景下安徽省口腔专科医疗联合体建设现状调查

目的 调查安徽省口腔专科医联体建设现状,分析安徽省口腔专科建设存在的问题,为加快安徽省口腔专科建设融入长三角地区医疗发展提供依据.方法 自行设计调查问卷,于2020年11～12月对安徽省口腔专科医联体内所有医院进行调查.发放问卷36份,回收有效问卷32份.运用统计描述、χ2检验和t检验对资料进行统计分析.结果 被调查的医院共有医护人员487人,其中男性286人(58.73％),女性201人(41.27％),医护比为1:0.43;技工24名,医技比为1:40;牙椅499张,牙椅与技工之比20.79:1;床位494张,床护比1:0.30;仅3个诊疗项目在调查医院中全部开展;加入与未加入其他医联体两类医院医护人员一般情况比较发现,职称、学历与年龄的差异有统计学意义(P<0.05);口腔人才匮乏,研究生及以上学历仅占30.80％.结论 安徽省口腔专科建设能力不足,通过对人才队伍及信息化建设等方式,逐步缩小与沪、苏、浙地区间差异,推进安徽省口腔专科加速融入长三角地区医疗发展.     

From the Cover: Amazonian functional diversity from forest canopy chemical assembly

Patterns of tropical forest functional diversity express processes of ecological assembly at multiple geographic scales and aid in predicting ecological responses to environmental change. Tree canopy chemistry underpins forest functional diversity, but the interactive role of phylogeny and environment in determining the chemical traits of tropical trees is poorly known. Collecting and analyzing foliage in 2,420 canopy tree species across 19 forests in the western Amazon, we discovered (i) systematic, community-scale shifts in average canopy chemical traits along gradients of elevation and soil fertility; (ii) strong phylogenetic partitioning of structural and defense chemicals within communities independent of variation in environmental conditions; and (iii) strong environmental control on foliar phosphorus and calcium, the two rock-derived elements limiting CO₂ uptake in tropical forests. These findings indicate that the chemical diversity of western Amazonian forests occurs in a regionally nested mosaic driven by long-term chemical trait adjustment of communities to large-scale environmental filters, particularly soils and climate, and is supported by phylogenetic divergence of traits essential to foliar survival under varying environmental conditions. Geographically nested patterns of forest canopy chemical traits will play a role in determining the response and functional rearrangement of western Amazonian ecosystems to changing land use and climate.Foliage is a locus of chemical investment undertaken by plants to capture and use sunlight for carbon gain under changing environmental conditions and compete with coexisting individuals and species. Plants acquire essential chemical elements from soils, and they synthesize a wide variety of compounds in their leaves to support multiple interdependent physiological processes. Uptake of nitrogen and phosphorus plus the internal production of photosynthetic pigments, including chlorophyll and carotenoids, are required for light capture and carbon fixation in foliage (1). Soluble carbon, primarily comprised of sugars, starch, pectins, and lipids, is then synthesized to meet the energy requirements of the entire plant (2). Other macro- and micronutrients (e.g., calcium) underpin critical leaf functions, such as stomatal conductance and cell wall development. To support the carbon capture process, foliar structural compounds, such as lignin and cellulose, are synthesized to provide strength and longevity (3), and polyphenols are generated for chemical defense (4). Variation in this leaf chemical portfolio expresses multiple strategies evolved in plants to maximize fitness through growth and longevity in any given environment.Despite our understanding of plant chemical and physiological processes, the way that environment and evolution interact to determine geographic variation in plant canopy chemistry remains a mystery. In turn, this shortfall sets a fundamental limit on our knowledge of the core determinants of functional diversity in and across ecosystems, with cascading limits on our understanding of biogeographic and biogeochemical processes. Although much research has either focused on plant functional trait differentiation among coexisting species in communities (5) or emphasized trait convergence in response to environmental filters, such as climate and soils (6), few studies have examined the interconnections between phylogeny and environment in determining functional diversity by way of canopy chemistry (7). This gap is particularly true in the tropics, where our understanding of the interplay between evolution and environmental factors is perhaps weakest because of high plant diversity and a poor understanding of plant community assembly (8). Today, we know very little about canopy chemical traits at community to biome scales in the tropics (9).Western Amazonian forests are a case in point. The forested corridor stretching from Colombia to Bolivia and from the Andean tree line to the Amazon lowlands harbors thousands of plant species arranged in communities distributed across widely varying elevation, geologic, soil, and hydrologic conditions (10, 11). Although the general biological diversity of the region is coming into focus (12, 13), the functional diversity of the forest remains unknown. To understand the regional assembly of forest functional traits and their underlying controls in Amazonia, we must determine the degree to which canopy chemistry is environmentally filtered and phylogenetically partitioned as well as how chemical traits are organized within and among communities. If chemical traits are plastic among coexisting taxa, then biological diversity may be decoupled from functional diversity. Alternatively, if there exists strong phylogenetic organization of canopy chemical traits, then biological diversity may express functional trait diversity and vice versa. Determining the connection between functional and biological diversity may help to explain how so many species coexist within communities and how communities differ throughout the region (14).Here, we are interested in chemical diversity among coexisting tropical canopy tree species and their evolved responses to regional environmental filters thought to limit functional trait divergence. Thus, we developed chemical trait portfolios for tree canopies spread along a 3,500-m elevation gradient stretching from lowland Amazonia to the Andean tree line in Peru (SI Methods and Tables S1 and S2). We assessed the role of taxonomy as well as within- (intraspecific) and between-species (interspecific) variations in determining community and regional chemical assembly. Our study incorporated 2,420 canopy tree species in 19 forests along the elevation gradient, and our sampling included the majority of canopy tree species known to occur in the western Amazon (11, 12). Because submontane to montane Andean forests exist primarily on younger geologic surfaces, whereas lowland forests occur on a mosaic of young to old substrates, we also considered the role of soils in mediating canopy chemical trait distributions. We asked two questions. (i) How does the canopy chemistry of western Amazonian forests vary with elevation? (ii) How much of the variation is explained by taxonomy compared with plasticity within taxa? We focused on light capture and growth traits (including N, P, and photosynthetic pigments) as well as structure and defense traits (total C, lignin, cellulose, and phenols). We also considered Ca as a key element regulating foliar metabolism and nutrient cycling in humid tropical ecosystems (15, 16), and we measured δ¹³C and soluble carbon as indicators of performance (17). Finally, we assessed sources of variation in leaf mass per area (LMA), a foliar structural property expressing plant investment strategies based on multiple chemical and physiological traits (18).     

玉米/鹰嘴豆间作条件下不同施磷量对灌耕灰钙土无机磷组分的影响--测试文章

在甘肃引黄灌区的灌耕灰钙土区域,通过玉米/鹰嘴豆间作种植,采用蒋柏藩、顾益初石灰性土壤无机磷分级方法研究了施磷水平和间作种植方式对玉米、鹰嘴豆土壤无机磷素形态的影响。结果表明：研究区各无机磷形态含量顺序为O-P＞Ca₁₀-P＞Ca₈-P＞Al-P＞Fe-P＞Ca₂-P,施磷能够显著提高玉米和鹰嘴豆土壤中Ca₂-P、Ca₈-P、Al-P和Fe-P的含量,O-P和Ca₁₀-P的含量不随施磷量增加发生显著性变化;与单作相比,间作种植对鹰嘴豆土壤带各无机磷组分含量没有显著影响,但间作玉米种植带土壤各组分无机磷含量均低于单作土壤,其中不施磷肥处理下Fe-P、施纯磷 40 kg·hm^-2处理下Al-P及施纯磷 80 kg·hm^-2处理下Ca₁₀-P的含量显著低于单作土壤。     

福州市内河蚊虫孳生情况的调查

目的了解福州市内河的蚊虫孳生情况,为城市科学灭蚊提供依据。方法采用目测和勺捕相结合的方法,调查福州市城区和城乡接合部内河蚊虫孳生的情况,以500 ml勺捕捞幼虫,计算孳生严重的内河的蚊幼密度(条/勺);选取孳生严重的内河进行蚊虫孳生的季节消长调查。结果调查城区河道300处,孳生2处,孳生频率为0.67%,调查城乡接合部河道200处,孳生24处,孳生率为12.0%。主要孳生蚊种为致倦库蚊,伴有少量褐尾库蚊孳生,幼虫密度最高可达到657条/勺。幼虫主要孳生在内河两岸和水生植物周围。福州市内河蚊虫孳生有比较明显的季节变化,5和11月为密度的2个高峰,2和8月为密度的2个低谷。结论福州城市内河在一定条件下会成为超大型蚊虫孳生地,是城市灭蚊中不可忽视的孳生场所。     

Prevalence and predictive factors of stigmatizing attitudes towards people living with HIV in the remote villages on the Maroni River in French Guiana

The Maroni basin, an isolated region which lies between Suriname and French Guiana, has been affected by the HIV epidemic 10 years after coastal French Guiana. However, the rise in HIV prevalence was sharp with a prevalence exceeding 1% within 10 years. Stigma and discrimination towards people living with HIV (PLWHIV) or “suspected to have HIV” is rampant as reported by health professionals or non-governmental organisations. The objective of this article is to present the first quantitative data from the general population of this region on stigma towards people living with HIV. Data were collected in 2012 by a structured questionnaire among a random sample of 896 individuals residing in remote villages on the Maroni River. Proportion comparisons between the Maroni sample and the sample from the general population on the coastline in 2011 were conducted. Simple and multivariate logistic regression models were used to predict stigmatising attitudes. For all situations involving PLWHIV, the proportion of negative attitudes was significantly higher on the Maroni than in coastal French Guiana (p < 0.001). Findings indicate that the different levels of knowledge, erroneous beliefs and poor situation (not having electricity in one's home; not having French health insurance) were associated with stigmatising attitudes. The present data could help both sides coordinate interventions both at the individual level by improving knowledge and at the community level to change norms in order to reduce stigma and discrimination aiming for increased impact.     

Efficacy of liposomal bupivacaine versus bupivacaine in port site injections on postoperative pain within enhanced recovery after bariatric surgery program: a randomized clinical trial

BackgroundUse of liposomal bupivacaine (LB) in surgery is reported with decreased postoperative opioid requirements. The efficacy of LB versus standard bupivacaine injections at laparoscopic port sites during bariatric surgery is unknown.ObjectivesTo determine whether there was a difference in postoperative hospital opioid requirements after port site injections of LB versus standard bupivacaine during laparoscopic bariatric surgeries. Primary endpoint was total in hospital opioid use expressed as morphine-equivalent use. Secondary endpoints included home opioid use, pain scores, hospital length of stay, and adverse events.SettingAcademic-affiliated private practice.MethodsA 2-group randomized, double-blinded trial from November 2017 to August 2018 with patients randomly assigned to receive either LB or bupivacaine alone at trocar site injections during laparoscopic Roux-en-Y gastric bypass (LRYGB) or vertical sleeve gastrectomy (VSG). All patients underwent enhanced recovery after bariatric surgery protocols.ResultsAll patients undergoing LRYGB or VSG assessed for eligibility. Of 682 patients undergoing LRYGB or VSG, 231 met inclusion criteria, 52 patients excluded intraoperatively. Among 231 patients (mean age, 39.2 years; 79% women; mean body mass index 45.0), 179 patients (77%) completed the trial. Patients randomly assigned to receive either LB (n = 89) or bupivacaine alone (n = 90) at trocar site injection during LRYGB or VSG. Postoperative morphine-equivalent use were similar (LB 8.3 [standard deviation 4.0–13.9] versus bupivacaine group 7.5 [standard deviation 3.6–13.1] P = .94) with highest requirement in first 4 hours after surgery. There was no significant difference in length of stay, pain scores, or complications. There were more patients in the bupivacaine group that did not take pain medications on postoperative days 2 to 4 (P = .032, P = .23, P = .005, respectively). There were more patients in the bupivacaine group 48.1% (n = 39) compared with the LB group 34.2% (n = 27) that did not consume any narcotic tablets at home but this not found to be statistically significant (P value = .07).ConclusionsAmong patients undergoing primary bariatric surgery under enhanced recovery after bariatric surgery protocol, there was no significant difference in postoperative hospital opioid use in those receiving LB compared with standard bupivacaine. A greater percentage of patients in the standard bupivacaine group did not require any narcotics at home, which was significant on postoperative days 2 to 4. To become completely opioid free after bariatric surgery, resources should be focused on multimodal approaches instead of reliance on type of anesthetic medication used.     

Crude 4-methylcyclohexanemethanol (MCHM) did not cause skin irritation in humans in 48-h patch test

Crude 4-methylcyclohexanemethanol (MCHM) is an industrial chemical used to wash and clean coal. On January 9th, 2014 approximately 10,000 gallons of a mixture containing crude MCHM were released into the Elk River near Charleston, West Virginia, contaminating the local water supply. Following the spill, residents reported numerous health complaints, and sought medical attention for ailments including rashes and itching. The relationship between the complaints and the spill were unknown, as such symptoms are reported frequently in the background. In this study, the primary irritation potential of crude MCHM was evaluated in 206 individuals who underwent 48?hour semi-occluded patch testing. MCHM concentrations assessed in this study were 1, 5, 15, and 100?ppm. No appreciable skin reactions were observed in individuals at any concentration. Three of the five concentrations evaluated were above the highest measured concentration of MCHM in the tap water of residents in West Virginia (3.7?ppm). The results of this study suggest that crude MCHM would not be a dermal irritant for the vast majority, if not all, potentially exposed persons at the concentrations in the water reported after the spill.     

黄芪古产地白水、黑水、赤水、宜州新考

综合检索本草著作与历史地理文献,厘清黄芪古代产地解释的若干谬误。经文献检索分析表明:(1)黄芪古产地"白水"应该为今流经四川甘肃两省的白水江,而不是陕西白水县的白水河。(2)黄芪古产地"黑水"应该为今九寨沟县的黑河,而不是黑水县的黑水河。(3)黄芪古产地"赤水"是今甘肃陇西县城北咸河的支流大河。(4)《新修本草》中黄芪产地"宜州"是正确的,具体位置在今陕西省铜川市,而不应该被曲解为"直州"或"茂州"。(5)黄芪"陕西州郡多有之",主要是指唐、宋时期的"原州""华原""宜州""宁州""泾州"等地。因宋、明两代今甘肃之地属"陕西州郡"范围,如果再加上南北朝时的"陇西洮阳""宕昌黑水""陇西襄武"以及"白水""赤水",可以说黄芪古产地绝大部分在今甘肃境内。经考证得出,黄芪古产地白水为今白水江;黑水为今九寨沟县黑河;赤水为今陇西县城北咸河支流大河;宜州无误,在今陕西铜川市。