Pneumonic Plague: Incidence, Transmissibility and Future Risks

Pneumonic plague outbreaks are relatively infrequent in modern times, but in the early part of the 20th century, they were commonplace including several well-documented epidemics responsible for the deaths of thousands. The transmissibility of this disease seems to be discontinuous since in some outbreaks few transmissions occur, while in others, the progression of the epidemic is explosive. Modern epidemiological studies explain that transmissibility within populations is heterogenous with relatively few subjects likely to be responsible for most transmissions and that ‘super spreading events’, particularly at the start of an outbreak, can lead to a rapid expansion of cases. These findings concur with outbreaks observed in real-world situations. It is often reported that pneumonic plague is rare and not easily transmitted but this view could lead to unnecessary complacency since future risks such as the spontaneous incidence of anti-microbial strains, climate change leading to a disruption of natural cycles within plague foci and use of plague as a bioweapon cannot be discounted. Carers and first responders are vulnerable, particularly in poorer countries where access to medicines and protection equipment may be limited, outbreaks occur in inaccessible areas or where there is a lack of surveillance due to a paucity of funds.

A case report of heterotopic pregnancy

Heterotopic pregnancy is the presence of both intrauterine and extrauterine (ectopic) implantation as described by Reece in 1983 and is extremely rare. It accounts for 1 per 30000, in natural cycles and 9 per 10000, in assisted reproduction cycles. The aim of this report is to introduce this case as it poses a challenge to diagnosis due to its complex clinical and laboratory findings. A primigravida aged 30 at 6 weeks period of gestation, reported with minimal bleeding per vaginum. On performing a physical examination her vitals were stable and no significant findings were noted except for an enlarged uterus corresponding to 6 weeks with posterior forniceal fullness. Her beta-hCG was 23765 IU/ml and ultrasound showed a live intrauterine gestation with left adnexal mass- likely ectopic gestational sac. Laparoscopy showed a left tubal pregnancy and salpingectomy was done. The postoperative period was uneventful and she was discharged with a single live intrauterine gestation of 6-7 weeks. She carried on with her pregnancy and delivered a healthy baby at term. The diagnosis is possible only in cases when there is a high index of suspicion by the treating clinician. The adnexa must be inspected carefully in the confirmatory ultrasound. The early timely diagnosis gives a good maternal outcome and hence crucial in the management.

Peculiarities of biogenic elements migration in case of complex utilization of bioorganic component of municipal solid waste

Finding solutions to the problem of municipal solid waste management is impossible without involvement in the waste management system of the largest group of wastes – bioorganic waste, which form up to 60% of the municipal solid waste total mass. The aim of the article is to analyze the redistribution of biogenic elements subject to implementation of the Concept of solid municipal waste management by OSENU and subsequent utilization of bioorganic waste flow. Research methods include mass balance and equations of methane generation. The article presents the results of research on the biogenic elements migration in case of complex utilization of bioorganic component of municipal solid waste. The study shows that processing of easy-decomposed organic waste into a gaseous fermentation product and biomineral fertilizer allows full involvement of biogenic elements in natural cycles. The processed solid products present an additional source of organic matter and biogenic elements needed by soil. In the event of humus and nutrients shortage in soil the retrieved-from-waste fertilizer becomes an important secondary resource, containing up to 65% carbon and almost 100% nitrogen, phosphorus and potassium. The rest of carbon is released with biogas and is eventually involved in natural cycles. Burial of such waste results in localization of biogenic elements in a landfill's body and gradual release of carbon with the products of destruction (27% over 50 years). All this data indicate the need for efficient use of such waste resource potential which is possible in case of easy-decomposed organic waste separation at the beginning of the municipal solid waste life cycle. Combustion releases only carbon in the form of carbon dioxide, the rest remains in ash. However, complex utilization of easy-decomposed organic waste ensures complete return of biogenic elements to the environment. Reuse of secondary raw materials in the form of paper and textile waste minimizes involvement in economic turnover of carbon from natural sources.

DANCE AS A MARKER OF NATURAL CYCLES CHANGE IN TERRY PRATCHETT’S FANTASY NOVELS

Against the background of a widespread tendency to diminish the sacred meaning of ritual actions, Terry Pratchett’s strive to shed light on the archetypal principles of mythological consciousness in contemporary folklore makes it possible to restorethe connection of the old rites, which have lost their original sense, with the worldview bases of modern society and to reacralize the profane. The Elements of mythological consciousness, manifested in ritual actions inherent in the modern functioning of English folklore, play a meaningful and compositional role in Terry Pratchett’s novels «The Reaper» (1991), «Lords and Ladies» (1992) and «Wintersmith» (2006). In Pratchett’s novels, Morris dance, which traditionally heralds the summer beginning, is balanced by a dance that marks the beginning of winter, indicating the natural cycles change. This manifests the functions of a sacred act: a dialogue between the world and a human, extracting the last from the flow of everyday life, and finalizing the routine work of a farmer. The study suggests the analysis of artistic means describing the Morris dance ritual as a marker of natural cycle changes and as evidence of a human establishing contact with natural forces, enshrined in the narrative and embodied in the dynamic form of dance. A common harvest festival turns into a Dance of the Death and a Maiden, which moves the process of harvesting and preserving the harvest into the realm of the sacred. The motive of the Death and a Maiden dance is being developed in the same compositional plane with the Morris dance motive, as an element of the narrative about the natural balance of life and death,fertility and harvest, about the cycle of the universe based on the love drive. The article examines the compositional elements of choreographic ekphrasis, highlights the significant elements of such a description, indicates the markers of the sacred and the profane, intrinsic to ritual dance in Pratchett’s novels. The conducted research allows to determine the role of dance in Pratchett’s literature work as a marker of the transition from one state to another, as well as season cycle changes.

Pneumonic Plague: Incidence, Transmissibility and Future Risks

Pneumonic plague outbreaks are relatively infrequent in modern times but in the early part of the 20th century, they were commonplace including several well-documented epidemics responsible for the deaths of thousands. The transmissibility of this disease seems to be discontinuous since in some outbreaks few transmissions occur, while in others, the progression of the epidemic is explosive. Modern epidemiological studies explain that transmissibility within populations is heterogenous with relatively few subjects likely to be responsible for most transmissions and that ‘super spreading events’, particularly at the start of an outbreak, can lead to a rapid expansion of cases. These findings concur with outbreaks observed in real-world situations. It is often reported that pneumonic plague is rare and not easily transmitted but this view could lead to unnecessary complacency since future risks such as the spontaneous incidence of anti-microbial strains, climate change leading to a disruption of natural cycles within plague foci and use of plague as a bioweapon cannot be discounted. Carers and first responders are vulnerable, particularly in poorer countries where access to medicines may be limited, out-breaks occur in inaccessible areas or where there is a lack of surveillance due to a paucity of funds.

The Unsettled Landscape: The Core to Coastal Fabrics

<p>‘The Unsettled Landscape’ considers an alternative sustainable manner in which communities can settle New Zealand’s coastland. Living at the ocean edge is ingrained in the way many of our urban settlements have formed, and is intricately linked with how we define ourselves. Unfortunately the way these places have manifested in reality has produced ecological barriers to natural cycles paramount to ecosystem health. Sea walls, housing, roads and many other infrastructural typologies resist the natural ‘flux’ of these areas, which results in dysfunctional ecosystems as well as putting residents of these places at risk of numerous threats which occur along these interface sites. Earthquakes, river movement, erosion, sea level rise, flooding and the continual movement of the dunes are just some of the issues coastal settlements face. The conflict forms where the sought after coastal environments are applied to in a permanent manner that is irresponsive of a landscape which functions in a most dynamic way. This thesis looks towards the geomorphological patterns in the coast as an indicator for how a complete shift in infrastructural application might occur responsively. This new fabric distinguishes stable components in this shifting landscape, utilising them as a stable network from which settlement can develop. This network could become the basis of more responsive settlements, stronger communities, and will act as a way to future proof inhabitation of these fragile yet hazardous places. Design research explores the physical as well as intangible aspects of settlement application, and focuses on communities forming the ‘real’ foundation of these temporal environments. Responsive communities arise ‘reactively’ avoiding hazards, and allowing inhabitants to take advantage of what these precious sites offer.</p>

The Unsettled Landscape: The Core to Coastal Fabrics

<p>‘The Unsettled Landscape’ considers an alternative sustainable manner in which communities can settle New Zealand’s coastland. Living at the ocean edge is ingrained in the way many of our urban settlements have formed, and is intricately linked with how we define ourselves. Unfortunately the way these places have manifested in reality has produced ecological barriers to natural cycles paramount to ecosystem health. Sea walls, housing, roads and many other infrastructural typologies resist the natural ‘flux’ of these areas, which results in dysfunctional ecosystems as well as putting residents of these places at risk of numerous threats which occur along these interface sites. Earthquakes, river movement, erosion, sea level rise, flooding and the continual movement of the dunes are just some of the issues coastal settlements face. The conflict forms where the sought after coastal environments are applied to in a permanent manner that is irresponsive of a landscape which functions in a most dynamic way. This thesis looks towards the geomorphological patterns in the coast as an indicator for how a complete shift in infrastructural application might occur responsively. This new fabric distinguishes stable components in this shifting landscape, utilising them as a stable network from which settlement can develop. This network could become the basis of more responsive settlements, stronger communities, and will act as a way to future proof inhabitation of these fragile yet hazardous places. Design research explores the physical as well as intangible aspects of settlement application, and focuses on communities forming the ‘real’ foundation of these temporal environments. Responsive communities arise ‘reactively’ avoiding hazards, and allowing inhabitants to take advantage of what these precious sites offer.</p>

CO₂ Surface Variability, from the Stratosphere or Not?

Fluctuations in atmospheric CO2 can be measured with great precision and are used to identify human-driven sources as well as natural cycles of ocean and land carbon. One source of variability is the stratosphere, where the influx of aged CO2-depleted air can produce fluctuations at the surface. This process has been speculated a potential source of interannual variability (IAV) in CO2 that might obscure the quantification of other sources of IAV. Given the recent success in demonstrating that the stratospheric influx of N2O- and chlorofluorocarbon-depleted air is a dominant source of their surface IAV in the southern hemisphere, we here apply the same model and measurement analysis to CO2. Using chemistry-transport modeling or scaling of the observed N2O variability, we find that the stratosphere-driven surface variability in CO2 is at most 10 % of the observed IAV and is not an important source. The southern hemisphere stations with multi-decadal CO2 records can provide clues to sources through the phase shifts of the IAV relative to the northern hemisphere.

Local wisdom as environmental education on Kasepuhan Ciptagelar

The purpose of this study is to overview the local wisdom from local knowledge and local value, which build as an environmental educational approach to Kasepuhan Ciptagelar society. This research used a qualitative approach through in-depth interviews, observation, and document evaluation from June until November 2019 on the Kasepuhan Ciptagelar society. The data analysis of this study was completed through a process of reduction, verification, and conclusions. Local wisdom at Kasepuhan Ciptagelar contains environmental education values; physical, social, and cultural-environmental educations. It shows from their attachment to nature where the laws and natural cycles become their benchmark in the agricultural system used. Activities related to the society farming system are still implemented collectively to strengthen ties between residents through cooperation, which is a characteristic of their social-environmental education and seen from cultural-environmental education. It is closely related to a series of customary rituals that must be carried out by the Kasepuhan Ciptagelar agricultural activity.

Retrospective cohort study on preparation regimens for frozen embryo transfer

Objective: To examine the pregnancy outcomes from frozen embryo transfer (FET) cycles using different endometrial preparation regimens, compared to ovulation induction with letrozole (letrozole OI). Design: Retrospective cohort study. Setting: Fertility centre in Sydney, Australia. Patient(s): 6060 frozen embryo transfer cycles. Interventions: Cycles were stratified into one of four ways to achieve endometrial preparation. These were either a natural, letrozole OI, OI with follicle stimulating hormone (FSH OI) or a programmed cycle. Main Outcome Measure(s): The primary outcome was live birth rate per embryo transfer (LBR). Secondary outcomes included clinical pregnancy and biochemical pregnancy rates, adverse events including miscarriage, ectopic pregnancy, stillbirth, neonatal death and multiple births. Ovarian stimulation parameters were also analysed including time taken to reach the luteal phase and the number of blood or urine tests required for monitoring of the cycle. Results: The LBR following letrozole OI cycles was higher when compared to natural cycles (OR 1.27 (1.07 – 1.49)) and programmed cycles (OR 2.36 (1.67 – 3.34)). There was no significant difference between letrozole OI and FSH OI LBR (OR 0.99 (0.76 – 1.28)). An improved LBR with letrozole OI compared to natural cycles was maintained when only women with a normal length cycle were considered (OR 1.44 (1.10 – 1.89)). There was a significant reduction in miscarriage rates when letrozole OI was compared to programmed cycles (OR 0.46 (0.26 – 0.83)). Conclusion(s): The use of letrozole OI for endometrial preparation in an FET cycle may be associated with higher LBR and lower miscarriage rate, compared to using a programmed cycle.