Reductions in non-point source pollution through different management practices for an agricultural watershed in the Three Gorges Reservoir Area

Non-point source water pollution generated by agricultural production is considered a major environmental issue in the Three Gorges Reservoir Area （TGRA） of China. The Annualised Agricultural Non-Point Source Pollution （AnnAGNPS） model was selected to assess the impact of the application of various management treats, including seven crops, five fertilizer levels and three-group management practice scenarios, on water quality from Heigou River Watershed in TGRA. The scenario subsets include conservation tillage practice （CTP）, conservation reserve program （CRP） and conversion of cropland into forestland program （CCFP）. Results indicated that tea can not be replaced by other crops because comparatively tea resulted in a higher sediment yield. CTP with no-tillage was more effective to reduce sediment yield, but could increased nutrient loss. CRP reduced sediment yield significantly, but slightly benefited on nutrient loss. CCFP reduced not only sediment yield but also the nutrient loss significantly. The conversion of cropland with a slope greater than 10° into forestland was found to be the best scenario as the sediment yield export is less than 5 tons/ha and nutrient loss is within the permissible limit.

Sustainable Management of Rice Insect Pests by Non-Chemical-Insecticide Technologies in China

Chemical pesticides play crucial roles in the management of crop diseases and pests. However, excessive and irrational use of pesticides has become a major concern and obstacle to sustainable agriculture. As a result, the quality and security of agricultural products are reduced, and the ecological and environmental integrities are threatened. Recently, environment-friendly pest management measures have been introduced and adopted to manage rice insect pests and reduce the use of insecticides. This paper reviewed the advancements in development and application of non-chemical technologies for insect pest management during rice production in China.

Non-operative management of isolated liver trauma

Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management（NOM） is a selective method for liver trauma. The aim of this study was to determine the success rate, mortality and morbidity of NOM for isolated liver trauma.Medical records of 81 patients with isolated liver trauma in our unit were analyzed retrospectively. The success rate, mortality and morbidity of NOM were evaluated. In this series, 9 patients with grade IV-V liver injuries underwent emergent operation due to hemodynamic instability; 72 patients, 6 with grade V, 18 grade IV, 29 grade III, 15 grade II and 4 grade I, with hemodynamic stability received NOM. The overall success rate of NOM was 97.2%（70/72）. The success rates of NOM in the patients with grade I-III, IV and V liver trauma were100%, 94.4% and 83.3%. The complication rates were 10.0%and 45.5% in the patients who underwent NOM and surgical treatment, respectively. No patient with grade I-II liver trauma had complications. All patients who underwent NOM survived.NOM is the first option for the treatment of liver trauma if the patient is hemodynamically stable. The grade of liver injury and the volume of hemoperitoneum are not suitable criteria for selecting NOM. Hepatic angioembolization associated with the correction of hypothermia, coagulopathy and acidosis is important in the conservative treatment for liver trauma.

Population distribution and threats to sustainable management of selected non-timber forest products in tropical lowland rainforests of south western Nigeria

Uncontrolled harvesting of non-timber forest products （NTFPs） poses a serious risk of extermination to several of these species in Nigeria. Yet, there is a paucity of information on the distribution, population status and sustainable management of NTFPs in most of the tropical lowland rainforests. We, therefore, assessed the population, distribution and threats to sustainable management of NTFPs within the tropical lowland rainforests of Omo and Shasha Forest Reserves, south western Nigeria. Data were obtained through inventory surveys on five top priority species including： bush mango （Irvingia gabonensis （Aubry-Lecomte ex O’Rorke） Baill）, African walnut （Tetracarpidium conophorum （Mull. Arg.） Hutch. ＆ Dalziel syn. Plukenetia conophora）, chew-stick （Massularia acuminata （G. Don） Bullock）, fever bark （Annickia chlorantha Setten ＆ P.J.Maas syn. Enantia chloranta） and bush pepper （Piper guineense Schumach. ＆ Thonn.）. Purposive and stratified random sampling techniques were used for the inventory. Each forest reserve was stratified into three, viz： less disturbed natural forest （for areas that have been rested for at least ten years）, recently disturbed natural forest （for areas that have suffered one form of human perturbation or the other in the last five years）, and plantation forest （for areas carrying forest plantation）. Data were collected from eighteen 10 m × 500 m belt transects located in the above strata. The species were generally fewer in both plantation and recently disturbed natural forest than the less disturbed natural forest, suggesting that forest disturbances （habitat modification） for other uses may have an effect on the occurrence and densities of the NTFPs. Exceptions to this trend were found for P. guineense and T. conophorum, which were fairly common in both plantation and recently disturbed natural forest. Among three tree NTFP species （i.e. I. gabonensis, M. acuminata and A. chlorantha）, only I. gabonensis showed a significant difference in overall DBH size classes for both reserves （t=？2.404; df =21; p=0.026）. Three tree NTFP species in both reserves further showed differences from the regular patterns of distribution of trees. The fairly regular reverse J-shaped size class distribution observed for M. acuminata in the study sites, however, suggests a recuperating population. In general, destructive harvesting of species, logging operations, low population size, narrow distribution ranges and habitat degradation are the major threats to the population of NTFPs in the study area. The implications of our findings for sustainable management of NTFPs in the study area are discussed and recommendations are made for a feasible approach towards enhancing the status of the species.

The Effectiveness of Non-Surgical Weight Management Interventions for Obesity in the UK: A Review and Meta-Regression Analysis

Background: Obesity is regarded as one of the most serious challenges public health faces in the 21st century for adults and children alike. Accordingly weight management interventions remain a public health priority aiming to reduce the burden of obesity and co-morbidities. Therefore this review aims to assess the effectiveness of non-surgical weight management interventions for obesity in the UK. Method: Thirty one databases were searched that identified 20 articles for inclusion. Articles were screened and quality scored using the “Effective Public Health Practice Project Quality Assessment Tool”. Meta-regression analysis (MRA) was undertaken on seven studies that allowed for effect size calculations. Results: In adult populations, lifestyle interventions that targeted both diet and physical activity, delivered in the private sector were most effective in reducing weight and/or BMI, and were more cost-effective. In children the most successful interventions mirrored adult interventions, but were family-orientated. MRA supported these findings. Most frequent intervention duration was 12 weeks. Discussion: The results provide evidence to support policy makers for the effective delivery of weight management interventions. Findings suggest that weight management interventions in the UK are effective in reducing weight and/or BMI for both children and adults. Interventions delivered in the private sector (e.g. Weight Watchers), targeting diet and physical activity levels, demonstrated the highest levels of effectiveness. However, compared to these models, NHS programmes are less well defined in the research literature and may not have been optimised. For children, effectiveness is improved by family-level programmes incorporating children and their parents.

A Study on Compensation for Management and Protection Expenses of Non-commercial Forests

This paper analyzes the compensation nature of non-commercial forests under different ownership from two aspects, namely, whether the property right is limited and whether the management and protection expense has been incurred: there are no economic loss compensation problems caused by changes and limitation of property rights for the state-owned non-commercial forests with only the compensation on management and protection expense; but for the non-commercial forests owned by collectives or individuals, double compensation for both the economic loss and management expense exists because of limitation on the property right. In addition, an inframarginal economic analysis framework has been built for the management and protection compensation problems faced by non-commercial forests under different ownership in the perspective of the division of labor. Research results show that: the compensation standard for the management and protection expenses of non-commercial forests shall fall in between the "completely self-sufficient forestry economic structure U(Ayz)" and the "completely specialized productive structure of non-commercial forests U(B1)".

A Project Management and Decision Support System for Non-standard Equipment's Eexecuting Work

Based on the features of the non-standard equipment executing work, a project management and decision support system oriented to the non-standard equipment is developed, and the information model, function model as well as the structure framework of the system are also introduced in this paper.

Sedimentation retention basin utilization for best management practice

Approaches to the artificial impoundment and theoretical design of sedimentation retention basin are reviewed with particular attention to best management practice(BMP) to control agriculture and surface runoff. Sediments retention basins are the small version of farm pond used where a criteria of farm pond is not met. Such basin traps the pollutants and suspended solids prior to entry into streams and lakes. The study is focused with special reference to the assessment and control of non point source pollution(NPSP) from the sub basin area of Tai Lake in the Xishan County of Wuxi City of China. The author suggested two different approaches to conduct this study including theoretical design for sedimentation retention basin and computation of flow, sediment transport and deposition during the artificial impoundment of retention basin for BMP's utilization. Theoretical design will provide a useful function as a first line defense against the movement of sediments and transport of pollutants into the Tai Lake while the assessment of sediments deposition will help to make its proper use and periodic cleanup.

Liver trauma: What current management?

Background: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years.Methods: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied. The patients were divided into 2 groups, operated and non-operated groups, according to the initial management considered appropriate at the time of patient admission. Clinical features and outcomes were analyzed.Results: The study involved 83 patients, with a mean age of 33 years and a marked male predominance(85.5%). The most common type of lesions was blunt trauma and the main cause was road traffic accidents. Sixty-eight liver injuries(81.9%) were of low severity(grades Ⅰ,Ⅱ,Ⅲ), while 15(18.1%) were of high severity(grade Ⅳ or greater). Fifty-six patients(67.5%) had multiple injuries. Surgical treatment was performed in 26(31.3%) patients. Non-operative management was undertaken in 57 cases(68.7%). The morbidity and mortality rates were clearly lower in non-operative patients compared to those in the operated group.Conclusions: Careful non-operative management is an adequate therapeutic strategy for the patients suffering from liver trauma with stable hemodynamics. Patients with complex hepatic trauma and especially those with other organ injuries continue to have significantly higher mortality.

Management of proximal humerus fractures in adults

The majority of proximal humerus fractures are lowenergy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures.Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each indi-vidual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes.

Options for Healthcare Waste Management and Treatment in China

Healthcare waste management and treatment is one of the national priority tasks of China’s Tenth Five-Year Plan. Numerous installations disposing medical waste have already operated the project or under construction to the operation in 2006. This paper focuses on the assessment of existing and future options to handle medical waste (MW). Internationally available and so far in China applied technologies and management practice are analysed, including the problems how to segregate medical waste streams at the source and to reduce the ‘critical waste’ to mainly infectious and aesthetically sensible materials. Non-hazardous MW can be managed and treated in analogue to municipal solid waste (MSW). In most of the European countries decentralised hospital incinerators have been, because of high operation costs and pollution problems, widely banned and replaced by pre-treatment technologies at the source and centralised incineration plants for hazardous MW. Information for adapting and further developing MW management solutions and treatment technologies in China and applying the most appropriate MWM practice is provided.

Differential Game Based Link Resource Management for Next Generation Optical Network

In this paper, we investigate the link resource management problem for optical networks, to achieve the resource cost during the information transmission. We use the differential game to formulate the cost control problem for the link resource management, to minimize the resource allocation cost functions, which dynamic behaviours are described by differential equations. Each link controls its transmission bandwidth based on the Nash equilibriums of the differential game. The effectiveness of the proposed model is given through numerical simulations.

Acute pain management in symptomatic cholelithiasis

AIM To review the evidence for the use of different nonsteroidal anti-inflammatory drugs(NSAIDs) in the treatment of biliary colic.METHODS The strategies employed included an extensive literature review for articles and studies related to biliary colic from electronic databases including Pub Med,Science Direct,Wiley Inter Science,Medline and Cochrane from last 15 years.Keywords: "Biliary colic","management of biliary colic","non-steroidal anti-inflammatory drugs","cholelithiasis" and "biliary colic management".Six randomized control trials,1 non-randomized trial and 1 meta-analysis were included in this review.The outcomes of these studies and their significance have been reviewed in this paper.RESULTS Current evidence suggests there are no set protocols for biliary colic pain management.NSAIDs are potent in the management of biliary colic,not only in terms of symptom control but in disease progression as well.Apart from the studies on diclofenac and ketorolac,there are studies which have shown that intravenous tenoxicam and injectable flurbiprofen are equally effective in managing biliary colic.The efficacy of NSAIDs is superior in terms of lower number of doses and longer duration of action in comparison to other analgesic agents.CONCLUSION This literature review has found that NSAIDs are safe and effective for pain control in biliary colic,and reduce the likelihood of further complications.

Decentralized Control for Residential Energy Management of a Smart Users' Microgrid with Renewable Energy Exchange

This paper presents a decentralized control strategy for the scheduling of electrical energy activities of a microgrid composed of smart homes connected to a distributor and exchanging renewable energy produced by individually owned distributed energy resources. The scheduling problem is stated and solved with the aim of reducing the overall energy supply from the grid, by allowing users to exchange the surplus renewable energy and by optimally planning users' controllable loads. We assume that each smart home can both buy/sell energy from/to the grid taking into account time-varying non-linear pricing signals. Simultaneously, smart homes cooperate and may buy/sell locally harvested renewable energy from/to other smart homes. The resulting optimization problem is formulated as a non-convex non-linear programming problem with a coupling of decision variables in the constraints. The proposed solution is based on a novel heuristic iterative decentralized scheme algorithm that suitably extends the Alternating Direction Method of Multipliers to a non-convex and decentralized setting. We discuss the conditions that guarantee the convergence of the presented algorithm. Finally, the application of the proposed technique to a case study under several scenarios shows its effectiveness.

Penetrating Abdominal Injuries: Pattern and Outcome of Management in Khartoum

Background: The pattern and presentation of penetrating abdominal trauma vary according to places and the structure of the present health system. As well controversies in management exist ranging from mandatory exploration to selective non-operative management. Objectives: To determine the pattern of penetrating abdominal trauma, current management practiced and outcome in Khartoum. Patients and Methods: The study was prospective, descriptive and hospital-based. It was carried out at the main three hospitals in Khartoum State. It was conducted over a period of one year from 2012 Mar to 2013 Mar. All patients who presented penetrating injury to their abdomen were included. Results: The study included 85 patients with a mean age of 28 years (SD ± 10). The male to female ratio was 11:1. Most of the patients (89.4%) were in the first four decades of their life. Twenty-three patients (27.1%) presented shock. Stab wound is the commonest mode of trauma seen in 83.5% of our patients. The majority of our patients were managed by exploratory laparotomy (81.2%), however 16 (18.8%) underwent conservative measures. Of the operated group, solid organ injuries were found in 22.9%, yet hollow viscous injuries were reported in 86.9% of the patients. Registrars operated on 78.26% of the patients. The rate of negative laparotomy of this study was 8.7%. Complications and mortality were encountered in 25.9% and 4.7% respectively. The mean hospital stay was 8.47 days (SD ± 10.6). Conclusion: This study demonstrates no difference in the pattern of intra-abdominal injuries. The rate of operative treatment is acceptable, but more laparotomies can be avoided if the haemodynamic stable patients without features of peritonitis were given a period of observation. The overall outcome was satisfactory.

Nitrogen and Phosphorus Loss Law and Emission Reduction Effects Under Water and Fertilizer Management Integrated Mode in Dike Paddy Field

To achieve the purpose of reducing farm non-point source pollution, we integrated site specific nitrogen management precise irrigation, controlled drainage, and wetland eco-repair system in dike area of Taihu basin. During investigation, it had given prominence for the water and fertilizer coupling effects of precise irrigation and site specific nutrient management, the characteristics of integration on controlled irrigation, controlled drainage and wetland ecosystem non-point source pollution control. Then the water and fertilizer integrated management mode of paddy field was put forward in Taihu basin where the water production efficiency increased to 1.64 kg. m-3, water saved 37.8%, fertilizer use efficiency raised 15,4%, yield raised 10%, and N, P load decreased 26%-72%. The modern agricultural and farmland ecosystems that control and cut down the farm non-point source pollution came into being, which can be a reference by Taihu basin to control its agricultural non-point source pollution and eutrophicated water body.

Management of local recurrence after endoscopic resection of neoplastic colonic polyps

A proportion of neoplastic polyps are incompletely resected, resulting in local recurrence, especially after resection of large polyps or piecemeal resection. Local recurrences that develop after endoscopic resection of intramucosal neoplasms that lacked risk factors for lymph node metastasis or positive vertical margins are usually treated endoscopically. Endoscopic submucosal dissection(ESD) is indicated for local residual or recurrent early carcinomas after endoscopic resection. However, ESD for such recurrent lesions is technically difficult and is typically a lengthy procedure. Underwater endoscopic mucosal resection(UEMR), which was developed in 2012, is suitable for recurrent or residual lesions and reportedly achieves superior en bloc resection rates and endoscopic complete resection rates than conventional EMR. However, a large recurrent lesion is a negative independent predictor of successful en bloc resection and of complete endoscopic removal. We therefore perform UEMR for relatively small(≤ 10-15 mm) recurrent lesions and ESD for larger lesions.

State-of-the-Art management of knee osteoarthritis

Osteoarthritis(OA) is the most common type of arthritis found in the United States' population and is also the most common disease of joints in adults throughout the world with the knee being the most frequently affected of all joints. As the United States' population ages along with the increasing trends in obesity prevalence in other parts of the world, it is expected that the burden of OA on the population, healthcare system, and overall economy will continue to increase in the future without making major improvements in managing knee OA. Numerous therapies aim to reduce symptoms of knee OA and continued research has helped to further understand the complex pathophysiology of its disease mechanism attempting to uncover new potential targets for the treatment of OA. This review article seeks to evaluate the current practices for managing knee OA and discusses emerging therapies on the horizon. These practices include non-pharmacological treatments such as providing patient education and self-management strategies, advising weight loss, strengthening programs, and addressing biomechanical issues with bracing or foot orthoses. Oral analgesics and anti-inflammatories are pharmacologicals that are commonly used and the literature overall supports that some of these medications can be helpful for managing knee OA in the short-term but are less effective for long-term management. Additionally, more prolonged use significantly increases the risk of serious associated side effects that are not too uncommon. Diseasemodifying osteoarthritis drugs are being researched as a treatment modality to potentially halt or slow disease progression but data at this time is limited and continued studies are being conducted to further investigate their effectiveness. Intra-articular injectables are also implemented to manage knee OA ranging from corticosteroids to hyaluronans to more recently plateletrich plasma and even stem cells while several other injection therapies are presently being studied. The goal of developing new treatment strategies for knee OA is to prolong the need for total knee arthroplasty which should be utilized only if other strategies have failed. High tibial osteotomy and unicompartmental knee arthroplasty are potential alternatives if only a single compartment is involved with more data supporting unicompartmental knee arthroplasty as a good treatment option in this scenario. Arthroscopy has been commonly used for many years to treat knee OA to address degenerative articular cartilage and menisci, however, several high-quality studies have shown that it is not a very effective treatment for the majority of cases and should generally not be considered when managing knee OA. Improving the management of knee OA requires a multi-faceted treatment approach along with continuing to broaden our understanding of this complex disease so that therapeutic advancements can continue to be developed with the goal of preventing further disease progression and even potentially reversing the degenerative process.

Recreational Access Management Planning: Understanding Perceptions Regarding Public Forest Lands in SW Alberta

Management of recreational access on public forest lands is a complex issue of growing global importance. The provision of public recreation opportunities is part of the suite of ecological goods and services that must be considered by many forest managers. Effective access management is predicated on understanding the attitudes and perceptions of recreation users in order to predict and influence visitor behaviour and gauge the acceptance of new management strategies. Potential access management strategies vary given the nature of recreation activities and include: restricting the amount, type, and spatial distribution of use, visitor education, temporal restrictions and enhancing site durability. In this research we examined the views of recreation users on public lands in southwestern Alberta, Canada through implementation of an online survey (n = 945) with a focus on access management options. The results indicate a strong belief that the quality of the recreation experience is declining and that increased management and enforcement are required. More detailed analysis indicates that demographic and user-type variables strongly influence ideas about appropriate management. Forest managers need to engage with, understand, and respond to a wide variety of recreation user needs and preferences.

Conservative Management of Bilateral Tendoachilles (TA) Rupture—A Case Report

Tendo Achilles ruptures are generally traumatic in origin and while bilateral tendo Achilles ruptures are a rare occurrence, most of them are associated with risk factors or pre-existing disease and generally involve trauma or sporting activities. Most of the cases of bilateral rupture are generally treated operatively. A spontaneous onset case of bilateral tendo achilles rupture is reported in a healthy man and its conservative (non operative) management discussed with a review of the literature.