A biophysical model of atrial fibrillation ablation: what can a surgeon learn from a computer model?

AIMS: Surgical ablation procedures for treating atrial fibrillation have been shown to be highly successful. However, the ideal ablation pattern still remains to be determined. This article reports on a systematic study of the effectiveness of the performance of different ablation line patterns. METHODS AND RESULTS: This study of ablation line patterns was performed in a biophysical model of human atria by combining basic lines: (i) in the right atrium: isthmus line, line between vena cavae and appendage line and (ii) in the left atrium: several versions of pulmonary vein isolation, connection of pulmonary veins, isthmus line, and appendage line. Success rates and the presence of residual atrial flutter were documented. Basic patterns yielded conversion rates of only 10-25 and 10-55% in the right and the left atria, respectively. The best result for pulmonary vein isolation was obtained when a single closed line encompassed all veins (55%). Combination of lines in the right/left atrium only led to a success rate of 65/80%. Higher rates, up to 90-100%, could be obtained if right and left lines were combined. The inclusion of a left isthmus line was found to be essential for avoiding uncommon left atrial flutter. CONCLUSION: Some patterns studied achieved a high conversion rate, although using a smaller number of lines than those of the Maze III procedure. The biophysical atrial model is shown to be effective in the search for promising alternative ablation strategies.

Stocking densities and feeding strategies in shrimp and tilapia polyculture in tanks

The objective of this work was to evaluate the performance of Pacific marine shrimp (Litopenaeus vannamei) and tilapia (Oreochromis niloticus), in a polyculture in tanks subjected to different stocking densities and feeding strategies, in comparison with monoculture. Two experiments were performed, at the same time, in a completely randomized design with three treatments and four replicates each. Treatments for experiment I were: monoculture with 10 shrimp per m² (10S:0T); polyculture with 10 shrimp and 0.5 tilapia per m² (10S:0.5T); and polyculture with 10 shrimp and 1 tilapia per m² (10S:1T). Shrimp was the main crop, and feed was provided based on shrimp biomass. Treatments for experiment II were: monoculture with 2 tilapia per m² (2T:0S); polyculture with 2 tilapia and 2.5 shrimp per m² (2T:2.5S); and polyculture with 2 tilapia and 5 shrimp per m² (2T:5S). Tilapia was the main crop, and feed was provided based on fish requirements. In the experiment I, tilapia introduction to shrimp culture resulted in lower shrimp growth and poor feed conversion rate. In experiment II, shrimp introduction to tilapia culture did not interfere with fish performance. Polyculture is more efficient with the combination of 2 tilapia and 2.5 or 5 shrimp per m² and feed based on fish requirements.

A model for organ donation in switzerland, the latin organ donation programme (lodp); an ongoing successful regional initiative

Background: The 1st Swiss federal Transplant Law was finally enforced in July 2007 with the obligation to promote quality and efficiency in transplant procedures. The LODP was created to develop organ and tissue donation in the Latin area of Switzerland covering seventeen hospitals (29% of the population).Methods: Each of the partner hospitals designated at least one Local Donor Coordinator (LDC), member of the Intensive Care team, trained in the organ donation (OD) process. The principal tasks of the LDC's are the introduction of OD procedures, organisation of educational sessions for hospital staff and execution of the Donor Action programme. The LODP has been operational since July 2009, when training of the LDC's was completed, the web-site and hotline activated and the attendance of Transplant Procurement Coordinators (TPC) during the OD process organised.Results: National and regional guidelines are accessible on the LODP website. The Hospital Attitude Survey obtained a 57% return rate. Many of the staff requested training and sessions are now running in the partner hospitals. The Medical Record Revue revealed an increase in the conversion rate from 3.5% to 4.5%. During the 5 years before creation of LODP the average annual number of utilised donors was 31, an increase of 70%, has since been observed.Conclusion: This clear progression in utilised donors in the past two years can be attributed to the fact that partner hospitals benefit from the various support given (hotline, website and from TPC's). Despite the increase in OD within the LODP the Swiss donation rates remain low, on average 11.9 donors per million population. This successful model should be applied throughout Switzerland, but the crucial point is to obtain financial support.

Web Presence Building and Performance Measuring in Business-to-Business Markets

Tutkimuksen tavoite oli selvittää yrityksen web toiminnan rakentamisen vaiheita sekä menestyksen mittaamista. Rakennusprosessia tutkittiin viisiportaisen askelmallin avulla. Mallin askeleet ovat; arviointi, strategian muotoilu, suunnitelma, pohjapiirros ja toteutus. Arviointi- ja toteutusvaiheiden täydentämiseksi sekä erityisesti myös internet toiminnan onnistumisen mittaamisen avuksi internet toiminnan hyödyt (CRM,kommunikointi-, myynti-, ja jakelukanava hyödyt markkinoinnin kannalta) käsiteltiin. Toiminnan menestyksen arvioinnin avuksi esiteltiin myös porrasmalli internet toimintaan. Porrasmalli määrittelee kauppakulissi-, dynaaminen-, transaktio- ja e-businessportaat. Tutkimuksessa löydettiin menestystekijöitä internet toimintojen menestykselle. Nämä tekijät ovat laadukas sisältö, kiinnostavuus, viihdyttävyys, informatiivisuus, ajankohtaisuus, personoitavuus, luottamus, interaktiivisuus, käytettävyys, kätevyys, lojaalisuus, suoriutuminen, responssiivisuus ja käyttäjätiedon kerääminen. Mittarit jaettiin tutkimuksessa aktiivisuus-, käyttäytymis- ja muunnosmittareihin. Lisäksi muita mittareita ja menestysindikaattoreita esiteltiin. Nämä menestyksen elementit ja mittarit koottiin yhteen uudessa internet toimintojen menestyksenarviointimallissa. Tutkielman empiirisessä osuudessa,esitettyjä teorioita peilattiin ABB:n (ABB:n sisällä erityisesti ABB Stotz-Kontakt) web toimintaan. Apuna olivat dokumenttianalyysi sekä haastattelut. Empiirinen osa havainnollisti teoriat käytännössä ja toi ilmi mahdollisuuden teorioiden laajentamiseen. Internet toimintojen rakentamismallia voidaan käyttää myös web toimintojen kehittämiseen ja porrasmalli sopii myös nykyisten internet toimintojen arvioimiseen. Mittareiden soveltaminen käytännössä toi kuitenkin ilmi tarpeen niiden kehittämiseen ja aiheen lisätutkimukseen. Niiden tulisi olla myös aiempaatiiviimmin liitetty kokonaisvaltaisen liiketoiminnan menestyksen mittaamiseen.

Assessment of metabolic fluxes in the mouse brain in vivo using 1H-[13C] NMR spectroscopy at 14.1 Tesla.

(13)C magnetic resonance spectroscopy (MRS) combined with the administration of (13)C labeled substrates uniquely allows to measure metabolic fluxes in vivo in the brain of humans and rats. The extension to mouse models may provide exclusive prospect for the investigation of models of human diseases. In the present study, the short-echo-time (TE) full-sensitivity (1)H-[(13)C] MRS sequence combined with high magnetic field (14.1 T) and infusion of [U-(13)C6] glucose was used to enhance the experimental sensitivity in vivo in the mouse brain and the (13)C turnover curves of glutamate C4, glutamine C4, glutamate+glutamine C3, aspartate C2, lactate C3, alanine C3, γ-aminobutyric acid C2, C3 and C4 were obtained. A one-compartment model was used to fit (13)C turnover curves and resulted in values of metabolic fluxes including the tricarboxylic acid (TCA) cycle flux VTCA (1.05 ± 0.04 μmol/g per minute), the exchange flux between 2-oxoglutarate and glutamate Vx (0.48 ± 0.02 μmol/g per minute), the glutamate-glutamine exchange rate V(gln) (0.20 ± 0.02 μmol/g per minute), the pyruvate dilution factor K(dil) (0.82 ± 0.01), and the ratio for the lactate conversion rate and the alanine conversion rate V(Lac)/V(Ala) (10 ± 2). This study opens the prospect of studying transgenic mouse models of brain pathologies.

Sinkkirikasteen liuotusprosessin kineettinen mallinnus

Työssä on tehty kineettinen simulointimalli sinkkirikasteen liuotusprosessista. Prosessi on pieni osa Kokkolan sinkinvalmistusprosessia, jonka muita osia ovat: pasutus, neutraaliliuotus, konversio, liuospuhdistus ja elektrolyysi. Rikasteen liuotukseen tulee konversioprosessin liuos ja liuotuksesta lähtevä neste menee takaisin neutraaliliuotukseen. Saostunut jarosiitti läjitetään. Kokkolan liuotusprosessi koostuu liettoreaktorista ja kahdesta neljän liuotusreaktorin sarjasta. Liuotukseen syötetään paluuhappoa liettoreaktoriin ja liuotuspiirien ensimmäisiin liuotusreaktoreihin. Happea syötetään kaikkiin liuotusreaktoreihin. Prosessin mallintamiseen käytettiin Aspen Plus-simulointiohjelmaa, johon pystyttiin syöttämään kineettisiä yhtälöitä. Reaktionopeusyhtälöitä käytettiin raudan hapetuksen, sulfidien liuotuksen ja jarosiitiin saostumisen mallintamiseen, eli kaikkiin liuotusreaktoreissa tapahtuviin reaktioihin. Kineettiset yhtälöt etsittiin kirjallisuudesta. Liettoreaktori puolestaan mallinnettiin syöttämällä ohjelmaan reaktioyhtälöt ja antamalla niille etenemisasteet. Jarosiitin liukenemisesta työssä on tehty laboratoriokokeita, koska aiheesta ei kirjallisuudesta löytynyt kineettistä tietoa. Liuotuskokeissa käytetyn kiintoaineen kuitenkin todettiin sisältävän liikaa götiittiä, että tuloksista olisi voitu laskea kinetiikkaa jarosiitin liukenemiselle. Simulointimallilla laskettiin yksi tapaus vertailukohdaksi, johon malliin tehtyjä muutoksia verrattiin. Mallilla tutkittiin konversiosta tulevan jarosiitin määrän vaikutusta, reaktorikoon merkitystä ja rikasteen liuotuksen sekä jarosiitin saostuksen reaktionopeuksien muutoksen vaikutuksia. Käytetyillä kineettisillä yhtälöillä reaktioiden todettiin tarvitsevan vain ¾ käytetystä reaktiotilavuudesta, rikasteen liuotusnopeuden kohtalaisen pienellä hidastamisen todettiin vähentävän sinkin saantoa ja jarosiitin saostuksen reaktionopeuden kasvulla todettiin myös olevan negatiivinen vaikutus sinkin saantoon. Simulointimallissa käytettyjen reaktionopeusyhtälöiden varmentaminen kokeilla todettiin tarpeelliseksi, sillä jo kohtalaisen pienillä muutoksilla havaittiin olevan merkitystä prosessin toimivuuteen. Lisäksi todettiin jarosiitin liukenemisen huomioimisen olevan tarpeen.

Otimização das condições de produção de ésteres etílicos a partir de óleo de peixe com elevado teor de ácidos graxos ômega-3

The production of ethyl esters by alcoholysis is an alternative for splitting triacylglycerols due to the possibility of using low temperatures, which results in oxidative protection of the polyunsaturated fatty acids. Ethyl esters produced under mild conditions of temperature could be used as substrate for obtaining structured lipids. The reaction parameters of production of ethyl esters from fish oil with high content of omega-3 fatty acids by alcoholysis were optimized using response surface methodology. An experimental design (2³) (with levels +1 and -1, six axial points with levels -alpha and +alpha and three central points) was applied. The variables investigated were concentration of catalyst, amount of ethyl alcohol and temperature. Ethyl ester conversion was monitored by high performance size exclusion chromatography (HPSEC) and the best result obtained was 95% conversion rate. The optimal conditions were 40 °C, 1% of NaOH and 36% of ethanol.

Optimization of wood flour acetylation by factorial design and partial least squares regression

Acetylation was performed to reduce the polarity of wood and increase its compatibility with polymer matrices for the production of composites. These reactions were performed first as a function of acetic acid and anhydride concentration in a mixture catalyzed by sulfuric acid. A concentration of 50%/50% (v/v) of acetic acid and anhydride was found to produced the highest conversion rate between the functional groups. After these reactions, the kinetics were investigated by varying times and temperatures using a 3² factorial design, and showed time was the most relevant parameter in determining the conversion of hydroxyl into carbonyl groups.

Aplication of videothoracoscopy in trauma - experience of a service

Objective: To evaluate patients with chest trauma submitted to videothoracoscopy during hospitalization. In 2007, the Trauma Surgery Group was created in the General Surgery Department of the Hospital Municipal Lourenço Jorge of Rio de Janeiro-RJ, and started following all trauma victims who were admitted to the Hospital. Methods : We conducted a retrospective analysis of patients submitted to thoracoscopy from July 2007 to May 2015, based on a database started at the beginning of this period and on data collection from patients who underwent thoracoscopy. We evaluated the following parameters: procedure effectiveness, indication of the procedure, conversion rate, complications and mortality. We included patients who presented post-traumatic pleural collections, such as retained hemothorax and pleural empyema, and penetrating injury in the thoracoabdominal transition. All patients were hemodynamic stable and signed an informed consent. Results: In the analyzed period 53 patients were submitted to videothoracoscopy; 24 had penetrating trauma (45.3%) and 29, blunt (54.7%), with a predominance of males (75.5%). The procedure was performed in 26 cases of retained hemothorax (49%), 14 cases of empyema (26.5%) and in 13 patients for evaluation of injury in the thoracoabdominal transition (24.5%). The thoracoscopy was effective in resolution of 36 cases (80%), without need for further procedure. There was a conversion rate of 15.5% and 3 procedure complications related (6.6%). Mortality was nil. Conclusion: In this series, videothoracoscopy proved that this diagnostic and therapeutic procedure is safe and effective, if performed by a surgeon with appropriate training, especially when it is indicated in cases of retained hemothorax and evaluation of penetrating thoracoabdominal trauma.

Comparison between open and laparoscopic elective cholecystectomy in elderly, in a teaching hospital

Objective: to analyze the differences in mortality rates, length of hospital stay, time of surgery and the conversion rate between elective open cholecystectomies (OC) and laparoscopic ones (LC) in elderly patients. Methods : we evaluated medical records of patients 65 years of age or older undergoing open or laparoscopic cholecystectomy at the Hospital Regional de Mato Grosso do Sul between January 2008 and December 2011. We excluded individuals operated in non-elective scenarios or who underwent intraoperative cholangiography. Results : we studied 113 patients, of whom 38.1% were submitted to the OC and 61.9%, to LC. Women accounted for 69% of patients and men, for 31%. The conversion rate was 2.9%. The mean age and duration of the procudure was 70.1 and 84 minutes, respectively, with no significant difference between OC and LC. Patients undergoing LC had shorter hospital stays (2.01 versus 2.95 days, p=0.0001). We identified operative complications in sixpatients (14%) after OC and in nine (12%) after LC, with no statistical difference. Conclusion : there was no difference in morbidity and mortality when comparing OC with LC. The laparoscopic approach led to shorter hospital stay. Operative time did not differ between the two access routes. The conversion rate was similar to other studies.

Effects of fumonisin B1 on selected biological responses and performance of broiler chickens

The objective of this study was to determine the effects of three doses of fumonisin B1 (0, 100, and 200mg/kg of feed) on biological variables (relative weight of liver [RWL], total plasma protein [TPP], albumin [Alb], calcium [Ca], phosphorus [P], uric acid [UA], alanine aminotransferase [ALT], aspartate aminotransferase [AST], gamma glutamyltransferase [GGT], alkaline phosphatase [AP], total cholesterol [Chol], triglycerides [Tri], sphinganine-to-sphingosine ratio [SA:SO], and C-reactive protein [CRP]), morphological evaluation of the small intestine (villus height [VH], crypt depth [CD], and villus-to-crypt ratio [V:C]), histological evaluation, and on performance (body weight [BW], feed intake [FI], and feed conversion rate [FCR]) of broiler chickens. Significant effects of FB were observed on BW and FI (reduced), on RWL, TPP, Ca, ALT, AST, GGT, Chol, and Tri (increased) at both 14 and 28 days evaluations. In addition, significant increase was observed on FCR, Alb, P, SA:SO, and CRP and significant reduction in UA, VH, and V:C only at the 28 days evaluation. Significant histological lesions were observed on liver and kidney of FB inoculated broilers at 14 and 28 days. Those results show that FB has a significant effect on biological and histological variables and on performance of broiler chickens.

Search engine advertising in web retailing : an efficiency analysis

This study examines the efficiency of search engine advertising strategies employed by firms. The research setting is the online retailing industry, which is characterized by extensive use of Web technologies and high competition for market share and profitability. For Internet retailers, search engines are increasingly serving as an information gateway for many decision-making tasks. In particular, Search engine advertising (SEA) has opened a new marketing channel for retailers to attract new customers and improve their performance. In addition to natural (organic) search marketing strategies, search engine advertisers compete for top advertisement slots provided by search brokers such as Google and Yahoo! through keyword auctions. The rationale being that greater visibility on a search engine during a keyword search will capture customers' interest in a business and its product or service offerings. Search engines account for most online activities today. Compared with the slow growth of traditional marketing channels, online search volumes continue to grow at a steady rate. According to the Search Engine Marketing Professional Organization, spending on search engine marketing by North American firms in 2008 was estimated at $13.5 billion. Despite the significant role SEA plays in Web retailing, scholarly research on the topic is limited. Prior studies in SEA have focused on search engine auction mechanism design. In contrast, research on the business value of SEA has been limited by the lack of empirical data on search advertising practices. Recent advances in search and retail technologies have created datarich environments that enable new research opportunities at the interface of marketing and information technology. This research uses extensive data from Web retailing and Google-based search advertising and evaluates Web retailers' use of resources, search advertising techniques, and other relevant factors that contribute to business performance across different metrics. The methods used include Data Envelopment Analysis (DEA), data mining, and multivariate statistics. This research contributes to empirical research by analyzing several Web retail firms in different industry sectors and product categories. One of the key findings is that the dynamics of sponsored search advertising vary between multi-channel and Web-only retailers. While the key performance metrics for multi-channel retailers include measures such as online sales, conversion rate (CR), c1ick-through-rate (CTR), and impressions, the key performance metrics for Web-only retailers focus on organic and sponsored ad ranks. These results provide a useful contribution to our organizational level understanding of search engine advertising strategies, both for multi-channel and Web-only retailers. These results also contribute to current knowledge in technology-driven marketing strategies and provide managers with a better understanding of sponsored search advertising and its impact on various performance metrics in Web retailing.

The Development, Validation and Implementation of a Broad-Based ADME Genotyping Assay into Research and Clinical Trials

Afin d’adresser la variabilité interindividuelle observée dans la réponse pharmacocinétique à de nombreux médicaments, nous avons créé un panel de génotypage personnalisée en utilisant des méthodes de conception et d’élaboration d’essais uniques. Celles-ci ont pour but premier de capturer les variations génétiques présentent dans les gènes clés impliqués dans les processus d'absorption, de distribution, de métabolisme et d’excrétion (ADME) de nombreux agents thérapeutiques. Bien que ces gènes et voies de signalement sont impliqués dans plusieurs mécanismes pharmacocinétiques qui sont bien connues, il y a eu jusqu’à présent peu d'efforts envers l’évaluation simultanée d’un grand nombre de ces gènes moyennant un seul outil expérimental. La recherche pharmacogénomique peut être réalisée en utilisant deux approches: 1) les marqueurs fonctionnels peuvent être utilisés pour présélectionner ou stratifier les populations de patients en se basant sur des états métaboliques connus; 2) les marqueurs Tag peuvent être utilisés pour découvrir de nouvelles corrélations génotype-phénotype. Présentement, il existe un besoin pour un outil de recherche qui englobe un grand nombre de gènes ADME et variantes et dont le contenu est applicable à ces deux modèles d'étude. Dans le cadre de cette thèse, nous avons développé un panel d’essais de génotypage de 3,000 marqueurs génétiques ADME qui peuvent satisfaire ce besoin. Dans le cadre de ce projet, les gènes et marqueurs associés avec la famille ADME ont été sélectionnés en collaboration avec plusieurs groupes du milieu universitaire et de l'industrie pharmaceutique. Pendant trois phases de développement de cet essai de génotypage, le taux de conversion pour 3,000 marqueurs a été amélioré de 83% à 97,4% grâce à l'incorporation de nouvelles stratégies ayant pour but de surmonter les zones d'interférence génomiques comprenant entre autres les régions homologues et les polymorphismes sous-jacent les régions d’intérêt. La précision du panel de génotypage a été validée par l’évaluation de plus de 200 échantillons pour lesquelles les génotypes sont connus pour lesquels nous avons obtenu une concordance > 98%. De plus, une comparaison croisée entre nos données provenant de cet essai et des données obtenues par différentes plateformes technologiques déjà disponibles sur le marché a révélé une concordance globale de > 99,5%. L'efficacité de notre stratégie de conception ont été démontrées par l'utilisation réussie de cet essai dans le cadre de plusieurs projets de recherche où plus de 1,000 échantillons ont été testés. Nous avons entre autre évalué avec succès 150 échantillons hépatiques qui ont été largement caractérisés pour plusieurs phénotypes. Dans ces échantillons, nous avons pu valider 13 gènes ADME avec cis-eQTL précédemment rapportés et de découvrir et de 13 autres gènes ADME avec cis eQTLs qui n'avaient pas été observés en utilisant des méthodes standard. Enfin, à l'appui de ce travail, un outil logiciel a été développé, Opitimus Primer, pour aider pour aider au développement du test. Le logiciel a également été utilisé pour aider à l'enrichissement de cibles génomiques pour d'expériences séquençage. Le contenu ainsi que la conception, l’optimisation et la validation de notre panel le distingue largement de l’ensemble des essais commerciaux couramment disponibles sur le marché qui comprennent soit des marqueurs fonctionnels pour seulement un petit nombre de gènes, ou alors n’offre pas une couverture adéquate pour les gènes connus d’ADME. Nous pouvons ainsi conclure que l’essai que nous avons développé est et continuera certainement d’être un outil d’une grande utilité pour les futures études et essais cliniques dans le domaine de la pharmacocinétique, qui bénéficieraient de l'évaluation d'une longue liste complète de gènes d’ADME.

Structural and catalytic investigation of vanadia supported on ceria promoted with high surface area rice husk silica

Rice husk silica was utilized as the promoter of ceria for preparing supported vanadia catalysts. Effect of vanadium content was investigated with 2–10 wt.% V2O5 loading over the support. Structural characterization of the catalysts was done by various techniques like energy dispersive X-ray (EDX), X-ray diffraction (XRD), BET surface area, thermal analysis (TGA/DTA), FT-infrared spectroscopy (FT-IR), UV–vis diffused reflectance spectroscopy (DR UV–vis), electron paramagnetic spectroscopy (EPR) and solid state magnetic resonance spectroscopies (29Si and 51V MASNMR). Catalytic activity was studied towards liquid-phase oxidation of benzene. Surface area of ceria enhanced upon rice husk silica promotion, thus makes dispersion of the active sites of vanadia easier. Highly dispersed vanadia was found for low V2O5 loading and formation of cerium orthovanadate (CeVO4) occurs as the loading increases. Spectroscopic investigation clearly confirms the formation of CeVO4 phase at higher loadings of V2O5. The oxidation activity increases with vanadia loading up to 8 wt.% V2O5, and further increase reduces the conversion rate. Selective formation of phenol can be attributed to the presence of highly dispersed active sites of vanadia over the support.

On the energetics of stratified turbulent mixing, irreversible thermodynamics, Boussinesq models and the ocean heat engine controversy

In this paper, the available potential energy (APE) framework of Winters et al. (J. Fluid Mech., vol. 289, 1995, p. 115) is extended to the fully compressible Navier– Stokes equations, with the aims of clarifying (i) the nature of the energy conversions taking place in turbulent thermally stratified fluids; and (ii) the role of surface buoyancy fluxes in the Munk & Wunsch (Deep-Sea Res., vol. 45, 1998, p. 1977) constraint on the mechanical energy sources of stirring required to maintain diapycnal mixing in the oceans. The new framework reveals that the observed turbulent rate of increase in the background gravitational potential energy GPEr , commonly thought to occur at the expense of the diffusively dissipated APE, actually occurs at the expense of internal energy, as in the laminar case. The APE dissipated by molecular diffusion, on the other hand, is found to be converted into internal energy (IE), similar to the viscously dissipated kinetic energy KE. Turbulent stirring, therefore, does not introduce a new APE/GPEr mechanical-to-mechanical energy conversion, but simply enhances the existing IE/GPEr conversion rate, in addition to enhancing the viscous dissipation and the entropy production rates. This, in turn, implies that molecular diffusion contributes to the dissipation of the available mechanical energy ME =APE +KE, along with viscous dissipation. This result has important implications for the interpretation of the concepts of mixing efficiency γmixing and flux Richardson number Rf , for which new physically based definitions are proposed and contrasted with previous definitions. The new framework allows for a more rigorous and general re-derivation from the first principles of Munk & Wunsch (1998, hereafter MW98)’s constraint, also valid for a non-Boussinesq ocean: G(KE) ≈ 1 − ξ Rf ξ Rf Wr, forcing = 1 + (1 − ξ )γmixing ξ γmixing Wr, forcing , where G(KE) is the work rate done by the mechanical forcing, Wr, forcing is the rate of loss of GPEr due to high-latitude cooling and ξ is a nonlinearity parameter such that ξ =1 for a linear equation of state (as considered by MW98), but ξ <1 otherwise. The most important result is that G(APE), the work rate done by the surface buoyancy fluxes, must be numerically as large as Wr, forcing and, therefore, as important as the mechanical forcing in stirring and driving the oceans. As a consequence, the overall mixing efficiency of the oceans is likely to be larger than the value γmixing =0.2 presently used, thereby possibly eliminating the apparent shortfall in mechanical stirring energy that results from using γmixing =0.2 in the above formula.