Foreskin surgery under local anaesthetic – OK? Or oh no!

Aim: Foreskin surgical procedures such as circumcision, prepuceplasty, frenuloplasty, dorsal slit, reduction of paraphimosis etc. in the adult male is usually performed by both general surgeons and urologists. Our aim was to evaluate the acceptance of performing these procedures in the day procedure unit or in the emergency unit under penile block. 
Method: Fifty patients who underwent foreskin surgeries under local anaesthetic (LA) were evaluated with their experience. Twenty patients who underwent circumcision, 20 patients who underwent foreskin preserving operations such as frenuloplasty or prepuceplasty and 10 patients who underwent other procedures such as reduction of paraphimosis (five) and dorsal slit (five) were included inthe study. The patients were asked about their symptoms such as pain or discomfort during local infiltration of lignocaine, any discomfort during the actual procedure, post-operative discomfort and general acceptance. All the patients were given penile block using smaller size needle (25 gauge, 5/8th inch orange sterile luer slip hypodermic needle) and 1% plain lignocaine. Thirty doctors from general surgery (10), urology (10) and emergency medicine (10) participated in the survey. They were asked about their opinion, confidence and preference about performing foreskin surgical procedures under LA. This included both junior trainees, middle grade doctors and consultants. The majority of middle grade doctors and consultants were fairly confident in performing procedures under LA, whereas the junior trainees in surgery, urology and emergency were lacking confidence. 
Conclusion: Penile block is a safe and effective way ofproviding sufficient anaesthesia for foreskin surgeries. Thetechnique is easy to learn. It reduces post-operative pain aswell. It can reduce the risk and cost of administering generalanaesthesia. doctors who are in training surgical specialityand emergency medicine should be encouraged to learnthe principles and technique in administering penile block.

Thermal transport in out-of-equilibrium quantum harmonic chains

We address the problem of heat transport in a chain of coupled quantum harmonic oscillators, exposed to the influences of local environments of various nature, stressing the effects that the specific nature of the environment has on the phenomenology of the transport process. We study in detail the behavior of thermodynamically relevant quantities such as heat currents and mean energies of the oscillators, establishing rigorous analytical conditions for the existence of a steady state, whose features we analyze carefully. In particular, we assess the conditions that should be faced to recover trends reminiscent of the classical Fourier law of heat conduction and highlight how such a possibility depends on the environment linked to our system.

Nonequilibrium processes from generalized Langevin equations: Realistic nanoscale systems connected to two thermal baths

We extend the generalized Langevin equation (GLE) method [L. Stella, C. D. Lorenz, and L. Kantorovich, Phys. Rev. B 89, 134303 (2014)] to model a central classical region connected to two realistic thermal baths at two different temperatures. In such nonequilibrium conditions a heat flow is established, via the central system, in between the two baths. The GLE-2B (GLE two baths) scheme permits us to have a realistic description of both the dissipative central system and its surrounding baths. Following the original GLE approach, the extended Langevin dynamics scheme is modified to take into account two sets of auxiliary degrees of freedom corresponding to the mapping of the vibrational properties of each bath. These auxiliary variables are then used to solve the non-Markovian dissipative dynamics of the central region. The resulting algorithm is used to study a model of a short Al nanowire connected to two baths. The results of the simulations using the GLE-2B approach are compared to the results of other simulations that were carried out using standard thermostatting approaches (based on Markovian Langevin and Nosé-Hoover thermostats). We concentrate on the steady-state regime and study the establishment of a local temperature profile within the system. The conditions for obtaining a flat profile or a temperature gradient are examined in detail, in agreement with earlier studies. The results show that the GLE-2B approach is able to treat, within a single scheme, two widely different thermal transport regimes, i.e., ballistic systems, with no temperature gradient, and diffusive systems with a temperature gradient.

A Agenda 21 local e o desenvolvimento sustentável em Portugal : que perspetivas?

Assumindo a sociedade atual o paradigma do desenvolvimento sustentável como modelo capaz de garantir uma gestão equilibrada dos recursos atuais que não comprometa o futuro das futuras gerações, é fundamental compreender o instrumento da Agenda 21 Local (A21L), ferramenta saída da Conferência do Rio, em 1992, que se apresenta como uma resposta internacional aos objetivos da sustentabilidade. Ao constituir-se como país signatário da Declaração do Rio, Portugal assumiu o compromisso de cooperar internacionalmente para a aplicação deste instrumento, no esforço comum de unir a proteção do ambiente com o desenvolvimento económico e social. Verifica-se que a resposta de Portugal, em matéria de A21L, foi pouco conseguida, marcada por um arranque ténue, desconcertado e disperso a que acresce o caráter dúbio que caracterizou a natureza dos primeiros processos e que, no quadro internacional, atira Portugal para o grupo de países europeus que mais tardiamente conseguiram responder ao apelo da comunidade internacional no que se refere à implementação de A21L. Neste âmbito, esta dissertação visa aprofundar o conhecimento cientifico sobre este instrumento no quadro das experiências de Agenda 21 Local implementadas no território português. O trabalho procurou examinar os objetivos, características e resultados dos processos de Agenda, dando atenção aos elementos individuais que marcaram cada um e, igualmente, avaliando as repercussões que estes tiveram no todo nacional. O estudo incidiu na dinâmica espaciotemporal das Agendas21L, no território nacional, e na análise integrativa de indicadores físicos, sociais e económicos que permitiram compreender as especificidades e os contrastes verificados nos processos implementados e desenvolvidos. Na investigação não foram, igualmente, negligenciadas questões históricas, políticas e culturais, sabendose da importância que estes vários domínios configuram no caso português. O trabalho contou com uma investigação assente na seguinte metodologia: i) Revisão da literatura e recolha de dados bibliográficos sobre a temática da Agenda 21 Local; ii) Levantamento de informação, através de um inquérito por questionário, dirigido a todas as localidades do País, onde decorrem Agendas 21 Local, a fim de complementar informação já processada; iii) Pesquisa direta de dados no terreno que envolveu a utilização de procedimentos de teor quantitativo (inquérito por questionário) e de teor qualitativo (entrevistas), relativamente ao caso de estudo (Agenda 21 Local de Mindelo); iv) Tratamento e análise dos resultados obtidos através da confrontação da perspetiva teórica com a prática com a consequente elaboração de conclusões fundamentadas pela confrontação dos dados com as hipóteses. Para além de se tratar do caso pioneiro de A21L com início no poder mais próximo do cidadão (respeitando um dos princípios inerentes a este instrumento – o princípio da subsidiariedade), afirmou-se, igualmente, como um caso de referência em matéria de coesão e mobilização dos cidadãos locais para os problemas locais existentes. Os resultados empíricos da investigação identificam uma série de dificuldades que condicionaram o arranque e progresso das A21L. Desde logo, a inabilidade dos poderes políticos locais em trabalharem com um modelo que rompe com as típicas e tradicionais formas pré-concebidas de fazer política, isto é, com as práticas instituídas dos políticos fazerem “política” para os cidadãos e não “com” os cidadãos. O próprio desconhecimento do poder político local quanto à natureza de um processo de A21L que evidenciou inaptidão, impreparação e até embaraço para lidar com este instrumento, resultando na necessidade, na grande maioria dos processos desenvolvidos, de serem acompanhados por entidades externas que cooperaram na sua dinamização. Acresce que a nova dinâmica, subjacente à A21L, que desafia os governos locais a mobilizar a participação generalizada dos cidadãos e apela à participação de novos atores (associações, grupos de interesse, ONG e atores sociais, em geral) para a definição de estratégias de desenvolvimento local, não é totalmente aceite pelos vários poderes locais que, não raras vezes, menosprezam a importância dos cidadãos nos momentos de tomada de decisão. A falta de empenho do governo central, em matéria de sustentabilidade, que negligenciou, numa primeira etapa, a figura do poder central na assessoria às entidades locais cerceou o país da existência de uma campanha nacional para a afirmação deste instrumento. A falta/insuficiência de recursos financeiros como resultante da ausência de apoios estatais e a dificuldade na obtenção de fundos da União Europeia configurou-se como um entrave à promoção dos processos ficando as entidades locais e regionais incapazes de ultrapassar a falta de meios imprescindíveis para o desenvolvimento da A21L. O próprio desconhecimento generalizado dos cidadãos sobre a A21L afigura-se como um estigma ao sucesso de qualquer processo com as caraterísticas de um instrumento A21L visto que a participação dos cidadãos é condição sine qua non para a sua operacionalização. Neste quadro, e olhando o futuro, urge a necessidade das autoridades locais criarem modelos de autofinanciamento capazes de garantir a criação, funcionamento e manutenção de infraestruturas económicas e sociais subjacentes aos programas de A21L, assim como o dever do poder político em reforçar a importância da função da informação e da mobilização dos cidadãos em prole do desenvolvimento sustentável, ações indispensáveis para a execução das políticas inerentes à A21L.

Examining the roles of core and local temperature on forearm skin blood flow

The interaction between local and reflexive control of skin blood flow (SkBF) is unclear. This thesis isolated the roles of rectal (Tre) and local (Tloc) temperature on forearm SkBF regulation at normal and elevated body temperatures, and to investigate the interaction between local and reflexive SkBF control. While either normothermic (Tre ~37.0°C) or hyperthermic (∆Tre +1.1°C), SkBF was assessed on the dorsal aspect of each forearm in 10 participants while Tloc was manipulated in an A-B-A-B fashion between neutral (33.0°C) and hot (38.5°C). Finally, local heating to 44°C was performed to elicit maximal SkBF. Data are presented as a percentage of maximal cutaneous vascular conductance (CVC), calculated as laser-Doppler flux divided by mean arterial pressure. Tloc manipulations performed during normothermia had significantly greater effects on CVC than during hyperthermia. The decreased modification to SkBF from the Tloc changes during hyperthermia suggests that strong reflexive vasodilation attenuates local SkBF control mechanisms.

Environnement local des défauts structurels et ordre à moyenne portée dans le silicium amorphe

Malgré une vaste littérature concernant les propriétés structurelles, électroniques et ther- modynamiques du silicium amorphe (a-Si), la structure microscopique de ce semi-cond- ucteur covalent échappe jusqu’à ce jour à une description exacte. Plusieurs questions demeurent en suspens, concernant par exemple la façon dont le désordre est distribué à travers la matrice amorphe : uniformément ou au sein de petites régions hautement déformées ? D’autre part, comment ce matériau relaxe-t-il : par des changements homo- gènes augmentant l’ordre à moyenne portée, par l’annihilation de défauts ponctuels ou par une combinaison de ces phénomènes ? Le premier article présenté dans ce mémoire propose une caractérisation des défauts de coordination, en terme de leur arrangement spatial et de leurs énergies de formation. De plus, les corrélations spatiales entre les défauts structurels sont examinées en se ba- sant sur un paramètre qui quantifie la probabilité que deux sites défectueux partagent un lien. Les géométries typiques associées aux atomes sous et sur-coordonnés sont extraites du modèle et décrites en utilisant les distributions partielles d’angles tétraédriques. L’in- fluence de la relaxation induite par le recuit sur les défauts structurels est également analysée. Le second article porte un regard sur la relation entre l’ordre à moyenne portée et la relaxation thermique. De récentes mesures expérimentales montrent que le silicium amorphe préparé par bombardement ionique, lorsque soumis à un recuit, subit des chan- gements structuraux qui laissent une signature dans la fonction de distribution radiale, et cela jusqu’à des distances correspondant à la troisième couche de voisins.[1, 2] Il n’est pas clair si ces changements sont une répercussion d’une augmentation de l’ordre à courte portée, ou s’ils sont réellement la manifestation d’un ordonnement parmi les angles dièdres, et cette section s’appuie sur des simulations numériques d’implantation ionique et de recuit, afin de répondre à cette question. D’autre part, les corrélations entre les angles tétraédriques et dièdres sont analysées à partir du modèle de a-Si.

CH Overtones in Acetophenone and Benzaldehyde: Aryl and Methyl Local Modes

Vibrational overtone spectra of acetophenone and benzaldehyde in the visible and near-infrared regions are studied by the dual beam thermal lens and the conventional near-infrared absorption techniques. The observed increase in the mechanical frequency of the aryl CH bond from that of benzene is attributed to the decrease in the aryl CH bond length caused by the electron-withdrawing property of the substituents. Overtone spectra also demonstrate that acetophenone contains two types of methyl CH bonds arising from the anisotropic environments created by oxygen lone pair and carbonyl P electrons. The local-mode parameters of the two types of CH bonds are compared with those of acetone and acetaldehyde. The possible factors influencing the methyl CH bonds in acetophenone are discussed.

CH local mode overtone excitations in benzyl chloride—A conformational study

The CH local mode overtone spectrum of benzyl chloride in the visible and NIR regions studied by laser induced thermal lens and conventional NIR absorption is presented. The analysis shows that the −CH2Cl group is symmetrically oriented with respect to the benzene ring, thus finalizing one of the two possible conformational models predicted by electron diffraction studies. The aryl CH bonds have a slightly larger force constant than that in benzene.

Structures and negative thermal expansion properties of the one-dimensional cyanides, CuCN, AgCN and AuCN

The behaviour of the lattice parameters of HTCuCN (high-temperature form), AgCN and AuCN have been investigated as a function of temperature over the temperature range 90–490 K. All materials show one-dimensional negative thermal expansion (NTE) along the ––(M––CN)–– chain direction c (ac(HT-CuCN) ¼32.1 10–6 K1, ac(AgCN)¼23.910–6 K1 and ac(AuCN) ¼9.3106 K1 over the temperature range 90–490 K). The origin of this behaviour has been studied using RMC modelling of Bragg and total neutron diffraction data from AgCN and AuCN at 10 and 300 K. These analyses yield details of the local motions within the chains responsible for NTE. The low-temperature form of CuCN, LT-CuCN, has been studied using single-crystal X-ray diffraction. In this form of CuCN, wavelike distortions of the ––(Cu––CN)–– chains occur in the static structure, which are reminiscent of the motions seen in the RMC modelling of AgCN and AuCN, which are responsible for the NTE behaviour.

Thermal comfort assessment in a non-uniform thermal environment

This paper presents results for thermal comfort assessment in non-uniform thermal environments. Three types of displacement ventilation (DV) units that created stratified condition in an environmental test chamber have been selected to carry out the thermal comfort assessment: a flat diffuser (DV1), semi-circular diffuser (DV2), and floor swirl diffuser (DV3). The CBE (Center for the Built Environment at Berkeley) comfort model was implemented in this study to assess the occupant’s thermal comfort for the three DV types. The CBE model predicted the occupant’s mean skin as well as local skin temperatures very well when compared with measurements found in the literature, while it underestimated the occupant’s core temperature. The predicted occupant’s thermal sensation and thermal comfort for the case of (DV2) were the best. Therefore, the semi-circular diffuser (DV2) provided better thermal comfort for the occupant in comparison with the other two DV types.

Influence of thermal effects on street canyon circulations

A numerical study has been carried out to investigate the influence of large-scale thermal effects and strong local-scale temperature gradients near the ground on the circulation inside a street canyon. The results show that the dynamical forcing dominates the circulation inside a street canyon. But this forcing is influenced by the large-scale thermal stability. Thus, atmospheric stability indirectly controls the street canyon circulation. Small temperature gradients inside the street-canyon are neutralised by the external dynamical forcing. Strong temperature gradients inside the street-canyon show an impact on the street canyon circulation. While stable stratification reduces the circulation for the building configuration investigated, convective stratification seems to intensify it.

Generation of inertia-gravity waves in the rotating thermal annulus by a localised boundary layer instability

Waves with periods shorter than the inertial period exist in the atmosphere (as inertia-gravity waves) and in the oceans (as Poincaré and internal gravity waves). Such waves owe their origin to various mechanisms, but of particular interest are those arising either from local secondary instabilities or spontaneous emission due to loss of balance. These phenomena have been studied in the laboratory, both in the mechanically-forced and the thermally-forced rotating annulus. Their generation mechanisms, especially in the latter system, have not yet been fully understood, however. Here we examine short period waves in a numerical model of the rotating thermal annulus, and show how the results are consistent with those from earlier laboratory experiments. We then show how these waves are consistent with being inertia-gravity waves generated by a localised instability within the thermal boundary layer, the location of which is determined by regions of strong shear and downwelling at certain points within a large-scale baroclinic wave flow. The resulting instability launches small-scale inertia-gravity waves into the geostrophic interior of the flow. Their behaviour is captured in fully nonlinear numerical simulations in a finite-difference, 3D Boussinesq Navier-Stokes model. Such a mechanism has many similarities with those responsible for launching small- and meso-scale inertia-gravity waves in the atmosphere from fronts and local convection.

An introduction to the Chinese Evaluation Standard for the indoor thermal environment

Designing for indoor thermal environmental conditions is one of the key elements in the energy efficient building design process. This paper introduces a development of the Chinese national Evaluation Standard for indoor thermal environments (Evaluation Standard). International standards including the ASHRAE55, ISO7730, DIN EN, and CIBSE Guide-A have been reviewed and referenced for the development of the Evaluation Standard. In addition, over 28,000 subjects participated in the field study from different climate zones in China and over 500 subjects have been involved in laboratory studies. The research findings reveal that there is a need to update the Chinese thermal comfort standard based on local climates and people's habitats. This paper introduces in detail the requirements for the thermal environment for heated and cooled buildings and free-running buildings in China.

Observations of large field-aligned flows of thermal plasma in the auroral ionosphere

Large upward field-aligned ion flows have previously been observed in the high latitude ionosphere in response to frictional heating of the local ion population. Results from a recent experiment using the EISCAT radar show similar features but allow, for the first time, determination of the field-aligned profiles of plasma parameters during these events. The upflows occur during frictional heating. The flows are shown to be transient plasma upwellings, from regions where the ion temperature has been elevated by the motion of a convection shear over the observed field line.

Preferred response of the East Asian summer monsoon to local and non-local anthropogenic sulphur dioxide emissions

In this study, the atmospheric component of a state-of-the-art climate model (HadGEM2-ES) that includes earth system components such as interactive chemistry and eight species of tropospheric aerosols considering aerosol direct, indirect, and semi-direct effects, has been used to investigate the impacts of local and non-local emissions of anthropogenic sulphur dioxide on the East Asian summer monsoon (EASM). The study focuses on the fast responses (including land surface feedbacks, but without sea surface temperature feedbacks) to sudden changes in emissions from Asia and Europe. The initial responses, over days 1–40, to Asian and European emissions show large differences. The response to Asian emissions involves a direct impact on the sulphate burden over Asia, with immediate consequences for the shortwave energy budget through aerosol–radiation and aerosol–cloud interactions. These changes lead to cooling of East Asia and a weakening of the EASM. In contrast, European emissions have no significant impact on the sulphate burden over Asia, but they induce mid-tropospheric cooling and drying over the European sector. Subsequently, however, this cold and dry anomaly is advected into Asia, where it induces atmospheric and surface feedbacks over Asia and the Western North Pacific (WNP), which also weaken the EASM. In spite of very different perturbations to the local aerosol burden in response to Asian and European sulphur dioxide emissions, the large scale pattern of changes in land–sea thermal contrast, atmospheric circulation and local precipitation over East Asia from days 40 onward exhibits similar structures, indicating a preferred response, and suggesting that emissions from both regions likely contributed to the observed weakening of the EASM. Cooling and drying of the troposphere over Asia, together with warming and moistening over the WNP, reduces the land–sea thermal contrast between the Asian continent and surrounding oceans. This leads to high sea level pressure (SLP) anomalies over Asia and low SLP anomalies over the WNP, associated with a weakened EASM. In response to emissions from both regions warming and moistening over the WNP plays an important role and determines the time scale of the response.