Cerebral venous thrombosis as a complication of intracranial hypotension after lumbar puncture

Background Optic neuritis is recognised by the international classification of headache disorders as a painful cranial nerve lesion. A lumbar puncture may be performed in the investigation of optic neuritis. Postdural puncture headache (PDPH) due to intracranial hypotension is a frequent complication of this procedure. In contrast, cerebral venous thrombosis (CVT) is a rare but potentially fatal complication of dural puncture. A few studies have identified an association between iron deficiency anaemia and venous thrombosis. There are no reports linking CVT with lumbar puncture and iron deficiency anaemia. Methods and results We present a 32-year-old woman with optic neuritis and iron deficiency anaemia complicated by a PDPH and CVT. Conclusion CVT should be considered in a patient with persistent headache, recent lumbar puncture and iron deficiency anaemia. Early recognition and treatment of this condition are vital to avoiding mortality and morbidity

Capacity-building barriers to S3 implementation: an empirical framework for catch-up regions

In this paper, we investigate the implementation challenge of Smart Specialisation Strategies (S3) in catch-up regional environments, through the lens of capacity building. We analyse capacity building at two levels: micro-level (individual organisations) and meso-level (regional inter-organisational networks). We use empirical evidence from 50 interviews conducted in the period 2015–2017 from two Greek regions dramatically hit by the economic crisis (Crete and Central Macedonia). We argue that in the Cretan and Central Macedonian context, the difficulty of implementing S3 is directly linked with firms’ lack of adsorptive capability to exploit university-generated knowledge, university knowledge that is too abstract for firm’s to easily acquire, as well as to the capability of regional actors to build inter-organisational networking that fits their strategic needs

Characteristics of stable flows over Southern Greenland

The main characteristic features of stable atmospheric flows over a large mountain plateau are summarised and then compared with mesoscale and synoptic scale numerical simulation, meteorological analysis, satellite imagery, and surface observations for the cases of flows over Southern Greenland for four wind directions. The detailed features are identified using the concepts and scaling of stably stratified flow over large mountains with variations in surface roughness, elevation, and heating. For westerly and easterly winds detached jets form at the southern tip, where coastal jets converge, which propagate large distances across the ocean. Near coasts katabatic winds can combine with barrier jets and wake flows generated by synoptic winds. Note how the approach flow rises/falls over southern Greenland for easterly/westerly winds, leading in both cases to more cloud on the western side. Some conclusions are drawn about the large-scale influences of these flows; detached jets in the atmosphere; air-sea interaction; formation of low pressure systems. For accurate simulations of these flows, mesoscale models are necessary with resolutions of order of 20 km or less. © Birkhäuser Verlag, Basel, 2005

Fiscal policy, macroeconomic performance and industry structure in a small open economy

We analyse how fiscal policy affects both the macroeconomy and the industry structure, using a multi-sector macroeconomic model of the Norwegian economy with an inflation targeting monetary policy. Our simulations show that the government spending multiplier in the case of a permanent expansionary fiscal policy coupled with a Taylor-type interest rate rule is around 1 over a ten-year horizon. The corresponding labour tax multiplier is about 0.5. These multipliers are somewhat larger in the case of a transitory fiscal stimulus. The government spending multiplier, in the case of either a permanent or a transitory fiscal stimulus, is considerably larger than 1 when monetary policy is made accommodative by keeping the interest rate fixed. Our simulations also show that the industry structure is substantially affected by an expansionary fiscal policy, as value added in the non-traded goods sector increases at the expense of value added in the traded goods sector. The contraction of activity in the traded goods sector increases when monetary tightening accompanies the fiscal stimulus. Hence, we find that such a policy mix is likely to produce significant de-industrialisation in a small open economy with inflation targeting

A Pluralistic Theory of Wordhood

What are words and how should we individuate them? There are two main answers on the philosophical market. For some, words are bundles of structural-functional features defining a unique performance profile. For others, words are non-eternal continuants individuated by their causal-historical ancestry. These conceptions offer competing views of the nature of words, and it seems natural to assume that at most one of them can capture the essence of wordhood. This paper makes a case for pluralism about wordhood: the view that there is a plurality of acceptable conceptions of the nature of words, none of which is uniquely entitled to inform us as to what wordhood consists in

Annual accumulation for Greenland updated using ice core data developed during 2000-2006 and analysis of daily coastal meteorological data

An updated accumulation map for Greenland is presented on the basis of 39 new ice core estimates of accumulation, 256 ice sheet estimates from ice cores and snow pits used in previous maps, and reanalysis of time series data from 20 coastal weather stations. The period 1950-2000 is better represented by the data than are earlier periods. Ice-sheetwide accumulation was estimated based on kriging. The average accumulation (95 confidence interval, or ±2 times standard error) over the Greenland ice sheet is 30.0 ± 2.4 g cm -2 a-1, with the average accumulation above 2000-m elevation being essentially the same, 29.9 ± 2.2 g cm-2 a -1. At higher elevations the new accumulation map maintains the main features shown in previous maps. However, there are five coastal areas with obvious differences: southwest, northwest, and eastern regions, where the accumulation values are 20-50 lower than previously estimated, and southeast and northeast regions, where the accumulation values are 20-50 higher than previously estimated. These differences are almost entirely due to new coastal data. The much lower accumulation in the southwest and the much higher accumulation in the southeast indicated by the current map mean that long-term mass balance in both catchments is closer to steady state than previously estimated. However, uncertainty in these areas remains high owing to strong gradients in precipitation from the coast inland. A significant and sustained precipitation measurement program will be needed to resolve this uncertainty. Copyright 2009 by the American Geophysical Union

Egalitarian justice and expected value

According to all-luck egalitarianism, the differential distributive effects of both brute luck, which defines the outcome of risks which are not deliberately taken, and option luck, which defines the outcome of deliberate gambles, are unjust. Exactly how to correct the effects of option luck is, however, a complex issue. This article argues that (a) option luck should be neutralized not just by correcting luck among gamblers, but among the community as a whole, because it would be unfair for gamblers as a group to be disadvantaged relative to non-gamblers by bad option luck; (b) individuals should receive the warranted expected results of their gambles, except insofar as individuals blamelessly lacked the ability to ascertain which expectations were warranted; and (c) where societal resources are insufficient to deliver expected results to gamblers, gamblers should receive a lesser distributive share which is in proportion to the expected results. Where all-luck egalitarianism is understood in this way, it allows risk-takers to impose externalities on non-risk-takers, which seems counterintuitive. This may, however, be an advantage as it provides a luck egalitarian rationale for assisting ‘negligent victims’

Changes in Greenland’s peripheral glaciers linked to the North Atlantic Oscillation

Glaciers and ice caps peripheral to the main Greenland Ice Sheet contribute markedly to sea-level rise1,2,3. Their changes and variability, however, have been difficult to quantify on multi-decadal timescales due to an absence of long-term data4. Here, using historical aerial surveys, expedition photographs, spy satellite imagery and new remote-sensing products, we map glacier length fluctuations of approximately 350 peripheral glaciers and ice caps in East and West Greenland since 1890. Peripheral glaciers are found to have recently undergone a widespread and significant retreat at rates of 12.2 m per year and 16.6 m per year in East and West Greenland, respectively; these changes are exceeded in severity only by the early twentieth century post-Little-Ice-Age retreat. Regional changes in ice volume, as reflected by glacier length, are further shown to be related to changes in precipitation associated with the North Atlantic Oscillation (NAO), with a distinct east–west asymmetry; positive phases of the NAO increase accumulation, and thereby glacier growth, in the eastern periphery, whereas opposite effects are observed in the western periphery. Thus, with projected trends towards positive NAO in the future5,6, eastern peripheral glaciers may remain relatively stable, while western peripheral glaciers will continue to diminish

Greenland Ice Sheet late-season melt: investigating multi-scale drivers of K-transect events

One consequence of recent Arctic warming is an increased occurrence and longer seasonality of above-freezing air temperature episodes.There is significant disagreement in the literature concerning potential physical connectivity between high-latitude open water duration proximate to the Greenland Ice Sheet (GrIS) and unseasonal (i.e. late summer and autumn) GrIS melt events. Here, a new date of sea ice advance (DOA) product is used to determine the occurrence of Baffin Bay sea ice growth along Greenland’s west coast for the 2011–2015 period. For the unseasonal melt period preceding the DOA, northwest Atlantic Ocean and atmospheric conditions are analyzed and linked to unseasonal melt events observed at a series of on-ice automatic weather stations (AWS) along the K-transect in southwest Greenland. Mesoscale and synoptic influences on the above and below freezing surface air temperature events are assessed through analyses of AWS wind, pressure, and humidity observations. These surface observations are further compared against Modèle Atmosphérique Régional (MAR), Regional Atmospheric Climate Model (RACMO2), and ERA-Interim reanalysis fields to understand the airmass origins and (thermo)dynamic drivers of the melt events. Results suggest that the K-transect late season, ablation zone melt events are strongly affected by ridging atmospheric circulation patterns that transport warm, moist air from the sub-polar North Atlantic toward west Greenland. While thermal conduction and advection off south Baffin Bayopen waters impact coastal air temperatures, consistent with previous studies, marine air incursions from Baffin Bay onto the ice sheet are obstructed by barrier flows and the pressure gradient-driven katabatic regime along the western GrIS margin