A model of mercury cycling and isotopic fractionation in the ocean

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155773/1/Archer_and_Blum_2018_model_of_mercury.pd

Effects of colour-coded compartmentalised syringe trays on anaesthetic drug error detection under cognitive load

oai:repository.derby.ac.uk:q4qv7Background Anaesthetic drug administration is complex, and typical clinical environments can entail significant cognitive load. Colour-coded anaesthetic drug trays have shown promising results for error identification and reducing cognitive load. Methods We used experimental psychology methods to test the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a simulated visual search task. Effects of cognitive load were also explored through an accompanying working memory-based task. We hypothesised that colour-coded compartmentalised trays would improve drug-detection error, reduce search time, and reduce cognitive load. This comprised a cognitive load memory task presented alongside a visual search task to detect drug errors. Results All 53 participants completed 36 trials, which were counterbalanced across the two tray types and 18 different vignettes. There were 16 error-present and 20 error-absent trials, with 18 trials presented for each preloaded tray type. Syringe errors were detected more often in the colour-coded trays than in the conventional trays (91% vs 83%, respectively; P=0.006). In signal detection analysis, colour-coded trays resulted in more sensitivity to the error signal (2.28 vs 1.50, respectively; P<0.001). Confidence in response accuracy correlated more strongly with task performance for the colour-coded tray condition, indicating improved metacognitive sensitivity to task performance (r=0.696 vs r=0.447). Conclusions Colour coding and compartmentalisation enhanced visual search efficacy of drug trays. This is further evidence that introducing standardised colour-coded trays into operating theatres and procedural suites would add an additional layer of safety for anaesthetic procedures

Model sensitivity in the effect of Antarctic sea ice and stratification on atmospheric pCO2

Several recent papers have demonstrated a decrease in atmospheric pCO2 resulting from barriers to communication between the deep sea and the atmosphere in the Southern Ocean. Stephens and Keeling [2000] decreased pCO2 by increasing Antarctic sea ice in a seven-box model of the world ocean, and Toggweiler [1999] showed a similar response to Southern Ocean stratification. In box models the pCO2 of the atmosphere is controlled by the region of the surface ocean that fills the deep sea [Archer et al., 2000a]. By severing the Southern Ocean link between the deep sea and the atmosphere, atmospheric pCO2 in these models is controlled elsewhere and typically declines, although the models range widely in their responses. “Continuum models,” such as three-dimensional (3-D) and 2-D general circulation models, control pCO2 in a more distributed way and do not exhibit box model sensitivity to high-latitude sea ice or presumably stratification. There is still uncertainty about the high-latitude sensitivity of the real ocean. Until these model sensitivities can be resolved, glacial pCO2 hypotheses and interpretations based on Southern Ocean barrier mechanisms (see above mentioned references plus Elderfield and Rickaby [2000], Francois et al. [1998], Gildor and Tziperman [2001], Sigman and Boyle [2000], and Watson et al. [2000]) are walking on thin ice

Case based reasoning approach for transaction outcomes prediction on currency markets

This paper presents a case based reasoning approach for making profit in the foreign exchange (forex) market with controlled risk using k nearest neighbour (kNN) and improving on the results with neural networks (NNs) and a combination of both. Although many professionals have proven that exchange rates can be forecast using neural networks for example, poor trading strategies and unpredictable market fluctuation can inevitably still result in substantial loss. As a result, the method proposed in this paper will focus on predicting the outcome of potential trades with fixed stop loss (ST) and take profit (TP) positions1, in terms of a win or loss. With the help of the Monte Carlo method, randomly generated trades together with different traditional technical indicators are fed into the models, resulting in a win or lose output. This is clearly a case based reasoning approach, in terms of searching similar past trade setups for selecting successful trades. There are several advantages over classical forecasting associated with such an approach, and the technique presented in this paper brings a novel perspective to problem of exchange trades predictability. The strategies implemented have not been empirically investigated with such wide a range of time granularities as is done in this paper, in any to the authors known academic literature. The profitability of this approach is back-tested at the end of this paper and highly encouraging results are reported

Oral estradiol/micronized progesterone may be associated with lower risk of venous thromboembolism compared with conjugated equine estrogens/medroxyprogesterone acetate in real-world practice.

OBJECTIVES The Women's Health Initiative study reported an increased risk of venous thromboembolism among menopausal women treated with conjugated equine estrogens/medroxyprogesterone acetate (CEE/MPA) versus placebo. Newer hormone therapies may have a lower venous thromboembolism risk. The study compared the risk of venous thromboembolism between women treated with the combined oral product 17β-estradiol/micronized progesterone (E2/P4) and those treated with oral CEE/MPA regimens. STUDY DESIGN In a retrospective longitudinal study using real-world claims data from April 2019 to June 2021, women aged 40 years or more treated with oral E2/P4 or oral CEE/MPA who did not have a venous thromboembolism diagnosis before first dispensing claim of CEE/MPA or E2/P4 identified on or after May 1st 2019 (index date) were observed for 6 months or more after the index date. Oral E2/P4 and oral CEE/MPA had been prescribed by the treating physician in real-world practice and were observed through pharmacy dispensing records. MAIN OUTCOME MEASURES Venous thromboembolism risk was compared between women receiving oral E2/P4 versus oral CEE/MPA. RESULTS The study included 36,061 women treated with oral E2/P4 or oral CEE/MPA. In the analyses weighted by the inverse probability of treatment for control of potential confounding factors, the incidence of venous thromboembolism was significantly lower for oral E2/P4 compared with oral CEE/MPA (37/10,000 women-years for oral E2/P4 vs 53/10,000 women-years for oral CEE/MPA; incidence rate ratio 0.70, 95 % confidence interval: 0.53-0.92). CONCLUSIONS Real-world evidence suggests that the risk of venous thromboembolism is significantly lower among women treated with oral E2/P4 compared with oral CEE/MPA

Metal-rich organic matter and hot continental passive margin: drivers for Devonian copper-cobalt-germanium mineralization in dolomitized reef-bearing carbonate platform

The abundance and types of reef-bearing carbonate platforms reflect the evolution of Devonian climate, with conspicuous microbial-algal reefs in the warm Early and Late Devonian and sponge-coral reefs in the cooler Middle Devonian. A dolomitized Wenlock-Lower Devonian microbial-algal reef-bearing carbonate platform hosts epigenetic copper-cobalt-germanium (Cu-Co-Ge) sulfide mineralization at Ruby Creek-Bornite in the Brooks Range, Alaska. Here, we present rhenium-osmium (Re-Os) radiometric ages and molybdenum and sulfur (δ(98/95)Mo = +2.04 to +5.48‰ and δ(34)S = −28.5 to −1.8‰) isotope variations for individual Cu-Co-Fe sulfide phases along the paragenetic sequence carrollite-bornite-pyrite. In the context of a hot, extensional passive margin, greenhouse conditions in the Early Devonian favored restriction of platform-top seawater circulation and episodic reflux of oxidized brines during growth of the carbonaceous carbonate platform. Molybdenum and sulfur isotope data signal the stepwise reduction of hot brines carrying Cu during latent reflux and geothermal circulation for at least ca. 15 million years from the Early Devonian until Cu-Co sulfide mineralization ca. 379–378 million years ago (Ma) in the Frasnian, Late Devonian (weighted mean of Re-Os model ages of carrollite at 379 ± 15 Ma [n = 4]; Re-Os isochron age of bornite at 378 ± 15 Ma [n = 6]). On the basis of petrographic relationships between sulfides and solid bitumen, and the Mo and S isotope data for sulfides, we imply that the endowment in critical metals (e.g., Co, Ge, Re) in the Ruby Creek-Bornite deposit is linked to the activity of primary producers that removed trace metals from the warm Early Devonian seawater and concentrated Co, Ge, and Re in algal-bacterial organic matter in carbonate sediments. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00126-022-01123-1

Characteristics of effective collaborative care for treatment of depression: a systematic review and meta-regression of 74 randomised controlled trials

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Collaborative care is a complex intervention based on chronic disease management models and is effective in the management of depression. However, there is still uncertainty about which components of collaborative care are effective. We used meta-regression to identify factors in collaborative care associated with improvement in patient outcomes (depressive symptoms) and the process of care (use of anti-depressant medication). METHODS AND FINDINGS: Systematic review with meta-regression. The Cochrane Collaboration Depression, Anxiety and Neurosis Group trials registers were searched from inception to 9th February 2012. An update was run in the CENTRAL trials database on 29th December 2013. Inclusion criteria were: randomised controlled trials of collaborative care for adults ≥18 years with a primary diagnosis of depression or mixed anxiety and depressive disorder. Random effects meta-regression was used to estimate regression coefficients with 95% confidence intervals (CIs) between study level covariates and depressive symptoms and relative risk (95% CI) and anti-depressant use. The association between anti-depressant use and improvement in depression was also explored. Seventy four trials were identified (85 comparisons, across 21,345 participants). Collaborative care that included psychological interventions predicted improvement in depression (β coefficient -0.11, 95% CI -0.20 to -0.01, p = 0.03). Systematic identification of patients (relative risk 1.43, 95% CI 1.12 to 1.81, p = 0.004) and the presence of a chronic physical condition (relative risk 1.32, 95% CI 1.05 to 1.65, p = 0.02) predicted use of anti-depressant medication. CONCLUSION: Trials of collaborative care that included psychological treatment, with or without anti-depressant medication, appeared to improve depression more than those without psychological treatment. Trials that used systematic methods to identify patients with depression and also trials that included patients with a chronic physical condition reported improved use of anti-depressant medication. However, these findings are limited by the observational nature of meta-regression, incomplete data reporting, and the use of study aggregates.NIH

Repeated Plyometric Exercise Attenuates Blood Glucose in Healthy Adults

International Journal of Exercise Science 10(7): 1076-1084, 2017. Plyometric exercise is popular in commercial exercise programs aiming to maximize energy expenditure for weight loss. However, the effect of plyometric exercise on blood glucose is unknown. The purpose of this study was to investigate the effect of relatively high intensity plyometric exercise on blood glucose. Thirteen subjects (6 females age= 21.8 ± 1.0 yrs.; height= 163.7 ± 7.8 cm; mass= 60.8 ± 6.7 kg and 7 males age= 22.0 ± 2.6 yrs.; height= 182.3 ± 3.6 cm; mass= 87.4 ± 12.5 kg) volunteered to participate. Subjects completed two random conditions on two separate days, consisting of either five sets of 10 maximal effort countermovement squat jumps (SJ) with 50 seconds’ rest between sets or quiet sitting (SIT) for the time equated to the SJ duration (~4min). Immediately after each condition, subjects drank 75g of anhydrous glucose (CHO) in 100ml of water. Blood glucose measurements were taken via finger prick pre and immediately post SJ or SIT, and 5, 15, 30, and 60 min post. A 2x6 (condition x time) ANOVA revealed a significant interaction where SJ blood glucose was lower at 15 (114.0 ± 14.6 mg/dl) and 30 (142.1 ± 22.5 mg/dl) min compared to SIT (15min 130.8 ± 14.0 mg/dl and 30min 159.3 ± 21.0 mg/dl). The current plyometric protocol attenuated CHO-induced blood glucose at 15 and 30 min. This may be due to increased physiological stress applied to the muscles, thus increasing muscular glucose uptake

Causal hierarchy within the thalamo-cortical network in spike and wave discharges

Background: Generalised spike wave (GSW) discharges are the electroencephalographic (EEG) hallmark of absence seizures, clinically characterised by a transitory interruption of ongoing activities and impaired consciousness, occurring during states of reduced awareness. Several theories have been proposed to explain the pathophysiology of GSW discharges and the role of thalamus and cortex as generators. In this work we extend the existing theories by hypothesizing a role for the precuneus, a brain region neglected in previous works on GSW generation but already known to be linked to consciousness and awareness. We analysed fMRI data using dynamic causal modelling (DCM) to investigate the effective connectivity between precuneus, thalamus and prefrontal cortex in patients with GSW discharges. Methodology and Principal Findings: We analysed fMRI data from seven patients affected by Idiopathic Generalized Epilepsy (IGE) with frequent GSW discharges and significant GSW-correlated haemodynamic signal changes in the thalamus, the prefrontal cortex and the precuneus. Using DCM we assessed their effective connectivity, i.e. which region drives another region. Three dynamic causal models were constructed: GSW was modelled as autonomous input to the thalamus (model A), ventromedial prefrontal cortex (model B), and precuneus (model C). Bayesian model comparison revealed Model C (GSW as autonomous input to precuneus), to be the best in 5 patients while model A prevailed in two cases. At the group level model C dominated and at the population-level the p value of model C was ∼1. Conclusion: Our results provide strong evidence that activity in the precuneus gates GSW discharges in the thalamo-(fronto) cortical network. This study is the first demonstration of a causal link between haemodynamic changes in the precuneus - an index of awareness - and the occurrence of pathological discharges in epilepsy. © 2009 Vaudano et al