Validity of the Polar V800 heart rate monitor to measure RR intervals at rest

Purpose To assess the validity of RR intervals and short-term heart rate variability (HRV) data obtained from the Polar V800 heart rate monitor, in comparison to an electrocardiograph (ECG). Method Twenty participants completed an active orthostatic test using the V800 and ECG. An improved method for the identification and correction of RR intervals was employed prior to HRV analysis. Agreement of the data was assessed using intra-class correlation coefficients (ICC), Bland–Altman limits of agreement (LoA), and effect size (ES). Results A small number of errors were detected between ECG and Polar RR signal, with a combined error rate of 0.086 %. The RR intervals from ECG to V800 were significantly different, but with small ES for both supine corrected and standing corrected data (ES 0.999 for both supine and standing corrected intervals. When analysed with the same HRV software no significant differences were observed in any HRV parameters, for either supine or standing; the data displayed small bias and tight LoA, strong ICC (>0.99) and small ES (≤0.029). Conclusions The V800 improves over previous Polar models, with narrower LoA, stronger ICC and smaller ES for both the RR intervals and HRV parameters. The findings support the validity of the Polar V800 and its ability to produce RR interval recordings consistent with an ECG. In addition, HRV parameters derived from these recordings are also highly comparable

Effect of universal adhesives on microtensile bond strength to hybrid ceramic.

Background The aim of this study was to evaluate the effect of universal adhesives (UA) and silane on the microtensile bond strength (μTBS) of resin cement to a hybrid ceramic Vita Enamic (VE). Methods VE specimens were acid etched using hydrofluoric acid (HF) and were assigned to three groups (n = 10) based on the applied bonding technique. In group 1 (S), a silane-based primer was used as a surface treatment prior to the application of a resin cement (Variolink Esthetic DC). In group 2, a silane-containing UA, Clearfil Universal Bond (CUB) was used for the surface treatment, and in group 3, A silane-free UA, Tetric N-Bond Universal (TNU) was used for surface treatment. Resin cement build-ups were prepared. The bonded specimens were sectioned into resin-ceramic beams. Half of the beams of each group were stored for 24 h at 37 °C and the other half were subjected to a thermo-cycling aging. The microtensile bond strength (μTBS) was measured at a crosshead speed of 0.5 mm/min. Failure modes were assessed accordingly. Data were analyzed using a) two-way analysis of variance ANOVA followed by one-way ANOVA and Tukey tests between groups and b) independent t-test to detect differences (α = 0.05) for each group. The surface topographies of the ceramic surface were evaluated using scanning electron microscopy. Results The results showed that silane-based primer (S) application resulted in significantly higher (p < 0.05) μTBS values after 24 h and after thermocycling compared to both silane-containing UA (CUB) and silane-free UA (TNU). The μTBS values of all groups were significantly reduced after thermocycling. No statistically significant difference was observed between the μTBS of CUB and TNU after 24 h. However, TNU showed significantly higher μTBS after thermocycling. Different failure modes were observed, and adhesive failure was the most common in all groups. Marked surface topographic changes were observed following HF etching. Conclusion It is concluded that, the UAs tested cannot be recommended as substitutes to the silanization of Hybrid ceramic

Recent Advances in Our Understanding of the Role of Meltwater in the Greenland Ice Sheet System

Nienow, Sole and Cowton’s Greenland research has been supported by a number of UK NERC research grants (NER/O/S/2003/00620; NE/F021399/1; NE/H024964/1; NE/K015249/1; NE/K014609/1) and Slater has been supported by a NERC PhD studentshipPurpose of the review:  This review discusses the role that meltwater plays within the Greenland ice sheet system. The ice sheet’s hydrology is important because it affects mass balance through its impact on meltwater runoff processes and ice dynamics. The review considers recent advances in our understanding of the storage and routing of water through the supraglacial, englacial, and subglacial components of the system and their implications for the ice sheet Recent findings:   There have been dramatic increases in surface meltwater generation and runoff since the early 1990s, both due to increased air temperatures and decreasing surface albedo. Processes in the subglacial drainage system have similarities to valley glaciers and in a warming climate, the efficiency of meltwater routing to the ice sheet margin is likely to increase. The behaviour of the subglacial drainage system appears to limit the impact of increased surface melt on annual rates of ice motion, in sections of the ice sheet that terminate on land, while the large volumes of meltwater routed subglacially deliver significant volumes of sediment and nutrients to downstream ecosystems. Summary:  Considerable advances have been made recently in our understanding of Greenland ice sheet hydrology and its wider influences. Nevertheless, critical gaps persist both in our understanding of hydrology-dynamics coupling, notably at tidewater glaciers, and in runoff processes which ensure that projecting Greenland’s future mass balance remains challenging.Publisher PDFPeer reviewe

Basal topographic controls on rapid retreat of Humboldt Glacier, northern Greenland

This is the final version of the article. Available from CUP via the DOI in this record.Discharge from marine-terminating outlet glaciers accounts for up to half the recent mass loss from the Greenland ice sheet, yet the causal factors are not fully understood. Here we assess the factors controlling the behaviour of Humboldt Glacier (HG), allowing us to evaluate the influence of basal topography on outlet glacier response to external forcing since part of HG’s terminus occupies a large overdeepening. HG’s retreat accelerated dramatically after 1999, coinciding with summer atmospheric warming of up to 0.19°C a–1 and sea-ice decline. Retreat was an order of magnitude greater in the northern section of the terminus, underlain by a major basal trough, than in the southern section, where the bedrock is comparatively shallow. Velocity change following retreat was spatially non-uniform, potentially due to a pinning point near HG’s northern lateral margin. Consistent with observations, numerical modelling demonstrates an order-of-magnitude greater sensitivity to sea-ice buttressing and crevasse depth (used as a proxy for atmospheric warming) in the northern section. The trough extends up to 72 km inland, so it is likely to facilitate sustained retreat and ice loss from HG during the 21st century.Funding for this work was provided by a Durham Doctoral Studentship to J.R.C. Radio-echo sounding data were acquired and processed through UK Natural Environment Research Council (NERC) grant NE/H020667 to J.A.D. and P.C. and a G. Unger Vetlesen grant to the University of Texas Institute for Geophysics (UTIG). GrOGG laser altimetry was supported by NNXAD33G to D.D.B. This paper is UTIG contribution No. 2733. S.S.R.J. was supported by UK NERC fellowship NE/J018333/1

Recent progress in understanding and projecting regional and global mean sea-level change

Considerable progress has been made in understanding the present and future regional and global sea level in the 2 years since the publication of the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change. Here, we evaluate how the new results affect the AR5’s assessment of (i) historical sea level rise, including attribution of that rise and implications for the sea level budget, (ii) projections of the components and of total global mean sea level (GMSL), and (iii) projections of regional variability and emergence of the anthropogenic signal. In each of these cases, new work largely provides additional evidence in support of the AR5 assessment, providing greater confidence in those findings. Recent analyses confirm the twentieth century sea level rise, with some analyses showing a slightly smaller rate before 1990 and some a slightly larger value than reported in the AR5. There is now more evidence of an acceleration in the rate of rise. Ongoing ocean heat uptake and associated thermal expansion have continued since 2000, and are consistent with ocean thermal expansion reported in the AR5. A significant amount of heat is being stored deeper in the water column, with a larger rate of heat uptake since 2000 compared to the previous decades and with the largest storage in the Southern Ocean. The first formal detection studies for ocean thermal expansion and glacier mass loss since the AR5 have confirmed the AR5 finding of a significant anthropogenic contribution to sea level rise over the last 50 years. New projections of glacier loss from two regions suggest smaller contributions to GMSL rise from these regions than in studies assessed by the AR5; additional regional studies are required to further assess whether there are broader implications of these results. Mass loss from the Greenland Ice Sheet, primarily as a result of increased surface melting, and from the Antarctic Ice Sheet, primarily as a result of increased ice discharge, has accelerated. The largest estimates of acceleration in mass loss from the two ice sheets for 2003–2013 equal or exceed the acceleration of GMSL rise calculated from the satellite altimeter sea level record over the longer period of 1993–2014. However, when increased mass gain in land water storage and parts of East Antarctica, and decreased mass loss from glaciers in Alaska and some other regions are taken into account, the net acceleration in the ocean mass gain is consistent with the satellite altimeter record. New studies suggest that a marine ice sheet instability (MISI) may have been initiated in parts of the West Antarctic Ice Sheet (WAIS), but that it will affect only a limited number of ice streams in the twenty-first century. New projections of mass loss from the Greenland and Antarctic Ice Sheets by 2100, including a contribution from parts of WAIS undergoing unstable retreat, suggest a contribution that falls largely within the likely range (i.e., two thirds probability) of the AR5. These new results increase confidence in the AR5 likely range, indicating that there is a greater probability that sea level rise by 2100 will lie in this range with a corresponding decrease in the likelihood of an additional contribution of several tens of centimeters above the likely range. In view of the comparatively limited state of knowledge and understanding of rapid ice sheet dynamics, we continue to think that it is not yet possible to make reliable quantitative estimates of future GMSL rise outside the likely range. Projections of twenty-first century GMSL rise published since the AR5 depend on results from expert elicitation, but we have low confidence in conclusions based on these approaches. New work on regional projections and emergence of the anthropogenic signal suggests that the two commonly predicted features of future regional sea level change (the increasing tilt across the Antarctic Circumpolar Current and the dipole in the North Atlantic) are related to regional changes in wind stress and surface heat flux. Moreover, it is expected that sea level change in response to anthropogenic forcing, particularly in regions of relatively low unforced variability such as the low-latitude Atlantic, will be detectable over most of the ocean by 2040. The east-west contrast of sea level trends in the Pacific observed since the early 1990s cannot be satisfactorily accounted for by climate models, nor yet definitively attributed either to unforced variability or forced climate change

Whole exome re-sequencing implicates CCDC38 and cilia structure and function in resistance to smoking related airflow obstruction

Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality and, whilst smoking remains the single most important risk factor, COPD risk is heritable. Of 26 independent genomic regions showing association with lung function in genome-wide association studies, eleven have been reported to show association with airflow obstruction. Although the main risk factor for COPD is smoking, some individuals are observed to have a high forced expired volume in 1 second (FEV1) despite many years of heavy smoking. We # hypothesised that these ‘‘resistant smokers’’ may harbour variants which protect against lung function decline caused by smoking and provide insight into the genetic determinants of lung health. We undertook whole exome re sequencing of 100 heavy smokers who had healthy lung function given their age, sex, height and smoking history and applied three complementary approaches to explore the genetic architecture of smoking resistance. Firstly, we identified novel functional variants in the ‘‘resistant smokers’’ and looked for enrichment of these novel variants within biological pathways. Secondly, we undertook association testing of all exonic variants individually with two independent control sets. Thirdly, we undertook gene-based association testing of all exonic variants. Our strongest signal of association with smoking resistance for a non-synonymous SNP was for rs10859974 (P = 2.3461024) in CCDC38, a gene which has previously been reported to show association with FEV1/FVC, and we demonstrate moderate expression of CCDC38 in bronchial epithelial cells. We identified an enrichment of novel putatively functional variants in genes related to cilia structure and function in resistant smokers. Ciliary function abnormalities are known to be associated with both smoking and reduced mucociliary clearance in patients with COPD. We suggest that genetic influences on the development or function of cilia in the bronchial epithelium may affect growth of cilia or the extent of damage caused by tobacco smoke

Fructose-1, 6-diphosphate (FDP) as a novel antidote for yellow oleander-induced cardiac toxicity: A randomized controlled double blind study

BACKGROUND: Cardiac toxicity due to ingestion of oleander plant seeds in Sri Lanka and some other South Asian countries is very common. At present symptomatic oleander seed poisoning carries a mortality of 10% in Sri Lanka and treatment of yellow oleander poisoning is limited to gastric decontamination and atropine administration. The only proven effective antidote is digoxin antibodies but these are not available for routine use because of the high cost. The main objective of this study is to investigate the effectiveness of a new and inexpensive antidote for patients with life threatening arrhythmias due oleander poisoning. METHOD/DESIGN: We set up a randomised double blind clinical trial to assess the effectiveness of Fructose 1, 6 diphosphate (FDP) in acute yellow oleander poisoning patients admitted to the adult medical wards of a tertiary hospital in Sri Lanka. Patients will be initially resuscitated following the national guidelines and eligible patients will be randomised to receive either FDP or an equal amount of normal saline. The primary outcome measure for this study is the sustained reversion to sinus rhythm with a heart rate greater than 50/min within 2 hours of completion of FDP/placebo bolus. Secondary outcomes include death, reversal of hyperkalaemia on the 6, 12, 18 and 24 hour samples and maintenance of sinus rhythm on the holter monitor. Analysis will be on intention-to-treat. DISCUSSION: This trial will provide information on the effectiveness of FDP in yellow oleander poisoning. If FDP is effective in cardiac glycoside toxicity, it would provide substantial benefit to the patients in rural Asia. The drug is inexpensive and thus could be made available at primary care hospitals if proven to be effective. TRIAL REGISTRATION: Current Controlled trial ISRCTN71018309

From the front

The causes of recent dynamic thinning of Greenland's outlet glaciers have been debated. Realistic simulations suggest that changes at the marine fronts of these glaciers are to blame, implying that dynamic thinning will cease once the glaciers retreat to higher ground. For the last decade, many outlet glaciers in Greenland that terminate in the ocean have accelerated, thinned, and retreated. To explain these dynamic changes, two hypotheses have been discussed. Atmospheric warming has increased surface melting and may also have increased the amount of meltwater reaching the glacier bed, increasing lubrication at the base and hence the rate of glacier sliding. Alternatively, a change in the delicate balance of forces where the glacier fronts meet the ocean could trigger the changes. Faezeh Nick and colleagues5 present ice-sheet modeling experiments that mimic the observations on Helheim glacier, East Greenland, and suggest that the dynamic behaviour of outlet glaciers follows from perturbations at their marine fronts. Greenland's ice sheet loses mass partly through surface melting and partly through fast flowing outlet glaciers that connect the vast plateau of inland ice with the ocean. Earlier ice sheet models have failed to reproduce the dynamic variability exhibited by ice sheets over time. It has therefore not been possible to distinguish with confidence between basal lubrication from surface meltwater and changes at the glaciers' marine fronts as causes for the observed changes on Greenland's outlet glaciers. But this distinction bears directly on future sea-level rise, the raison d'etre of much of modern-day glaciology: If the recent dynamic mass loss Greenland's outlet glaciers is linked to changing atmospheric temperatures, it may continue for as long as temperatures continue to increase. On the other hand, if the source of the dynamic mass loss is a perturbation at the ice-ocean boundary, these glaciers will lose contact with that perturbation after a finite amount of thinning and retreat. Therefore, the first hypothesis implies continued retreat of outlet glaciers into the foreseeable future, while the second does not -- provided the bedrock topography prohibits a connection between the retreating glacier and the ocean. Nick and coauthors test the physical mechanisms implied in each hypotbesis in an innovative ice-flow model, and use that model to try to match a time series of observations from Helheim glacier, one of Greenland's three largest outlet glaciers. Along with many observations, the simulations strongly support the contention that the recent retreat of Greenland's outlet glaciers is the result of changes at their marine fronts.Further, the simulations confirm the earlier hypotheses that bedrock topography largely controlled Helheim glacier's rapid acceleration and retreat in 2004 and 2005, and its deceleration and stabilization in 2006. Finally, the current work implies that if requirements of observational data (high-resolution bed topography) and computational resources (fine computational grid resolution) can be met, improved predictive capability for ice-sheet models is attainable. With respect to the concerns raised by the IPCC, this study signals progress

Rapid circulation of warm subtropical waters in a major glacial fjord in East Greenland

Author Posting. © The Authors, 2009. This is the author's version of the work. It is posted here by permission of Nature Publishing Group for personal use, not for redistribution. The definitive version was published in Nature Geoscience 3 (2010): 182-186, doi:10.1038/ngeo764.The recent rapid increase in mass loss from the Greenland Ice Sheet is primarily attributed to an acceleration of outlet glaciers. One possible cause is increased melting at the ice/ocean interface driven by the synchronous warming of subtropical waters offshore of Greenland. This hypothesis is largely untested, however, because of the lack of observations from Greenland’s glacial fjords and our limited understanding of their dynamics. Here, we present new ship-based and moored oceanographic data, collected in Sermilik Fjord, a large glacial fjord in East Greenland, showing that subtropical waters are present throughout the fjord and are continuously replenished via a wind-driven exchange with the shelf, where they occur year-round. The temperature and rapid renewal of these waters suggest that, at present, they drive enhanced submarine melting at the terminus. Key controls on the melting rate are the volume and properties of subtropical waters on the shelf and the patterns of the along-shore winds, suggesting the glaciers’ acceleration was triggered by a combination of atmospheric and oceanic changes. These measurements provide evidence of rapid advective pathway for the transmission of oceanic variability to the ice-sheet margins and highlight an important process that is missing from prognostic ice-sheet models.F.S. acknowledges support from WHOI’s Ocean and Climate Change Institute’s Arctic Research Initiative and from NSF OCE 0751896, and G.S.H and L.A.S from NASA’s Cryospheric Sciences Program. Funding for the hooded seal deployments was obtained from the International Governance and Atlantic Seal Research Program, Fisheries and Oceans, Canada, to G. B. S. and to the Greenland Institute of Natural Resources to A. R. A