Global heat flow trends resolved from multiple geological and geophysical proxies

International audienceBecause global coverage of heat flow measurements is still poor in many areas, empirical estimators based on the geology, the thermotectonic age or the velocity structure of the upper mantle have often been used to affect an estimate to regions where such measurements are absent. On the basis of the assumption that heat flow is strongly related to its geodynamic environment, one may integrate multiple proxies derived from a large body of global geo- logical and geophysical data sets assembled during the past decades; these should help to better capture the variety of present-day settings. This idea is illustrated through two simple empirical methods: both of them are based on a set of examples, where heat flow measure- ments are associated with relevant terrestrial observables such as surface heat production, upper-mantle velocity structure, tectono-thermal age, on a 1◦ × 1◦ grid. To a given target point owning a number of observables, the methods associate a heat flow distribution rather than a deterministic value to account for intrinsic variability and uncertainty within a defined geodynamic environment. The 'best combination method' seeks the particular combination of observables that minimizes the dispersion of the heat flow distribution generated from the set of examples. The 'similarity method' attributes a weight to each example depending on its degree of similarity with the target point. The methods are transparent and are able to handle sets of observables that are not available over the whole Earth (e.g. heat production). The resulting trends of the mean heat flow deduced from the two methods do not differ strongly, but the similarity method shows a better accuracy in cross-validation tests. These tests suggest that the selected proxies have the potential to recover at least partly medium- to large-scale features of surface heat flow. The methods depict the main global trends of low heat flow in stable and ancient regions, and thermal high in active orogens and rift zones. Broad thermal anomalies are outlined in the Sahara and in the tectonically active eastern part of Antarctica. The similarity method estimates a continental heat loss of 13.6 ± 0.8 TW (2σ uncertainty), which is consistent with previous estimates

HAPEX-Sahel : a large-scale study of land-atmosphere interactions in the semi-arid tropics

The Hydrologic Atmospheric Pilot EXperiment in the Sahel (HAPEX-Sahel) was carried out in Niger, West Africa, during 1991 - 1992, with an intensive observation period (IOP) in August - October 1992. It aims at improving the parameterization of land surface atmosphere interactions at the Global Circulation Model (GCM) gridbox scale. The experiment combines remote sensing and ground based measurements with hydrological and meteorological modelling to develop aggregation techniques for use in large scale estimates of the hydrological and meteorological behaviour of large areas in the Sahel. The experimental strategy consisted of a period of intensive measurements during the transition period of the rainy to the dry season, backed up by a series of long term measurements in a 1° by 1° square in Niger. Three "supersites" were instrumented with a variety of hydrological and (micro) meteorological equipment to provide detailed information on the surface energy exchange at the local scale. Boundary layer measurements and aircraft measurements were used to provide information at scales of 100 - 500 km2. All relevant remote sensing images were obtained for this period. This programme of measurements is now being analyzed and an extensive modelling programme is under way to aggregate the information at all scales up to the GCM grid box scale. The experimental strategy and some preliminary results of the IOP are described

Predictors of 1-year compliance with adaptive servoventilation in patients with heart failure and sleep disordered breathing: preliminary data from the ADVENT-HF trial

Despite its effectiveness in suppressing sleep disordered breathing (SDB), positive airway pressure therapy (PAP) is not always well tolerated by patients and long-term adherence can be problematic. Recently, two multicentre, randomised clinical trials (RCTs) tested the effects of PAP for patients with cardiovascular disease and co-existing SDB on morbidity and mortality with negative outcomes [1, 2]. Relatively poor adherence to PAP therapy (mean 3.7 and 3.3 h·day-1, respectively) in these two trials might have contributed to their poor results. Indeed, higher PAP use per day is associated with better clinical outcomes than lower use [3]

Gastrointestinal decontamination in the acutely poisoned patient

ObjectiveTo define the role of gastrointestinal (GI) decontamination of the poisoned patient.Data sourcesA computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.Study selection and data extractionClinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient.Data synthesisThe literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis, animal studies or small case series, and rarely based on randomized clinical trials.ConclusionsThe current literature supports limited use of GI decontamination of the poisoned patient

Biliary stenting is not a prerequisite to endoscopic placement of duodenal covered self-expandable metal stents

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