Case report : synergetic effect of ischaemia and increased vagal tone inducing ventricular fibrillation in a patient with Brugada syndrome

Background Brugada syndrome (BS) is a hereditary channelopathy associated with syncope, malignant ventricular arrhythmia, and sudden cardiac death. Right ventricular ischaemia and BS have similar underlying substrates precipitating ventricular tachycardia or fibrillation (VF). Case summary A 72-year-old woman with BS and a stenosis on the proximal right coronary artery received several subsequent implantable cardioverter-defibrillator shocks due to VF during an episode of extreme nausea with vomiting. Discussion This case report emphasizes on the synergetic effect of mild ischaemia and increased vagal tone on the substrate responsible for BS to create pathophysiological changes precipitating VF

Methylene Diphenyl Diisocyanate

The report provides the comprehensive risk assessment of the substance Methylenediphenyl diisocyanate (MDI). It has been prepared by Belgium in the frame of Council Regulation (EEC) No. 793/93 on the evaluation and control of the risks of existing substances, following the principles for assessment of the risks to humans and the environment, laid down in Commission Regulation (EC) No. 1488/94. Part I - Environment This part of the evaluation considers the emissions and the resulting exposure to the environment in all life cycle steps. Following the exposure assessment, the environmental risk characterisation for each protection goal in the aquatic, terrestrial and atmospheric compartment has been determined. The environmental risk assessment concludes that there is no concern. Part II ¿ Human Health This part of the evaluation considers the emissions and the resulting exposure to human populations in all life cycle steps. The scenarios for occupational exposure, consumer exposure and humans exposed via the environment have been examined and the possible risks have been identified. The human health risk assessment concludes that there is concern for workers and consumers with regard to irritation of skin, eye and respiratory tract, skin sensitisation and lung effects induced by repeated inhalation exposure. There is a need for further information and for testing (on hold) on the toxicity for fertility for workers and consumers. For humans exposed via the environment and for human health (physico-chemical properties) there is no concern. The conclusions of this report will lead to risk reduction measures to be proposed by the Commission¿s committee on risk reduction strategies set up in support of Council Regulation (EEC) N. 793/93.JRC.DDG.I.2-Chemical assessment and testin

Characterisations of Europe's integrated water vapour and assessments of atmospheric reanalyses using more than 2 decades of ground-based GPS

The ground-based Global Positioning System (GPS) has been used extensively to retrieve integrated water vapour (IWV) and has been adopted as a unique tool for the assessments of atmospheric reanalyses. In this study, we investigated the multi-temporal-scale variabilities and trends of IWV over Europe by using IWV time series from 108 GPS stations for more than 2 decades (1994–2018). We then adopted the GPS IWV as a reference to assess six commonly used atmospheric reanalyses, namely the Climate Forecast System Reanalysis (CFSR); ERA5; ERA-Interim; the Japanese 55-year Reanalysis (JRA-55); the Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2); and NCEP-DOE AMIP-II Reanalysis (NCEP-2). The GPS results show that the peaks of the diurnal harmonics are within 15:00–21:00 in local solar time at 90 % of the stations. The diurnal amplitudes are 0–1.2 kg m−2 (0 %–8 % of the daily mean IWV), and they are found to be related to seasons and locations with different mechanisms, such as solar heating, land–sea breeze, and orographic circulation. However, mismatches in the diurnal cycle of ERA5 IWV between 09:00 and 10:00 UTC as well as between 21:00 and 22:00 UTC were found and evaluated for the first time, and they can be attributed to the edge effect in each ERA5 assimilation cycle. The average ERA5 IWV shifts are −0.08 and 0.19 kg m−2 at the two epochs, and they were found to be more significant in summer and in the Alps and in Eastern and central Europe in some cases. Nevertheless, ERA5 outperforms the other reanalyses in reproducing diurnal IWV anomalies at all the 1-, 3-, and 6-hourly temporal resolutions. ERA5 is also superior to the others in modelling the annual cycle and linear trend of IWV. For instance, the IWV trend differences between ERA5 and GPS are quite small, with a mean value and a standard deviation of 0.01 % per decade and 0.97 % per decade, respectively. However, due to significant discrepancies with respect to GPS, CFSR and NCEP-2 are not recommended for the analysis of IWV trends over southern Europe and the whole of Europe, respectively.</p

Case report: Synergetic effect of ischaemia and increased vagal tone inducing ventricular fibrillation in a patient with Brugada syndrome

Background Brugada syndrome (BS) is a hereditary channelopathy associated with syncope, malignant ventricular arrhythmia, and sudden cardiac death. Right ventricular ischaemia and BS have similar underlying substrates precipitating ventricular tachycardia or fibrillation (VF). ................................................................................................................................................................................................... Case summary A 72-year-old woman with BS and a stenosis on the proximal right coronary artery received several subsequent implantable cardioverter-defibrillator shocks due to VF during an episode of extreme nausea with vomiting. ................................................................................................................................................................................................... Discussion This case report emphasizes on the synergetic effect of mild ischaemia and increased vagal tone on the substrate responsible for BS to create pathophysiological changes precipitating VF

Long-term photometric monitoring with the Mercator telescope. Frequencies and multicolour amplitudes of γ\gamma Doradus stars

Gamma Doradus stars are excellent targets for asteroseismology since the gravity modes present in these stars probe the deep stellar interiors. Mode identification will improve the knowledge of these stars considerably. A selected group of Gamma Doradus stars and some candidates were observed with the Mercator telescope to find and/or confirm the periodicities in the light variations and to derive reliable amplitude ratios in different pass bands. A frequency analysis was performed on all new data obtained in the Geneva photometric system. In order to have more reliable and accurate frequencies, the new data were combined with similar data from the literature and with Hipparcos observations. A set of frequencies that minimized the the residuals in a harmonic fit was searched for while allowing means and amplitudes to vary from one observation set to another. Frequencies and amplitudes in the photometric passbands of the Geneva system are given for 21 Gamma Doradus stars. We report the discovery of HD 74504 as a newly found Gamma Doradus star. Our study provides the first extensive multicolour database for the understanding of gravity modes in F-type stars.Comment: Electronic tables (5 to 25) not included in this versio

Review of Environmental Monitoring by Means of Radio Waves in the Polar Regions: From Atmosphere to Geospace

The Antarctic and Arctic regions are Earth's open windows to outer space. They provide unique opportunities for investigating the troposphere–thermosphere–ionosphere–plasmasphere system at high latitudes, which is not as well understood as the mid- and low-latitude regions mainly due to the paucity of experimental observations. In addition, different neutral and ionised atmospheric layers at high latitudes are much more variable compared to lower latitudes, and their variability is due to mechanisms not yet fully understood. Fortunately, in this new millennium the observing infrastructure in Antarctica and the Arctic has been growing, thus providing scientists with new opportunities to advance our knowledge on the polar atmosphere and geospace. This review shows that it is of paramount importance to perform integrated, multi-disciplinary research, making use of long-term multi-instrument observations combined with ad hoc measurement campaigns to improve our capability of investigating atmospheric dynamics in the polar regions from the troposphere up to the plasmasphere, as well as the coupling between atmospheric layers. Starting from the state of the art of understanding the polar atmosphere, our survey outlines the roadmap for enhancing scientific investigation of its physical mechanisms and dynamics through the full exploitation of the available infrastructures for radio-based environmental monitoring

Long term photometric monitoring with the Mercator telescope. Frequencies and mode identification of variable O-B stars

Aims. We selected a large sample of O-B stars that were considered as (candidate) slowly pulsating B, beta Cep, and Maia stars after the analysis of their hipparcos data. We analysed our new seven passband geneva data collected for these stars during the first three years of scientific operations of the mercator telescope. We performed a frequency analysis for 28 targets with more than 50 high-quality measurements to improve their variability classification. For the pulsating stars, we tried both to identify the modes and to search for rotationally split modes. Methods: We searched for frequencies in all the geneva passbands and colours by using two independent frequency analysis methods and we applied a 3.6 S/N-level criterion to locate the significant peaks in the periodograms. The modes were identified by applying the method of photometric amplitudes for which we calculated a large, homogeneous grid of equilibrium models to perform a pulsational stability analysis. When both the radius and the projected rotational velocity of an object are known, we determined a lower limit for the rotation frequency to estimate the expected frequency spacings in rotationally split pulsation modes. Results: We detected 61 frequencies, among which 33 are new. We classified 21 objects as pulsating variables (7 new confirmed pulsating stars, including 2 hybrid beta Cep/SPB stars), 6 as non-pulsating variables (binaries or spotted stars), and 1 as photometrically constant. All the Maia candidates were reclassified into other variability classes. We performed mode identification for the pulsating variables for the first time. The most probable l value is 0, 1, 2, and 4 for 1, 31, 9, and 5 modes, respectively, including only 4 unambiguous identifications. For 7 stars we cannot rule out that some of the observed frequencies belong to the same rotationally split mode. For 4 targets we may begin to resolve close frequency multiplets. Based on observations collected with the p7 photometer attached to the Flemish 1.2-m mercator telescope situated at the Roque de los Muchachos observatory on La Palma (Spain). Section [see full textsee full text], including Figs. is only available in electronic form at http://www.aanda.org, and Tables 2 and 3 are only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/cgi-bin/qcat?J/A+A/463/243Peer reviewe

A time-motion analysis of lightweight women’s judo in the 2010 World Championships

The Olympic sport of judo has a growing base of performance analysis research considering the technical aspects, the tactical aspects and time motion analysis. This study aimed to further analyse this sport by specifically considering the time motion aspects of work, rest, kumi-kata and ne-waza in lightweight women's judo to establish if there are differences in this specific population of judo athletes. Pre-recorded footage of the women's u48kg, u52kg and u57kg weight divisions (143 contests) from the 2010 world judo championships were coded into temporal sequences. The coding of five KPIs across the three weight groups produced a total of 1756 hajime to matte blocks (work), 1422 matte to hajime blocks (rest), 1786 kumi-kata sequences (gripping sequences), and 516 ne-waza sequences (ground work). The results suggest the time spent in hajime to matte (work) and in matte to hajime (rest) are similar to those seen in other studies. This suggests there is little difference in the work to rest segments for lightweight women's judo compared to heavier weights and males

Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA

Purpose: Whether the quality of the ethical climate in the intensive care unit (ICU) improves the identification of patients receiving excessive care and affects patient outcomes is unknown. Methods: In this prospective observational study, perceptions of excessive care (PECs) by clinicians working in 68 ICUs in Europe and the USA were collected daily during a 28-day period. The quality of the ethical climate in the ICUs was assessed via a validated questionnaire. We compared the combined endpoint (death, not at home or poor quality of life at 1 year) of patients with PECs and the time from PECs until written treatment-limitation decisions (TLDs) and death across the four climates defined via cluster analysis. Results: Of the 4747 eligible clinicians, 2992 (63%) evaluated the ethical climate in their ICU. Of the 321 and 623 patients not admitted for monitoring only in ICUs with a good (n = 12, 18%) and poor (n = 24, 35%) climate, 36 (11%) and 74 (12%), respectively were identified with PECs by at least two clinicians. Of the 35 and 71 identified patients with an available combined endpoint, 100% (95% CI 90.0–1.00) and 85.9% (75.4–92.0) (P = 0.02) attained that endpoint. The risk of death (HR 1.88, 95% CI 1.20–2.92) or receiving a written TLD (HR 2.32, CI 1.11–4.85) in patients with PECs by at least two clinicians was higher in ICUs with a good climate than in those with a poor one. The differences between ICUs with an average climate, with (n = 12, 18%) or without (n = 20, 29%) nursing involvement at the end of life, and ICUs with a poor climate were less obvious but still in favour of the former. Conclusion: Enhancing the quality of the ethical climate in the ICU may improve both the identification of patients receiving excessive care and the decision-making process at the end of life