Brachial plexopathy after prone positioning

Two cases of brachial plexus injury after prone position in the intensive care unit are described. Mechanisms of brachial plexus injury are described, as are methods for prevention of this unusual complication

Stellar Activity in Coeval Open Clusters: Praesepe and The Hyades

Randich and Schmitt [1995, A&A 298, 115] found that the coronal activity of solar-type and low mass stars in Praesepe is significantly lower than that of stars in the Hyades cluster. We have carried out several tests in order to find a possible explanation for this result. We have measured radial velocities of two groups of Praesepe stars (a dF-dK sample and a dM sample) and have measured H$\alpha$ as a chromospheric activity index for the dM sample. We conclude that the Praesepe catalog used in the X-ray analysis does not contain a significant number of non-members. The comparison of the H$\alpha$ equivalent widths for the M dwarfs in Praesepe with those in the Hyades indicates that, at least for stars in this mass range, the Praesepe stars are as active or more active than their Hyades counterparts. We have also analyzed a few ROSAT PSPC pointings of Praesepe in order to obtain a new and independent estimate of the X-ray luminosities and upper limits for a small sample of Praesepe members concluding that the small differences between the old and new upper limits are not large enough to explain the dichotomy in the X-ray properties of Praesepe and the Hyades. Therefore, our examination of the available data does not provide a clear reason to explain why the X-ray luminosity functions of the two clusters are different. Part of the explanation could be found in the binaries. Speculatively, these clusters could have different orbital period distributions, with more short period binaries among the Hyades, which would show larger coronal activity.Comment: Accepted for publiction in Ap

An Energy-Water Corridor Along the US/Mexico Border: Changing the \u27Conversation\u27

Over the last decade, migration has become a divisive issue around the world. A large number of countries have erected barriers along their borders to prevent migration, leading to geopolitical tension. Climate change effects will likely exacerbate migration tensions, which will require bold and creative solutions to this difficult social predicament. Here we detail a plan to construct an energy-water corridor along a border that has been the focus of much attention recently: The U.S.-Mexico border. Our proposed solution helps to alleviate some of the negative effects of climate change, while providing energy and economic stimulus to an area that begs for sustainable development. The energy-water corridor will take advantage of the unique renewable energy resources along the border states and will use state-of-the-art water desalination and treatment systems to provide the resources for economic development in the region

Monitoring quality of care in hepatocellular carcinoma: A modified delphi consensus

Although there are several established international guidelines on the management of hepatocellular carcinoma (HCC), there is limited information detailing specific indicators of good quality care. The aim of this study was to develop a core set of quality indicators (QIs) to underpin the management of HCC. We undertook a modified, two-round, Delphi consensus study comprising a working group and experts involved in the management of HCC as well as consumer representatives. QIs were derived from an extensive review of the literature. The role of the participants was to identify the most important and measurable QIs for inclusion in an HCC clinical quality registry. From an initial 94 QIs, 40 were proposed to the participants. Of these, 23 QIs ultimately met the inclusion criteria and were included in the final set. This included (a) nine related to the initial diagnosis and staging, including timing to diagnosis, required baseline clinical and laboratory assessments, prior surveillance for HCC, diagnostic imaging and pathology, tumor staging, and multidisciplinary care; (b) thirteen related to treatment and management, including role of antiviral therapy, timing to treatment, localized ablation and locoregional therapy, surgery, transplantation, systemic therapy, method of response assessment, and supportive care; and (c) one outcome assessment related to surgical mortality. Conclusion: We identified a core set of nationally agreed measurable QIs for the diagnosis, staging, and management of HCC. The adherence to these best practice QIs may lead to system-level improvement in quality of care and, ultimately, improvement in patient outcomes, including survival

Heat Safety in the Workplace:Modified Delphi Consensus to Establish Strategies and Resources to Protect U.S Workers

The purpose of this consensus document was to develop feasible, evidence‐based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans. An interdisciplinary roundtable comprised of 51 experts was assembled to create a narrative review summarizing current data and gaps in knowledge within eight heat safety topics: (a) heat hygiene, (b) hydration, (c) heat acclimatization, (d) environmental monitoring, (e) physiological monitoring, (f) body cooling, (g) textiles and personal protective gear, and (h) emergency action plan implementation. The consensus‐based recommendations for each topic were created using the Delphi method and evaluated based on scientific evidence, feasibility, and clarity. The current document presents 40 occupational heat safety recommendations across all eight topics. Establishing these recommendations will help organizations and employers create effective heat safety plans for their workplaces, address factors that limit the implementation of heat safety best‐practices and protect worker health and productivity

Adaptive regression modeling of biomarkers of potential harm in a population of U.S. adult cigarette smokers and nonsmokers

<p>Abstract</p> <p>Background</p> <p>This article describes the data mining analysis of a clinical exposure study of 3585 adult smokers and 1077 nonsmokers. The analysis focused on developing models for four biomarkers of potential harm (BOPH): white blood cell count (WBC), 24 h urine 8-epi-prostaglandin F_2α(EPI8), 24 h urine 11-dehydro-thromboxane B₂(DEH11), and high-density lipoprotein cholesterol (HDL).</p> <p>Methods</p> <p>Random Forest was used for initial variable selection and Multivariate Adaptive Regression Spline was used for developing the final statistical models</p> <p>Results</p> <p>The analysis resulted in the generation of models that predict each of the BOPH as function of selected variables from the smokers and nonsmokers. The statistically significant variables in the models were: platelet count, hemoglobin, C-reactive protein, triglycerides, race and biomarkers of exposure to cigarette smoke for WBC (R-squared = 0.29); creatinine clearance, liver enzymes, weight, vitamin use and biomarkers of exposure for EPI8 (R-squared = 0.41); creatinine clearance, urine creatinine excretion, liver enzymes, use of Non-steroidal antiinflammatory drugs, vitamins and biomarkers of exposure for DEH11 (R-squared = 0.29); and triglycerides, weight, age, sex, alcohol consumption and biomarkers of exposure for HDL (R-squared = 0.39).</p> <p>Conclusions</p> <p>Levels of WBC, EPI8, DEH11 and HDL were statistically associated with biomarkers of exposure to cigarette smoking and demographics and life style factors. All of the predictors togather explain 29%-41% of the variability in the BOPH.</p

Modelling climate and societal resilience in the Eastern Mediterranean in the last Millennium

This article analyses high-quality hydroclimate proxy records and spatial reconstructions from the Central and Eastern Mediterranean and compares them with two Earth System Model simulations (CCSM4, MPI-ESM-P) for the Crusader period in the Levant (1095–1290 CE), the Mamluk regime in Transjordan (1260–1516 CE) and the Ottoman crisis and Celâlî Rebellion(1580–1610 CE). During the three time intervals, environmental and climatic stress tested the resilience of complex societies.We find that the multidecadal precipitation and drought variations in the Central and Eastern Mediterranean cannot be explained by external forcings (solar variations, tropical volcanism); rather they were driven by internal climate dynamics. Our research emphasises the challenges, opportunities and limitations of linking proxy records, palaeoreconstructions and model simulations to better understand how climate can affect human history

The acid test: the discovery of two-pore channels (TPCs) as NAADP-gated endolysosomal Ca2+ release channels

In this review, we describe the background and implications of our recent discovery that two-pore channels (TPCs) comprise a novel class of calcium release channels gated by the intracellular messenger nicotinic acid adenine dinucleotide phosphate (NAADP). Their localisation to the endolysosomal system highlights a new function for these organelles as targets for NAADP-mediated Ca(2+) mobilisation. In addition, we describe how TPCs may also trigger further Ca(2+) release by coupling to the endoplasmic reticular stores through activation of IP(3) receptors and ryanodine receptors