A clinical decision support system for the treatment of common toxin overdose

Poisonings account for 0.8% of emergency room visits each year. Our review of current toxicological resources revealed a gap in their ability to provide expedient calculations and recommendations, as they are broad in scope and time-consuming to read. Time is crucial in a toxicologic emergency. Delay in first dose can lead to life-threatening sequelae. To bridge the gap, we developed the Antidote Application (AA), a computational system that automatically provides patient-specific antidote treatment recommendation(s) and individualized dose calculation(s). We implemented 27 algorithms that describe FDA approved use and evidence-based practices found in primary literature for the treatment of common toxin exposure. The AA covers 29 antidotes recommended by Poison Control and toxicology experts, 31 toxins from 19 toxin classes, and over 200 toxic entities. We implemented the AA in two formats: a standalone downloadable application for offline use and an online web application. The AA represents a unique educational resource for the study of toxicology with the potential of being adopted for point of care decision support. The system also provides guidance for reporting toxic exposures regionally and nationally as required by accrediting bodies and some states. The AA system has the potential for reducing initial dose delays and medication errors. To the best of our knowledge, the AA is the first educational and decision support system in toxicology that provides patient-specific treatment recommendations and drug dose calculations. The downloadable and online Antidote Applications are publically available at http://www.met-hilab.org/files/antidote/antidote_application.jar and http://projects.met-hilab.org/antidote/ respectively

Is there still a role for small wind in rural electrification programmes?

In the right context, Small Wind Turbines (SWTs) can offer a valuable complement to solar photovoltaics (PV) or diesel generators, offering diversity in power generation sources and the potential for local manufacture. However, the biggest challenges facing small wind are the high variability in the wind resource (in both space and time) and the high maintenance requirements of SWTs. What is more, PV prices have fallen dramatically in the last decade, resulting in the proliferation of an array of desirable and highly modular solar solutions, such as solar lanterns and Solar Home Systems (SHS). Consequently, outside of high wind regions, SWTs are now rarely directly economically competitive against solar PV. Going forward, SWTs are still likely to have a role to play, but in niche contexts and as a complimentary addition to hybridise solar PV or diesel systems, rather than as a standalone alternative. Market assessments are an essential first step to determine the relative viability of PV-wind or wind-diesel hybrid systems with PV or diesel systems in particular contexts. In favourable regions, the high maintenance requirements of SWTs can be tackled by providing stable institutional support to empower local champions, establish a decentralised maintenance network and foster the development of a local small wind industry. End users and local technicians should be empowered to carry out as much maintenance as they are able/willing to, especially in remote regions, where frequent long maintenance trips are likely to lead small wind electrification programmes to failure. Sustainable business models should focus on productive applications and addressing the weaknesses of diesel and/or solar generation through hybridisation

Posttraumatic Stress Disorder and Health-Related Quality of Life among a Sample of Treatment- and Pension-Seeking Deployed Canadian Forces Peacekeeping Veterans

Objectives: To examine the health-related quality of life (HRQOL) in deployed Canadian Forces peacekeeping veterans, addressing associations with posttraumatic stress disorder (PTSD), and depression severity. Methods: Participants (n = 125) were consecutive male veterans who were referred for a psychiatric assessment. Instruments administered included the Clinician-Administered PTSD Scale, Hamilton Depression Scale, Short-Form-36 Health Survey, and sociodemographic characteristics. Results: Mental HRQOL was significantly lower for peacekeepers with, than without, PTSD. Using univariate analyses, PTSD and depression severity were each significantly negatively related to mental HRQOL. In sequential regression analyses controlling for age, we found that PTSD and depression severity significantly predicted both mental and physical HRQOL. Conclusions: Veterans with PTSD have significant impairments in mental and physical HRQOL. This information is useful for clinicians and Veterans Affairs administrators working with the newer generation of veterans, as it stresses the importance of including measures of quality of life in the psychiatric evaluation of veterans to better address their rehabilitation needs

A Humanities-Based Explanation for the Effects of Emotional Eating and Perceived Stress on Food Choice Motives during the COVID-19 Pandemic

Perceived stress affects emotional eating and food choices. However, the extent to which stress associates with food choice motives is not completely understood. This study assessed whether emotional eating mediates the associations between perceived stress levels and food choice motives (i.e., health, mood, convenience, natural content, price, sensory appeal, familiarities, weight control, and ethical concerns) during the Coronavirus Disease 2019 pandemic. A total of 800 respondents were surveyed in the United States in June 2020. Their perceived stress, emotional eating, and food choice motives were assessed by the Perceived Stress Scale, Dutch Eating Behavior Questionnaire, and Food Choice Questionnaire, respectively. Moderate to high levels of perceived stress were experienced by the majority (73.6%) of respondents. Perceived stress was significantly correlated with emotional eating ( = 0.26) as well as five out of nine food choice motives: mood ( = 0.32), convenience ( = 0.28), natural content ( = -0.14), price ( = 0.27), and familiarity ( = 0.15). Emotional eating was significantly correlated with four out of nine food choice motives: mood ( = 0.27), convenience ( = 0.23), price ( = 0.16), and familiarity ( = 0.16). The mediation analyses showed that emotional eating mediates the associations between perceived stress and five food choices motives: mood, convenience, sensory appeal, price, and familiarity. Findings were interpreted using theories and concepts from the humanities, specifically, folklore studies, ritual studies, and symbolic anthropology

The northern sector of the last British ice sheet : maximum extent and demise

Strongly divided opinion has led to competing, apparently contradictory, views on the timing, extent, flow configuration and decay mechanism of the last British Ice Sheet. We review the existing literature and reconcile some of these differences using remarkable new sea-bed imagery. This bathymetric data provides unprecedented empirical evidence of confluence and subsequent separation of the last British and Fennoscandian Ice Sheets. Critically, it also allows a viable pattern of ice-sheet disintegration to be proposed for the first time. Covering the continental shelf around the northern United Kingdom, extensive echosounder data reveals striking geomorphic evidence – in the form of tunnel valleys and moraines – relating to the former British and Fennoscandian Ice Sheets. The pattern of tunnel valleys in the northern North Sea Basin and the presence of large moraines on the West Shetland Shelf, coupled with stratigraphic evidence from the Witch Ground Basin, all suggest that at its maximum extent a grounded ice sheet flowed from SE to NW across the northern North Sea Basin, terminating at the continental-shelf edge. The zone of confluence between the British and much larger Fennoscandian Ice Sheets was probably across the northern Orkney Islands, with fast-flowing ice in the Fair Isle Channel focusing sediment delivery to the Rona and Foula Wedges. This period of maximum confluent glaciation (c. 30–25 ka BP) was followed by a remarkable period of large-scale ice-sheet re-organisation. We present evidence suggesting that as sea level rose, a large marine embayment opened in the northern North Sea Basin, as far south as the Witch Ground Basin, forcing the two ice sheets to decouple rapidly along a north–south axis east of Shetland. As a result, both ice sheets rapidly adjusted to new quasi-stable margin positions forming a second distinct set of moraines (c. 24–18 ka BP). The lobate overprinted morphology of these moraines on the mid-shelf west of Orkney and Shetland indicates that the re-organisation of the British Ice Sheet was extremely dynamic — probably dominated by a series of internally forced readvances. Critically, much of the ice in the low-lying North Sea Basin may have disintegrated catastrophically as decoupling progressed in response to rising sea levels. Final-stage deglaciation was marked by near-shore ice streaming and increasing topographic control on ice-flow direction. Punctuated retreat of the British Ice Sheet continued until c. 16 ka BP when, following the North Atlantic iceberg-discharge event (Heinrich-1), ice was situated at the present-day coastline in NW Scotlan