645 research outputs found
Association of quality of life in old age in Britain with socioeconomic position: baseline data from randomised controlled trial
Power changes of EEG signals associated with muscle fatigue: The root mean square analysis of EEG bands
The paper reports a research conducted to determine changes in the electrical activity of the contralateral motor cortex of the brain that drives the maximum voluntary contraction (MVC) of the right adductor pollicis muscle (APM) after fatigue. The power changes of EEG signals after muscle fatigue were computed. In twenty-five subjects, EEG signals from the left motor cortical area (C3, FC3) were recorded simultaneously with EMG signals from the right APM, before and after exercise-induced fatigue. The root mean square (RMS) of the EEG bands (alpha, beta, and gamma) was calculated to determine the power changes of the EEG signals after right APM fatigue. The mean RMS of the EEG bands were increased during MVC of the fatigued right APM compared to the RMS value during relaxation before fatigue (p<0.05). The RMS value was seen to be greatest in the beta band, and lowest in the gamma band. The observed increase in the RMS of EEG bands during MVC of the fatigued right APM suggest an increase in the EEG signal power, which could reflect an increase in energy needed by the motor cortex to perform MVC in fatigued muscles, which might give an indication of neural fatigue in the motor cortex
Pharyngeal instillation of surfactant before the first breath for prevention of morbidity and mortality in preterm infants at risk of respiratory distress syndrome
Intrapartum pharyngeal instillation of surfactant before the first breath may result in surfactant administration to the infant lung, with the potential benefit of avoiding endotracheal intubation and ventilation, ventilator induced lung injury and bronchopulmonary dysplasia. To determine the effect of pharyngeal instillation of surfactant before the first breath compared to placebo, no treatment or intratracheal surfactant administration followed by intermittent positive pressure ventilation (IPPV) on morbidity and mortality in preterm infants at risk of respiratory distress syndrome (RDS). Searches were made of CENTRAL (The Cochrane Library, to September 2010), MEDLINE and PREMEDLINE (1950 to September 2010), EMBASE (1980 to 2010) and CINAHL (1982 to 2010). This strategy was supplemented by searches of proceedings of scientific meetings, Google Scholar and reference lists of identified studies, as well as contact with expert informants and surfactant manufacturers. Published, unpublished and ongoing randomised controlled or quasi-randomised trials (using individual or cluster allocation) of pharyngeal instillation of surfactant before the first breath compared to placebo or no treatment, or intratracheal surfactant instillation followed by IPPV, on morbidity and mortality in preterm infants at risk of RDS. Two authors independently assessed study eligibility and quality. No published, unpublished or ongoing trials that met the inclusion criteria for this review were found. There were no data from randomised controlled or quasi-randomised trials that evaluated the effect of intrapartum instillation of pharyngeal surfactant before the first breath. Evidence from animal and observational human studies suggest that pharyngeal instillation of surfactant before the first breath is potentially safe, feasible and may be effective. Well designed trials are needed
Pacific thermocline bridge revisited
The coupling on decadal time scales of the mid‐latitude and tropical Pacific via an oceanic ‘bridge’ in the thermocline is investigated using ocean general circulation model hindcasts and a coupled ocean atmosphere model. Results indicate that in the tropics decadal anomalies of isopycnal depth are forced by Ekman pumping and are largely independent of the arrival of subducted anomalies in the thermocline that originate in the mid‐latitudes of either hemisphere. In the coupled model, temperature anomalies on isopycnals show little coupling from the tropics to the northern hemisphere, but are lag correlated between southern hemisphere mid‐ and low‐latitudes. However, anomaly magnitudes on the equator are small. These results suggest that the oceanic ‘bridge’ to the northern hemisphere explains only a small part of the observed decadal variance in the equatorial Pacific. Coupling to the southern mid‐latitudes via temperature anomalies on isopycnals remains an intriguing possibility
Barriers to nurses performing physical assessments in rehabilitation care units: An observational study.
To describe the perceived barriers to nurses performing physical assessments of patients in rehabilitation wards. Secondarily, to investigate how sociodemographic and professional characteristics influence the use and frequency of physical assessments by nurses and their perceptions of barriers to their practice.
A multicentre, cross-sectional, observational study.
Data were collected from September to November 2020 among nurses working with inpatients in eight rehabilitation care institutions in French-speaking Switzerland. Instruments included the Barriers to Nurses' use of Physical Assessment Scale.
Almost half of the 112 nurses who responded reported performing physical assessments regularly. The predominant perceived barriers to performing physical assessments were 'specialty area', 'lack of nursing role models' and 'lack of time and interruptions'. Greater clinical nursing experience in rehabilitation wards and more senior nurse specialist positions were associated with significantly lower use of physical assessment procedures by nurses.
The present study revealed heterogeneity in the use of physical assessment by nurses practicing in rehabilitation units and highlighted their perceived barriers to this.
Most nurses working in rehabilitation care units did not routinely perform physical assessments as part of their daily clinical practice. These results should raise stakeholders' awareness of this fact. Effective interventions to increase the use of physical assessments in nursing practice are to be recommended, including continuing education or hiring enough highly qualified nurses as role models in wards. This will promote quality of care and patient safety in rehabilitation care units.
There was no patient or public involvement in the present study
Exceptional twentieth-century slowdown in Atlantic Ocean overturning circulation
Possible changes in Atlantic meridional overturning circulation (AMOC) provide a key source of uncertainty regarding future climate change. Maps of temperature trends over the twentieth century show a conspicuous region of cooling in the northern Atlantic. Here we present multiple lines of evidence suggesting that this cooling may be due to a reduction in the AMOC over the twentieth century and particularly after 1970. Since 1990 the AMOC seems to have partly recovered. This time evolution is consistently suggested by an AMOC index based on sea surface temperatures, by the hemispheric temperature difference, by coral-based proxies and by oceanic measurements. We discuss a possible contribution of the melting of the Greenland Ice Sheet to the slowdown. Using a multi-proxy temperature reconstruction for the AMOC index suggests that the AMOC weakness after 1975 is an unprecedented event in the past millennium (p > 0.99). Further melting of Greenland in the coming decades could contribute to further weakening of the AMOC
North Atlantic Climate Variability: Phenomena, Impacts and Mechanisms
Variability of the North Atlantic Oscillation and the Tropical Atlantic dominate the climate of the North Atlantic sector, the underlying ocean and surrounding continents on interannual to decadal time scales. Here we review these phenomena, their climatic impacts and our present state of understanding of their underlying caus
The hypoxic cancer secretome induces pre-metastatic bone lesions through lysyl oxidase
Tumour metastasis is a complex process involving reciprocal interplay
between cancer cells and host stroma at both primary and secondary
sites, and is strongly influenced by microenvironmental
factors such as hypoxia. Tumour-secreted proteins play a crucial role
in these interactions and present strategic therapeutic potential.
Metastasis of breast cancer to the bone affects approximately 85%
of patients with advanced disease and renders them largely untreatable. Specifically, osteolytic bone lesions, where bone is destroyed,
lead to debilitating skeletal complications and increased patient morbidity
and mortality. The molecular interactions governing the
early events of osteolytic lesion formation are currently unclear.
Here we show hypoxia to be specifically associated with bone relapse
in patients with oestrogen-receptor negative breast cancer. Global
quantitative analysis of the hypoxic secretome identified lysyl oxidase
(LOX) as significantly associated with bone-tropism and relapse.
High expression of LOX in primary breast tumours or systemic delivery
of LOX leads to osteolytic lesion formation whereas silencing or
inhibition of LOX activity abrogates tumour-driven osteolytic lesion
formation. We identify LOX as a novel regulator of NFATc1-driven
osteoclastogenesis,independent of RANK ligand, which disrupts normal
bone homeostasisleading to the formation of focal pre-metastatic
lesions. We show that these lesions subsequently provide a platform
for circulating tumour cells to colonize and form bone metastases.
Our study identifies a novel mechanism of regulation of bone homeostasis
and metastasis, opening up opportunities for novel therapeutic
intervention with important clinical implications
The tropical Atlantic observing system
The tropical Atlantic is home to multiple coupled climate variations covering a wide
range of timescales and impacting societally relevant phenomena such as continental
rainfall, Atlantic hurricane activity, oceanic biological productivity, and atmospheric
circulation in the equatorial Pacific. The tropical Atlantic also connects the southern and northern branches of the Atlantic meridional overturning circulation and receives
freshwater input from some of the world’s largest rivers. To address these diverse,
unique, and interconnected research challenges, a rich network of ocean observations
has developed, building on the backbone of the Prediction and Research Moored Array
in the Tropical Atlantic (PIRATA). This network has evolved naturally over time and out of
necessity in order to address the most important outstanding scientific questions and
to improve predictions of tropical Atlantic severe weather and global climate variability
and change. The tropical Atlantic observing system is motivated by goals to understand
and better predict phenomena such as tropical Atlantic interannual to decadal variability
and climate change; multidecadal variability and its links to the meridional overturning
circulation; air-sea fluxes of CO2 and their implications for the fate of anthropogenic CO2;
the Amazon River plume and its interactions with biogeochemistry, vertical mixing, and
hurricanes; the highly productive eastern boundary and equatorial upwelling systems;
and oceanic oxygen minimum zones, their impacts on biogeochemical cycles and
marine ecosystems, and their feedbacks to climate. Past success of the tropical
Atlantic observing system is the result of an international commitment to sustained
observations and scientific cooperation, a willingness to evolve with changing research
and monitoring needs, and a desire to share data openly with the scientific community
and operational centers. The observing system must continue to evolve in order to
meet an expanding set of research priorities and operational challenges. This paper
discusses the tropical Atlantic observing system, including emerging scientific questions
that demand sustained ocean observations, the potential for further integration of the
observing system, and the requirements for sustaining and enhancing the tropical
Atlantic observing system
Reconstructing extreme AMOC events through nudging of the ocean surface: a perfect model approach
While the Atlantic Meridional Overturning Circulation (AMOC) is thought to be a crucial component of the North Atlantic climate, past changes in its strength are challenging to quantify, and only limited information is available. In this study, we use a perfect model approach with the IPSL-CM5A-LR model to assess the performance of several surface nudging techniques in reconstructing the variability of the AMOC. Special attention is given to the reproducibility of an extreme positive AMOC peak from a preindustrial control simulation. Nudging includes standard relaxation techniques towards the sea surface temperature and salinity anomalies of this target control simulation, and/or the prescription of the wind-stress fields.
Surface nudging approaches using standard fixed restoring terms succeed in reproducing most of the target AMOC variability, including the timing of the extreme event, but systematically underestimate its amplitude. A detailed analysis of the AMOC variability mechanisms reveals that the underestimation of the extreme AMOC maximum comes from a deficit in the formation of the dense water masses in the main convection region, located south of Iceland in the model. This issue is largely corrected after introducing a novel surface nudging approach, which uses a varying restoring coefficient that is proportional to the simulated mixed layer depth, which, in essence, keeps the restoring time scale constant. This new technique substantially improves water mass transformation in the regions of convection, and in particular, the formation of the densest waters, which are key for the representation of the AMOC extreme. It is therefore a promising strategy that may help to better constrain the AMOC variability and other ocean features in the models. As this restoring technique only uses surface data, for which better and longer observations are available, it opens up opportunities for improved reconstructions of the AMOC over the last few decades
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