Die Giessener Zenonpapyri (P. Iand.) : Zwischenbericht über ihre Bearbeitung

Airway management is an essential component of the emergency medicine skill set. Management of the difficult airway may include airway adjuncts, including variants of laryngoscopic blades, supraglottic devices, stylets, and video laryngoscopy. These various airway adjuncts have certain advantages and disadvantages, and factors to be considered include ease of use, cost, maintenance, storage, and portability. Selection of a subset of the numerous products available can aid the clinician in the development of expertise with airway adjunct devices that can be reliably used in urgent situations

End-of-life issues in the acute and critically ill patient

The challenges of end-of-life care require emergency physicians to utilize a multifaceted and dynamic skill set. Such skills include medical therapies to relieve pain and other symptoms near the end-of-life. Physicians must also demonstrate aptitude in comfort care, communication, cultural competency, and ethical principles. It is imperative that emergency physicians demonstrate a fundamental understanding of end-of-life issues in order to employ the versatile, multidisciplinary approach required to provide the highest quality end-of-life care for patients and their families

Quantum non-Gaussianity witnesses in the phase space

We address detection of quantum non-Gaussian states, i.e. nonclassical states that cannot be expressed as a convex mixture of Gaussian states, and present a method to derive a new family of criteria based on generic linear functionals. We then specialise this method to derive witnesses based on $s$-parametrized quasiprobability functions, generalising previous criteria based on the Wigner function. In particular we discuss in detail and analyse the properties of Husimi Q-function based witnesses and prove that they are often more effective than previous criteria in detecting quantum non-Gaussianity of various kinds of non-Gaussian states evolving in a lossy channel.Comment: 9 pages, 6 figure

Mandatory and Permissive Reporting Laws: Obligations, Challenges, Moral Dilemmas, and Opportunities

The duty to report certain conditions to public health or law enforcement authorities is one that falls on all physicians and other health care workers as part of their duty to protect the public from harm. In an open society, others, such as teachers, clergy, police officers, or simply neighbors, share the responsibility of protecting individuals at risk, often by reporting them to authorities. The emergency physician and others in the emergency department are uniquely positioned to identify people at risk or who pose a risk, and to report them as required or allowed under the law. In some circumstances, these duties may conflict with ethical duties such as respect for patient autonomy or to protect confidentiality. This article will examine mandatory and permissive reporting laws in various states from an ethical perspective. It will also explore emerging issues such as the reporting of suspected human trafficking. Competing Interests: The authors have no conflicts of interest to report

Steps towards collective sustainability in biomedical research

The optimism surrounding multistakeholder research initiatives does not match the clear view of policies that are needed to exploit the potential of these collaborations. Here we propose some action items that stem from the integration between research advancements with the perspectives of patient-advocacy organizations, academia, and industry

A nonlocal diffusion problem on manifolds

In this paper we study a nonlocal diffusion problem on a manifold. These kinds of equations can model diffusions when there are long range effects and have been widely studied in Euclidean space. We first prove existence and uniqueness of solutions and a comparison principle. Then, for a convenient rescaling we prove that the operator under consideration converges to a multiple of the usual Heat-Beltrami operator on the manifold. Next, we look at the long time behavior on compact manifolds by studying the spectral properties of the operator. Finally, for the model case of hyperbolic space we study the long time asymptotics and find a different and interesting behavior.Fil: Bandle, Catherine. University Of Basel; SuizaFil: González, María del Mar. Universidad Autonoma de Madrid; EspañaFil: Fontelos, Marco A.. Instituto de Ciencias Matemáticas; EspañaFil: Wolanski, Noemi Irene. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Matemática; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Investigaciones Matemáticas "Luis A. Santaló". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Matemáticas "Luis A. Santaló"; Argentin

Predictors of New-Onset Atrial Fibrillation in Geriatric Trauma Patients

Geriatric patients (age \u3e65) comprise a growing segment of the trauma population. New-onset atrial fibrillation may occur after injury, complicating clinical management and resulting in significant morbidity and mortality. This study was undertaken to identify clinical and demographic factors associated with new-onset atrial fibrillation among geriatric trauma patients . Methods: In this case control study, eligible participants included admitted trauma patients age 65 and older who developed new-onset atrial fibrillation during the hospitalization. Controls were admitted trauma patients who were matched for age and injury severity score, who did not develop atrial fibrillation. We evaluated the associations between new-onset atrial fibrillation and clinical characteristics, including patient demographics, health behaviors, chronic medical conditions, and course of care. Results: Data were available for 63 cases and 25 controls. Patients who developed atrial fibrillation were more likely to be male, compared to controls (49% versus 24%; odds ratio 3.0[1.0, 8.9]). Other demographic and clinical factors were not associated with new-onset atrial fibrillation, including mechanism of injury, co-morbid medical conditions, drug or alcohol use, surgical procedures, and intravenous fluid administration. Conclusions: Male geriatric trauma patients were at higher risk for developing new-onset atrial fibrillation. Other demographic and clinical factors were not associated with new-onset atrial fibrillation. Competing Interests: The authors report no conflicts of interest

Early life stress induces long-term changes in limbic areas of a teleost fish: the role of catecholamine systems in stress coping

Early life stress (ELS) shapes the way individuals cope with future situations. Animals use cognitive flexibility to cope with their ever-changing environment and this is mainly processed in forebrain areas. We investigated the performance of juvenile gilthead seabream, previously subjected to an ELS regime. ELS fish showed overall higher brain catecholaminergic (CA) signalling and lower brain derived neurotrophic factor (bdnf) and higher cfos expression in region-specific areas. All fish showed a normal cortisol and serotonergic response to acute stress. Brain dopaminergic activity and the expression of the α2Α adrenergic receptor were overall higher in the fish homologue to the lateral septum (Vv), suggesting that the Vv is important in CA system regulation. Interestingly, ELS prevented post-acute stress downregulation of the α2Α receptor in the amygdala homologue (Dm3). There was a lack of post-stress response in the β2 adrenergic receptor expression and a downregulation in bdnf in the Dm3 of ELS fish, which together indicate an allostatic overload in their stress coping ability. ELS fish showed higher neuronal activity (cfos) post-acute stress in the hippocampus homologue (Dlv) and the Dm3. Our results show clear long-term effects on limbic systems of seabream that may compromise their future coping ability to environmental challenges.publishedVersio

The Perils of Recreational Marijuana Use: Relationships With Mental Health Among Emergency Department Patients

Abstract Introduction Marijuana is a commonly used drug in the United States. Many states have legalized the recreational use of marijuana. The effects of marijuana on mental health are unknown. Methods In this prospective survey study, eligible participants included ED patients age 18 and older, who had ever used recreational marijuana. A survey instrument was developed, piloted, and revised. Data collected included reasons for marijuana use, marijuana\u27s perceived effectiveness, and history of mental health conditions, including depression, anxiety, and suicidal thoughts. Results Among 303 participants (86% response rate), the median age of first marijuana use was 16 ([IQR 14, 19], range 6–65). The most commonly cited reasons for marijuana use included recreational use (70%; n = 211), to treat anxiety (30%; n = 89), to treat pain (25%; n = 74), and to treat depression (17%; n = 51). Mental health issues were common in the study population. A majority of patients reported anxiety in the last 30 days (59%; n = 176), and a significant minority of patients reported serious depression in the last 30 days (46%; n = 137). Some patients reported suicidal thoughts in the last 30 days (9%; n = 29). Participants who used marijuana more frequently reported more days of anxiety (median 15.5, compared to 1; P = 0.001). Among participants with mental health conditions, most began using marijuana before the onset of the mental health conditions (77%, n = 167). Earlier age of starting to use marijuana was correlated with higher number of years of anxiety or tension in lifetime (r = −0.11, P = 0.05, n = 301). Perceived effects of marijuana use on mental health were variable. Most participants stated that marijuana improved their mental health (62%; n = 163), and some reported that marijuana did not improve their mental health (37%; n = 98). Conclusions Many ED patients have used marijuana, either currently or in the past. Mental health conditions are also common, including anxiety, depression, and suicidal thoughts. Most participants reported marijuana use starting at an age under 18. Marijuana use preceded the onset of mental health conditions in the majority of participants

GEMS Survey Data and Catalog

We describe the data reduction and object cataloging for the GEMS survey, a large-area (800 arcmin(2)) two-band (F606W and F850LP) imaging survey with the Advanced Camera for Surveys on the Hubble Space Telescope, centered on the Chandra Deep Field-South.STScI HST-GO-9500.01NASA GO-9500, NAS5-26555, NAG5-13063, NAG5-13102European Community’s Human Potential Programunder contractHPRN-CT-2002-00316, HPRN-CT-2002-00305McDonald Observator