What is the best workup for hypocalcemia?

Unexplained hypocalcemia can usually be diagnosed by a limited number of serum tests when the cause isn't obvious from the history (recent neck surgery or renal failure): calcium corrected for serum albumin); creatinine; phosphorus; magnesium; parathyroid hormone (PTH). The most common causes, categorized according to the results of these tests, are (strength of recommendation: C, expert opinion, case series, and physiologic principles): high PTH, high phosphorus, and high creatinine: renal failure; high PTH, low or normal phosphorus, and normal creatinine: vitamin D deficiency or pancreatitis; low PTH, high phosphorus, and normal creatinine: inadequate parathyroid gland function or hypomagnesemia

Are antibiotics effective in preventing pneumonia for nursing home patients?

Antibiotics should not be used for prophylaxis of pneumonia in nursing homes. We found no studies testing the effectiveness of antibiotics in preventing pneumonia in any population, including persons with predisposing conditions such as influenza. Three measures effectively prevent pneumonia in nursing home patients: influenza vaccination of residents (strength of recommendation [SOR]: B, based on systematic review of homogenous cohort observational studies); influenza vaccination of caregivers (SOR: B, based on individual randomized controlled trial); pneumococcal vaccination of residents (SOR: B, based on randomized, nonblinded clinical trials and consistent case-control studies). Two other suggested interventions have not been extensively tested: antiviral chemoprophylaxis during an influenza outbreak in the nursing home, and oral hygiene programs for nursing home residents

What are the causes of hypomagnesemia?

The causes of magnesium depletion and hypomagnesemia are decreased gastrointestinal (GI) absorption and increased renal loss. Decreased GI absorption is frequently due to diarrhea, malabsorption, and inadequate dietary intake. Common causes of excessive urinary loss are diuresis due to alcohol, glycosuria, and loop diuretics. Medical conditions putting persons at high risk for hypomagnesemia are alcoholism, congestiveheart failure, diabetes, chronic diarrhea, hypokalemia, hypocalcemia, and malnutrition (strength of recommendation: C, based on expert opinion, physiology, and case series). Evidence suggests that magnesium deficiency is both more common and more clinically significant than generally appreciated

Report on the “Trait-based approaches to ocean life” scoping workshop, October 5-8, 2015

"Trait-based Approaches to Ocean Life” Scoping Workshop, October 5-8, 2015, Waterville Valley, NH, USAFrom the introduction: Marine ecosystems are rich and biodiverse, often populated by thousands of competing and interacting species with a vast range of behaviors, forms, and life histories. This great ecological complexity presents a formidable challenge to understanding how marine ecosystems are structured and controlled, but also how they respond to natural and anthropogenic changes. The trait-based approach to ocean life is emerging as a novel framework for understanding the complexity, structure, and dynamics of marine ecosystems, but also their broader significance. Rather than considering species individually, organisms are characterized by essential traits that capture key aspects of diversity. Trait distributions in the ocean emerge through evolution and natural selection, and are mediated by the environment, biological interactions, anthropogenic drivers, and organism behavior. Because trait variations within and across communities lead to variation in the rates of crucial ecosystem functions such as carbon export, this mechanistic approach sheds light on how variability in the environment, including climate change, impacts marine ecosystems, biogeochemical cycles, and associated feedbacks to climate and society.Funding from the National Science Foundation and National Aeronautics and Space Administration), the Simons Foundation, and the Gordon and Betty Moore Foundation

A modeling study of seasonal variations of sea ice and plankton in the Bering and Chukchi Seas during 2007–2008

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97464/1/jgrc20061.pd

Bio-optical Properties of Cyanobacteria Blooms in Western Lake Erie

There is a growing use of remote sensing observations for detecting and quantifying freshwater cyanobacteria populations, yet the inherent optical properties of these communities in natural settings, fundamental to bio-optical algorithms, are not well known. Toward bridging this knowledge gap, we measured a full complement of optical properties in western Lake Erie during cyanobacteria blooms in the summers of 2013 and 2014. Our measurements focus attention on the optical uniqueness of cyanobacteria blooms, which have consequences for remote sensing and bio-optical modeling. We found the cyanobacteria blooms in the western basin during our field work were dominated by Microcystis, while the waters in the adjacent central basin were dominated by Planktothrix. Chlorophyll concentrations ranged from 1 to over 135 μg/L across the study area with the highest concentrations associated with Microcystis in the western basin. We observed large, amorphous colonial Microcystis structures in the bloom area characterized by high phytoplankton absorption and high scattering coefficients with a mean particle backscatter ratio at 443 nm \u3e 0.03, which is higher than other plankton types and more comparable to suspended inorganic sediments. While our samples contained mixtures of both, our analysis suggests high contributions to the measured scatter and backscatter coefficients from cyanobacteria. Our measurements provide new insights into the optical properties of cyanobacteria blooms, and indicate that current semi-analytic models are likely to have problems resolving a closed solution in these types of waters as many of our observations are beyond the range of existing model components. We believe that different algorithm or model approaches are needed for these conditions, specifically for phytoplankton absorption and particle backscatter components. From a remote sensing perspective, this presents a challenge not only in terms of a need for new algorithms, but also for determining when to apply the best algorithm for a given situation. These results are new in the sense that they represent a complete description of the optical properties of freshwater cyanobacteria blooms, and are likely to be representative of bloom conditions for other systems containing Microcystis cells and colonies

Explaining ethnic inequality in the German labor market: Labor market institutions, context of reception, and boundaries

The descendants of immigrants comprise nearly a third of the West German population under the age of 25 years and will soon become a substantial proportion of the native born labor force. Owing to the young age of this group, and a lack of governmental data on parental place of birth, there is currently little research that compares the labor market outcomes of the second generation of different origins. Exploiting the first data set to allow the disaggregation of all immigrant groups in Germany, this article draws on the concepts of context of reception and boundary crossing to explain variation in the labor market performance of different immigrant origin groups. Positively received ethnic Germans consistently perform better than negatively received guest worker origin groups. Labor market inequality is greatest among men and in obtaining employment. Ethnic differences are more compressed among women and for occupational attainment among the employed. The boundary crossing mechanisms of naturalization and intermarriage have modest association with labor market success. Findings suggest that successful integration in Germany is influenced by labor market institutions, which encourage inequality in unemployment while diminishing inequality amongst the employed. © 2012 The Author

Satellite sensor requirements for monitoring essential biodiversity variables of coastal ecosystems.

The biodiversity and high productivity of coastal terrestrial and aquatic habitats are the foundation for important benefits to human societies around the world. These globally distributed habitats need frequent and broad systematic assessments, but field surveys only cover a small fraction of these areas. Satellite-based sensors can repeatedly record the visible and near-infrared reflectance spectra that contain the absorption, scattering, and fluorescence signatures of functional phytoplankton groups, colored dissolved matter, and particulate matter near the surface ocean, and of biologically structured habitats (floating and emergent vegetation, benthic habitats like coral, seagrass, and algae). These measures can be incorporated into Essential Biodiversity Variables (EBVs), including the distribution, abundance, and traits of groups of species populations, and used to evaluate habitat fragmentation. However, current and planned satellites are not designed to observe the EBVs that change rapidly with extreme tides, salinity, temperatures, storms, pollution, or physical habitat destruction over scales relevant to human activity. Making these observations requires a new generation of satellite sensors able to sample with these combined characteristics: (1) spatial resolution on the order of 30 to 100-m pixels or smaller; (2) spectral resolution on the order of 5 nm in the visible and 10 nm in the short-wave infrared spectrum (or at least two or more bands at 1,030, 1,240, 1,630, 2,125, and/or 2,260 nm) for atmospheric correction and aquatic and vegetation assessments; (3) radiometric quality with signal to noise ratios (SNR) above 800 (relative to signal levels typical of the open ocean), 14-bit digitization, absolute radiometric calibration <2%, relative calibration of 0.2%, polarization sensitivity <1%, high radiometric stability and linearity, and operations designed to minimize sunglint; and (4) temporal resolution of hours to days. We refer to these combined specifications as H4 imaging. Enabling H4 imaging is vital for the conservation and management of global biodiversity and ecosystem services, including food provisioning and water security. An agile satellite in a 3-d repeat low-Earth orbit could sample 30-km swath images of several hundred coastal habitats daily. Nine H4 satellites would provide weekly coverage of global coastal zones. Such satellite constellations are now feasible and are used in various applications