HAPEX-Sahel : a large-scale study of land-atmosphere interactions in the semi-arid tropics

The Hydrologic Atmospheric Pilot EXperiment in the Sahel (HAPEX-Sahel) was carried out in Niger, West Africa, during 1991 - 1992, with an intensive observation period (IOP) in August - October 1992. It aims at improving the parameterization of land surface atmosphere interactions at the Global Circulation Model (GCM) gridbox scale. The experiment combines remote sensing and ground based measurements with hydrological and meteorological modelling to develop aggregation techniques for use in large scale estimates of the hydrological and meteorological behaviour of large areas in the Sahel. The experimental strategy consisted of a period of intensive measurements during the transition period of the rainy to the dry season, backed up by a series of long term measurements in a 1° by 1° square in Niger. Three "supersites" were instrumented with a variety of hydrological and (micro) meteorological equipment to provide detailed information on the surface energy exchange at the local scale. Boundary layer measurements and aircraft measurements were used to provide information at scales of 100 - 500 km2. All relevant remote sensing images were obtained for this period. This programme of measurements is now being analyzed and an extensive modelling programme is under way to aggregate the information at all scales up to the GCM grid box scale. The experimental strategy and some preliminary results of the IOP are described

Iatrogenic post-intubation tracheal rupture treated conservatively without intubation: a case report

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Predictors of 1-year compliance with adaptive servoventilation in patients with heart failure and sleep disordered breathing: preliminary data from the ADVENT-HF trial

Despite its effectiveness in suppressing sleep disordered breathing (SDB), positive airway pressure therapy (PAP) is not always well tolerated by patients and long-term adherence can be problematic. Recently, two multicentre, randomised clinical trials (RCTs) tested the effects of PAP for patients with cardiovascular disease and co-existing SDB on morbidity and mortality with negative outcomes [1, 2]. Relatively poor adherence to PAP therapy (mean 3.7 and 3.3 h·day-1, respectively) in these two trials might have contributed to their poor results. Indeed, higher PAP use per day is associated with better clinical outcomes than lower use [3]

Thermal weakening localizes intraplate deformation along the southern Australian continental margin

The controls on seismicity and fault reactivation in stable intraplate crust located far from active plate boundaries are poorly understood. The southern Australian continental margin has been undergoing mild levels of deformation over the past ~10 Myr, manifested today by high levels of seismicity for a stable intraplate region. However, this deformation is partitioned, with zones of abundant neotectonic faults with evidence for Pliocene–Quaternary displacement, enhanced relief (up to 1–2 km) and high seismicity (numerous M > 5 earthquakes) such as the Flinders Ranges adjoining areas of little neotectonic activity, subdued topography and low levels of seismicity such as the Murray Basin and Nullarbor Plain. Here we present a new compilation of 192 heat flow data for the southern Australian margin. Variations in heat flow correlate well with variations in neotectonic and seismic activity, with regions of deformation corresponding to elevated heat flows of up to ~90 mW m− 2. We propose that the southern Australian margin provides the best evidence to-date that active intraplate deformation may be localized and controlled by the thermal properties of the crust and upper mantle.Simon P. Holford, Richard R. Hillis, Martin Hand, Mike Sandifor

Gastrointestinal decontamination in the acutely poisoned patient

ObjectiveTo define the role of gastrointestinal (GI) decontamination of the poisoned patient.Data sourcesA computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.Study selection and data extractionClinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient.Data synthesisThe literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis, animal studies or small case series, and rarely based on randomized clinical trials.ConclusionsThe current literature supports limited use of GI decontamination of the poisoned patient