Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome

Background: Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS) and in normal subjects. Methods: Responses to the Cold Intolerance Symptom Severity (CISS) questionnaire, Potential Work Exposure Scale (PWES), Disability of the Arm, Shoulder and Hand (DASH) and Short-Form 36 questionnaire (SF-36) were investigated in normal subjects (n = 94), hand injured patients (amputation and nerve injuries, n = 88) and patients with HAVS (n = 30). The results are presented as median (range), percent and mean deviation from norms. The Kruskal Wallis Test or Mann-Whitney U-Test were used to identify significant differences between multiple groups or subgroups. The Spearman rank correlation was used to study the relationship between cold sensitivity and disability. Results: Abnormal cold sensitivity (CISS score > 50) was seen in 75% and 45% of patients with HAVS and a traumatic hand injury, respectively. Patients were significantly more exposed to cold in their work environment than the normal population, with a consequently negative effect on work ability due to cold sensitivity. Patients with abnormal cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity [higher DASH scores and e. g. significantly larger mean deviation from norms in the subscales Role Physical and Bodily Pain (SF-36)]. Conclusion: Severe and abnormal cold sensitivity may have a profound impact on work capacity, leisure, disability and health-related quality of life. It is frequently seen in patients with traumatic hand injuries and particularly apparent in patients with HAVS

Using soil function evaluation in multi-criteria decision analysis for sustainability appraisal of remediation alternatives

Soil contamination is one of the major threats constraining proper functioning of the soil and thus provision of ecosystem services. Remedial actions typically only address the chemical soil quality by reducing total contaminant concentrations to acceptable levels guided by land use. However, emerging regulatory requirements on soil protection demand a holistic view on soil assessment in remediation projects thus accounting for a variety of soil functions. Such a view would require not only that the contamination concentrations are assessed and attended to, but also that other aspects are taking into account, thus addressing also physical and biological as well as other chemical soil quality indicators (SQIs). This study outlines how soil function assessment can be a part of a holistic sustainability appraisal of remediation alternatives using multi-criteria decision analysis (MCDA). The paper presents a method for practitioners for evaluating the effects of remediation alternatives on selected ecological soil functions using a suggested minimum data set (MDS) containing physical, biological and chemical SQIs. The measured SQls are transformed into sub-scores by the use of scoring curves, which allows interpretation and the integration of soil quality data into the MCDA framework. The method is demonstrated at a study site (Marieberg, Sweden) and the results give an example of how soil analyses using the suggested MDS can be used for soil function assessment and subsequent input to the MCDA framework

Biomarkers of neuronal damage in saturation diving-a controlled observational study

PURPOSE: A prospective and controlled observational study was performed to determine if the central nervous system injury markers glial fibrillary acidic protein (GFAp), neurofilament light (NfL) and tau concentrations changed in response to a saturation dive. METHODS: The intervention group consisted of 14 submariners compressed to 401 kPa in a dry hyperbaric chamber. They remained pressurized for 36 h and were then decompressed over 70 h. A control group of 12 individuals was used. Blood samples were obtained from both groups before, during and after hyperbaric exposure, and from the intervention group after a further 25-26 h. RESULTS: There were no statistically significant changes in the concentrations of GFAp, NfL and tau in the intervention group. During hyperbaric exposure, GFAp decreased in the control group (mean/median - 15.1/ - 8.9 pg·mL-1, p < 0.01) and there was a significant difference in absolute change of GFAp and NfL between the groups (17.7 pg·mL-1, p = 0.02 and 2.34 pg·mL-1, p = 0.02, respectively). Albumin decreased in the control group (mean/median - 2.74 g/L/ - 0.95 g/L, p = 0.02), but there was no statistically significant difference in albumin levels between the groups. In the intervention group, haematocrit and mean haemoglobin values were slightly increased after hyperbaric exposure (mean/median 2.3%/1.5%, p = 0.02 and 4.9 g/L, p = 0.06, respectively). CONCLUSION: Hyperbaric exposure to 401 kPa for 36 h was not associated with significant increases in GFAp, NfL or tau concentrations. Albumin levels, changes in hydration or diurnal variation were unlikely to have confounded the results. Saturation exposure to 401 kPa seems to be a procedure not harmful to the central nervous system. TRIAL REGISTRATION: ClinicalTrials.gov NCT03192930

Proving Type Class Laws for Haskell

Type classes in Haskell are used to implement ad-hoc polymorphism, i.e. a way to ensure both to the programmer and the compiler that a set of functions are defined for a specific data type. All instances of such type classes are expected to behave in a certain way and satisfy laws associated with the respective class. These are however typically just stated in comments and as such, there is no real way to enforce that they hold. In this paper we describe a system which allows the user to write down type class laws which are then automatically instantiated and sent to an inductive theorem prover when declaring a new instance of a type class.Comment: Presented at the Symposium for Trends in Functional Programming, 201