Multispectral analysis of Northern Hemisphere temperature records over the last five millennia

Aiming to describe spatio-temporal climate variability on decadal-to-centennial time scales and longer, we analyzed a data set of 26 proxy records extending back 1,000–5,000 years; all records chosen were calibrated to yield temperatures. The seven irregularly sampled series in the data set were interpolated to a regular grid by optimized methods and then two advanced spectral methods—namely singular-spectrum analysis (SSA) and the continuous wavelet transform—were applied to individual series to separate significant oscillations from the high noise background. This univariate analysis identified several common periods across many of the 26 proxy records: a millennial trend, as well as oscillations of about 100 and 200 years, and a broad peak in the 40–70-year band. To study common NH oscillations, we then applied Multichannel SSA. Temperature variations on time scales longer than 600 years appear in our analysis as a dominant trend component, which shows climate features consistent with the Medieval Warm Period and the Little Ice Age. Statistically significant NH-wide peaks appear at 330, 250 and 110 years, as well as in a broad 50–80-year band. Strong variability centers in several bands are located around the North Atlantic basin and are in phase opposition between Greenland and Western Europe

Late Rupture of a Saphenous Vein Aortorenal Graft

AbstractJ Vasc Surg 1999;29:722-3

Prog Urol

Introduction L’objectif était de réaliser des recommandations sur le cathétérisme intermittent dans toutes ses composantes. Matériel et méthodes Une revue systématique de la littérature à partir de Pubmed, Embase, Google scholar a été menée en décembre 2014 avec mise à jour en avril 2019. Devant l’absence de données suffisamment robustes et compte tenu des controverses concernant cette thématique, la méthode de recommandations par consensus formalisé d’experts a été appliquée. Des comités de pilotage, cotation et de lecture ont été constitués. Résultats Au final, 78 recommandations ont pu être élaborées. Elles portent sur les indications, les modalités d’apprentissage et de réalisation, le choix du matériel, la gestion de la colonisation et de l’infection urinaire, sa réalisation dans les populations pédiatriques, gériatriques, chez les hommes ayant une hyperplasie bénigne de la prostate et chez les patients ayant une dérivation urinaire cutanée continente et la gestion des complications. Elles portent à la fois sur l’autosondage et l’hétérosondage aussi bien en structure de soins qu’en ville. Conclusion Il s’agit des premières recommandations portant spécifiquement sur le cathétérisme intermittent et incluant toutes ses composantes. Elles vont permettre d’aider les utilisateurs dans leur décision clinique relative aux indications et aux modalités du cathétérisme intermittent. Ces recommandations s’adressent aux cliniciens urologues, gynécologues, gériatres, pédiatres, neurologues, médecins de médecine physique et de réadaptation, médecins généralistes ainsi qu’autres professionnels de santé notamment les infirmières, les aidants…Introduction Our objective was to provide guidelines covering all aspects of intermittent catheterisation (intermittent self-catheterisation and third-party intermittent catheterisation). Materials and methods A systematic review of the literature based on Pubmed, Embase, Google scholar was initiated in December 2014 and updated in April 2019. Given the lack of robust data and the numerous unresolved controversial issues, guidelines were established based on the formal consensus of experts from steering, scoring and review panels. Results This allowed the formulation of 78 guidelines, extending from guidelines on indications for intermittent catheterisation, modalities for training and implementation, choice of equipment, management of bacteriuria and urinary tract infections, to the implementation of intermittent catheterisation in paediatric, geriatric populations, benign prostatic hyperplasia patients and continent urinary diversion patients with a cutaneous reservoir as well as other complications. These guidelines are pertinent to both intermittent self-catheterisation and third-party intermittent catheterisation. Conclusion These are the first comprehensive guidelines specifically aimed at intermittent catheterisation and extend to all aspects of intermittent catheterisation. They assist in the clinical decision-making process, specifically in relation to indications and modalities of intermittent catheterisation options. These guidelines are intended for urologists, gynaecologists, geriatricians, paediatricians, neurologists, physical and rehabilitation physicians, general practitioners and other health professionals including nurses, carers