Magnesium recurarisation differences between no reversal, neostigmine/glycopyrrolate reversal and sugammadex reversal of neuromuscular block in an in vivo rat model

The neuromuscular junction (NMJ) is a synapse with one of the highest safety margins in the human body. The use of neuromuscular blocking agents to inhibit neuromuscular transmission is sufficient to produce skeletal muscle paralysis, a mechanism used to facilitate muscle relaxation during surgery. Residual neuromuscular block postoperatively has been found to be a major risk factor for postoperative complications. Sudden reinstatement of neuromuscular block (recurarisation), through use of magnesium, has also been observed clinically. This has led to a reluctance to use magnesium postoperatively for fear of recurarisation. Recurarisation following reversal of neuromuscular blockade with neostigmine or sugammadex has not been evaluated in a formal study, and for this reason, this study investigated recurarisation after 30 mg/kg magnesium sulphate (MgSO4) following reversal of neuromuscular blockade with neostigmine, two dosages of sugammadex or when reversal was omitted. Prior to investigating recurarisation, the effects of magnesium on neuromuscular transmission in the absence of neuromuscular blocking agents was investigated, in order to determine a standard clinical dose that did not produce detectable, by Train-of-Four Ratio (TOF-R) or Twitch 1 height (%T1), neuromuscular impairment

MARS Bulletin Vol.21 No. 12

MARS Bulletin Vol.21 No. 12JRC.H.4-Monitoring Agricultural Resource

Modelación de la caña de azúcar en Latinoamérica: Estado del arte y base de datos para parametrización

El objetivo de este informe es de describir el estado del arte de la modelación de la caña de azúcar en América Latina y el Caribe (LAC) y de proporcionar una base de dados que puede servir para la calibración y evaluación de modelos de crecimiento de la caña. La caña de azúcar es una de las especies C4 de gran importancia económica y alimentaria, proporcionando cerca del 75% del azúcar mundial. América Latina y el Caribe constituyen la principal región productora de caña de azúcar del mundo, con más del 30% de la producción de azúcar y el 45% de las exportaciones. La productividad de la caña de azúcar muestra una grande variabilidad entre los países Latinoamericanos, reflejando la diversidad de las condiciones ambientales de cultivos y una gran variabilidad de sistemas de producción. Hay varios modelos de crecimiento de la caña de azúcar, pero sólo dos (APSIM-Sugar y DSSAT / CANEGRO) están efectivamente disponibles para usuarios generales; y estos son los más utilizados en el mundo y en América del Sur. Los estudios sobre modelaje de caña de azúcar en América Latina se iniciaron en la década de 1970. Después de los años 2000, se observó un nuevo impulso, manteniéndose activa hasta la actualidad, con una relativa concentración de trabajos desarrollados en Brasil donde el cultivo tiene mayor importancia socio-económica; pero aún se encuentra en un nivel bastante atrasado en relación a lo que se ha hecho en Australia y Sudáfrica. En comparación con el nivel alcanzado por otros cultivos (por ejemplo, trigo y maíz) se observa que el estado de desarrollo de los modelos, en términos mundiales, es aún más atrasado, existiendo oportunidades para la evolución de los modelos. Para este informe fueran identificados 15 trabajos recientes con potencial de uso de datos para futuros trabajos de desarrollo y calibración de modelos y se obtuvieron datos completos de 4 experimentos con 2 variedades. La distribución geográfica de estos trabajos está concentrada principalmente en Brasil, pero se tiene en Colombia un polo de modelaje que también puede ganar fuerza en los próximos años. La base propuesta, aunque restringida geográficamente, representa la principal zona productora de caña de azúcar de América Latina (y del mundo) con una variación considerable de clima y suelo. La base genética de las variedades presentadas también sugiere que el desarrollo y ajuste de modelos basados en esos datos constituyen un importante primer paso para estudiar los impactos del cambio climático y las opciones de adaptación en la principal zona productora de caña mundial. Iniciativas como EUROCLIMA pueden actuar como polos irradiadores de conocimiento y facilitar la conexión entre los investigadores e instituciones interesados en el tema de la modelación biofísica, acelerando el desarrollo y uso de esas herramientas en América Latina y el Caribe. The objective of this report is to describe the state of the art of sugarcane modelling in Latin America and the Caribbean (LAC), and to provide a database of experimental data that can serve as a basis for the calibration and evaluation of sugarcane growth models. Sugarcane is one of the C4 species of great importance from an economic and food perspective, which provides about 70% of global sugar supplies. Latin America and the Caribbean comprise the world’s most important sugarcane producing and exporting region. Sugarcane yields vary greatly among Latin-American countries, reflecting a great diversity of environmental conditions and a great variety of production systems. Several models of sugarcane growth exist, but only two of these (APSIM-Sugar and DSSAT / CANEGRO are effectively available for general use; and these are the most commonly used in the world and in LAC. The first sugarcane modelling studies in Latin America date from the 1970’s. After the year 2000 a new impulse was observed, which is maintained until today, with a relative concentration of work developed in Brazil where sugarcane is economically most important compared to the other LAC countries. Nevertheless, sugarcane modelling (development and application) in LAC remains well behind Australia and South Africa. In comparison with the level obtained for other crops (e.g. maize, wheat), it is observed that sugarcane modelling is even more behind; which suggests a wide window of opportunities for further development in this area. For this report, 15 recent publications were identified, with potential of data sharing for future model development and calibration; and complete datasets for crop model calibration were obtained from four experiments with two varieties. Geographically, these studies show a concentration in Brazil, but Colombia also has a modelling pool, which may gain strength in the coming years. The datasets collected, even though geographically restricted, represents the main sugarcane producing region of Latin America (and the world), with considerable diversity in climate and soils. The genetic base of the varieties presented also suggests that the development and calibration of models using these data is an important first step to study climate impacts and adaptation options in the world’s main sugarcane producing region. Initiatives such as EUROCLIMA can act as knowledge hubs and facilitate the connection among researchers and institutes that are interested in biophysical modelling, thus accelerating the development and use of modelling tools in Latin America and the Caribbean. Key words: Saccharum, sugar cane, Latin America, simulation models, climate change, database, calibration, evaluation.JRC.D.5-Food Securit

Patient versus general population health state valuations:a case study of non-specific low back pain

PURPOSE: The purpose of this study was twofold: (1) to compare non-specific low back pain (LBP) patients' health state valuations with those of the general population, and (2) to explore how aspects of health-related quality of life as measured by the EQ-5D-3L impact non-specific LBP patient valuations. METHODS: Data were used of a randomized controlled trial, including 483 non-specific LBP patients. Outcomes included the EQ-VAS and the EQ-5D-3L. Patient valuations were derived from the EQ-VAS. Population valuations were derived from the EQ-5D-3L using a Dutch VAS-based tariff. The difference between patient and population valuations was assessed using t tests. An OLS linear regression model was constructed to explore how various aspects of health-related quality of life as measured by the ED-5D-3L impact non-specific LBP patient valuations. RESULTS: Non-specific LBP patients valued their health states 0.098 (95% CI 0.082-0.115) points higher than the general population. Only 22.2% of the variance in patient valuations was explained by the patients' EQ-5D-3L health states (R (2) = 0.222). Non-specific LBP patients gave the most weight to the anxiety/depression dimension. CONCLUSIONS: This study demonstrated that non-specific LBP patients value their health states higher than members of the general population and that the choice of valuation method could have important implications for cost-effectiveness analyses and thus for clinical practice

Modelación del frijol en Latinoamérica: Estado del arte y base de datos para parametrización

Frijol común (Phaseolus vulgaris L.) es la leguminosa de grano para consumo humano de mayor producción en el mundo, y es nativo de las Américas, donde juega un papel importante en la dieta. Los ambientes donde se cultiva el frijol varían desde zonas tropicales hasta alta montaña, con diversos hábitos de crecimiento (arbustivo determinado, arbustivo indeterminado, y voluble), y en sistemas de producción desde los tradicionales hasta los altamente tecnificados. Los esfuerzos en modelaje, por tanto, deben empezar desde identificar el tipo de frijol y el sistema objetivo. El frijol es muy sensible al estrés abiótico, hecho que ha animado el modelaje de su posible respuesta bajo escenarios de cambio climático. Se llevó a cabo una revisión de literatura para identificar quince ejercicios de modelaje ejecutados en América Latina, abarcando estudios de crecimiento (tazas de producción de nudos y área foliar), fenología, y de rendimiento. Los modelos empleados en dichos estudios incluyen EcoCrop, CROPGRO-DRYBEAN (implementado en la plataforma DSSAT), y en un caso cada uno, Maxent y CLIMEX. Se describen cuatro estudios en detalle: en los dos países de mayor producción en el mundo (Brasil y México), y en Centroamérica como región altamente vulnerable al cambio climático. Estos estudios concuerdan que la productividad del frijol podría sufrir serios efectos negativos en el transcurso del Siglo XXI a raíz del cambio climático. Finalmente, se informa sobre un ejercicio reciente de recopilar datos históricos de ensayos de frijol en Latinoamérica para alimentar futuros esfuerzos de modelaje. Common bean (Phaseolus vulgaris L.) is the grain legume of greatest volume of production for direct human consumption, and is native to the Americas where it plays an important role in the diet of consumers. Bean is cultivated in environments from lowland tropical areas to high mountainous zones; with growth habits ranging from determinate bush, to indeterminate bush, to climbing types; and in production systems varying from traditional low input agriculture to highly technified systems. As such, efforts at modelling should focus on a specific plant type and production system. Bean is very sensitive to abiotic stress, a fact that has motivated modelling of its response in light of the dangers of climate change. A review of literature was carried out revealing fifteen studies in Latin America considering different aspects of plant growth (rates of node and leaf area production), phenology, and yield. Models employed include EcoCrop, CROPGRO (a module within the DSSAT cropping system model), and in one instance each, Maxent and CLIMEX. Three studies in particular are detailed: in the two countries of greatest production in the world (Brazil and Mexico), and one study in Central America as a region under direct threat of climate change. These three studies confirm that bean productivity will likely suffer severe negative effects in the course of the 21st century, as a result of climate change. A recent effort has compiled data from historical yield trials in Latin America as a resource for future modelling efforts.JRC.D.5-Food Securit

Процеси сучасної інтернаціоналізації в Азійсько-Тихоокеанському регіоні у вимірах глобальної конкуренції

In 2012, governments worldwide renewed their commitments to a more sustainable development that would eradicate poverty, halt climate change and conserve ecosystems, and initiated a process to create a long-term vision by formulating Sustainable Development Goals (SDGs). Although progress in achieving a more sustainable development has been made in some areas, overall, actions have not been able to bend the trend in critical areas (including those related to the so-called food-water-energy nexus). Here, we analyze how different combinations of technological measures and behavioral changes could contribute to achieving a set of sustainability objectives, taking into account the interlinkages between them. The objectives include eradicating hunger, providing universal access to modern energy, preventing dangerous climate change, conserving biodiversity and controlling air pollution. The analysis identifies different pathways that achieve these objectives simultaneously, but they all require substantial transformations in the energy and food systems, that go far beyond historic progress and currently formulated policies. The analysis also shows synergies and trade-offs between achieving the different objectives, concluding that achieving them requires a comprehensive approach. The scenario analysis does not point at a fundamental trade-off between the objectives related to poverty eradication and those related to environmental sustainability. The different pathways of achieving the set of long-term objectives and their implications for short-term action can contribute to building a comprehensive strategy to meet the SDGs by proposing near-term actions

Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP).</p> <p>Methods</p> <p>We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses.</p> <p>Results</p> <p>541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention.</p> <p>Conclusions</p> <p>STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies.</p> <p>Trial registration number</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN73119486">ISRCTN73119486</a></p

Advances in emergency networking

Crisis situations require fast regain of control. Wireless ad-hoc networks will enable emergency services to act upon the actual status of the situation by retrieving and exchanging detailed up-to-date information. Deployment of highbandwidth, robust, self-organising ad-hoc networks will therefore enable quicker response to typical hat/where/when questions, than the more vulnerable low-bandwidth communication networks currently in use. This paper addresses a number of results of the projects AAF (Adaptive Ad-hoc Freeband communications) and Easy Wireless that enable high bandwidth robust ad-hoc networking

MARS Bulletin Vol.22 No 12 (2014) - Weakly hardened crops in western and central Europe

Crop Monitoring in EuropeJRC.H.4-Monitoring Agricultural Resource