Perioperative hypertension management

Perioperative hypertension is commonly encountered in patients that undergo surgery. While attempts have been made to standardize the method to characterize the intraoperative hemodynamics, these methods still vary widely. In addition, there is a lack of consensus concerning treatment thresholds and appropriate therapeutic targets, making absolute recommendations about treatment difficult. Nevertheless, perioperative hypertension requires careful management. When treatment is necessary, therapy should be individualized for the patient. This paper reviews the pharmacologic agents and strategies commonly used in the management of perioperative hypertension

Bench-to-bedside review: Rhabdomyolysis – an overview for clinicians

Rhabdomyolysis ranges from an asymptomatic illness with elevation in the creatine kinase level to a life-threatening condition associated with extreme elevations in creatine kinase, electrolyte imbalances, acute renal failure and disseminated intravascular coagulation. Muscular trauma is the most common cause of rhabdomyolysis. Less common causes include muscle enzyme deficiencies, electrolyte abnormalities, infectious causes, drugs, toxins and endocrinopathies. Weakness, myalgia and tea-colored urine are the main clinical manifestations. The most sensitive laboratory finding of muscle injury is an elevated plasma creatine kinase level. The management of patients with rhabdomyolysis includes early vigorous hydration

The Safe Drug Trade

Previše je komentatora koji krivnju za zločin povezuju s drogom. Da, oni su uistinu povezani, ali smjer uzrokovanja ide gotovo suprotno. Radi se o tome da zabrana supstanci koje uzrokoju ovisnost vodi do zločinačkog ponašanja, a ne obrnuto. Ukoliko želimo sigurnost povezanu s drogom, utoliko je legalizacija preferentno rješenje za javnu politiku.All too many commentators blame crime on drugs. Yes, the two are indeed correlated, but the direction of causation is almost entirely in the opposite direction. It is the prohibition of addictive substances that leads to criminal behavior, not the other way around. If we want drug safety, legalization is the preferred public policy solution

Sigurna trgovina drogom

Previše je komentatora koji krivnju za zločin povezuju s drogom. Da, oni su uistinu povezani, ali smjer uzrokovanja ide gotovo suprotno. Radi se o tome da zabrana supstanci koje uzrokoju ovisnost vodi do zločinačkog ponašanja, a ne obrnuto. Ukoliko želimo sigurnost povezanu s drogom, utoliko je legalizacija preferentno rješenje za javnu politiku

Detecting and quantifying methane emissions from oil and gas production: algorithm development with ground-truth calibration based on Sentinel-2 satellite imagery

Sentinel-2 satellite imagery has been shown by studies to be capable of detecting and quantifying methane emissions from oil and gas production. However, current methods lack performance calibration with ground-truth testing. This study developed a multi-band–multi-pass–multi-comparison-date methane retrieval algorithm that enhances Sentinel-2 sensitivity to methane plumes. The method was calibrated using data from a large-scale controlled-release test in Ehrenberg, Arizona, in fall 2021, with three algorithm parameters tuned based on the true emission rates. Tuned parameters are the pixel-level concentration upper-bound threshold during extreme value removal, the number of comparison dates, and the pixel-level methane concentration percentage threshold when determining the spatial extent of a plume. We found that a low value of the upper-bound threshold during extreme value removal can result in false negatives. A high number of comparison dates helps enhance the algorithm sensitivity to the plumes in the target date, but values in excess of 12 d are neither necessary nor computationally efficient. A high percentage threshold when determining the spatial extent of a plume helps enhance the quantification accuracy, but it may harm the yes/no detection accuracy. We found that there is a trade-off between quantification accuracy and detection accuracy. In a scenario with the highest quantification accuracy, we achieved the lowest quantification error and had zero false-positive detections; however, the algorithm missed three true plumes, which reduced the yes/no detection accuracy. In contrast, all of the true plumes were detected in the highest detection accuracy scenario, but the emission rate quantification had higher errors. We illustrated a two-step method that updates the emission rate estimates in an interim step, which improves quantification accuracy while keeping high yes/no detection accuracy. We also validated the algorithm's ability to detect true positives and true negatives in two application studies.</p