The health and wellbeing of offshore workers: a narrative review of the published literature.

Recent developments within the offshore industry have highlighted the role that health and wellbeing plays in ensuring the safety and longevity of the offshore workforce. Developing an understanding of the overall health and wellbeing of offshore workers could aid future developments. This narrative review aims to identify and synthesise the relevant published literature on offshore health and wellbeing. The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, PsycArticles, and Web of Science databases were searched with publication search dates limited from January 1994 to November 2014. Twenty-six studies were identified and covered aspects of occupational stress; mental wellbeing; body mass index; diet; physical activity; musculoskeletal disorder; smoking; alcohol and drug use; shift work amongst offshore workers. This narrative review has highlighted a lack of high quality and relevant research. There is a particular need to research workers' participation in self care activities and the resultant influence of domains on health and well being. NOTE: publisher link is not currently working (last checked 2019-01-25

Finding that needle in the haystack: Computable phenotypes

In a 1532 publication, Sir Thomas More—an English lawyer and social philosopher—likened one’s ability to find a line in St. Austin’s writing to finding a needle in a meadow—later interpreted as a “needle in the haystack.” The isolation experienced by patients with rare diseases can often make them feel like lost needles in the meadow of our large complex health care systems. As of 2018, there were 327.2 million people with the potential to have data stored across 5534 registered hospitals in the United States alone along with over 1100 different electronic health record vendors. The frustration experienced by those eager to connect individuals with rare diseases to clinical care and research opportunities is magnified by the fact that our electronic medical record systems at times fall short of “meaningful use” and do many things to the exception of connecting to other systems and providing efficient communication. The effect that this complicated meadow has on clinical care has been well described, but the barriers that this poses to patient recruitment into clinical and other research trials are less addressed in published literature

Thermal Decomposition of an Impure (Roxbury) Siderite: Relevance to the Presence of Chemically Pure Magnetite Crystals in ALH84001 Carbonate Disks

The question of the origin of nanophase magnetite in Martian meteorite ALH84001 has been widely debated for nearly a decade. Golden et al. have reported producing nearly chemically pure magnetite from thermal decomposition of chemically impure siderite [(Fe, Mg, Mn)CO3]. This claim is significant for three reasons: first, it has been argued that chemically pure magnetite present in the carbonate disks in Martian meteorite ALH84001 could have formed by the thermal decomposition of the impure carbonate matrix in which they are embedded; second, the chemical purity of magnetite has been previously used to identify biogenic magnetite; and, third, previous studies of thermal decomposition of impure (Mg,Ca,Mn)-siderites, which have been investigated under a wide variety of conditions by numerous researchers, invariably yields a mixed metal oxide phase as the product and not chemically pure magnetite. The explanation for this observation is that these siderites all possess the same crystallographic structure (Calcite; R3c) so solid solutions between these carbonates are readily formed and can be viewed on an atomic scale as two chemically different but structurally similar lattices

Emerging Agents for the Management of Nephrotic Syndrome: Progress to Date

Nephrotic Syndrome is a rare condition associated with high morbidity in the 20–40 % of children and adolescents who fail to respond to standard immunosuppressive therapies. Novel non-immunologic mechanisms of widely used immunosuppressive therapies, as well as emerging anti-inflammatory drugs, and anti-fibrotics may play a crucial role in the treatment of patients with refractory disease. This article will review some of these treatments and their various stages of investigation

Origin of Magnetite Crystals in Martian Meteorite ALH84001 Carbonate Disks

Martian meteorite ALH84001 preserves evidence of interaction with aqueous fluids while on Mars in the form of microscopic carbonate disks which are believed to have precipitated approx.3.9 Ga ago at beginning of the Noachian epoch. Intimately associated within and throughout these carbonate disks are nanocrystal magnetites (Fe3O4) with unusual chemical and physical properties, whose origins have become the source of considerable debate. One group of hypotheses argues that these Fe3O4 are the product of partial thermal decomposition of the host carbonate. Alternatively, the origins of Fe3O4 and carbonate may be unrelated; that is, from the perspective of the carbonate the magnetite is allochthonous. We have sought to resolve between these hypotheses through the detailed characterized of the compositional and structural relationships of the carbonate disks and associated magnetites with the orthopyroxene matrix in which they are embedded [1]. We focus this discussion on the composition of ALH84001 magnetites and then compare these observations with those from our thermal decomposition studies of sideritic carbonates under a range of plausible geological heating scenarios

Correlation-Polarization Effects in Electron/Positron Scattering from Acetylene: A Comparison of Computational Models

Different computational methods are employed to evaluate elastic (rotationally summed) integral and differential cross sections for low energy (below about 10 eV) positron scattering off gas-phase C$_2$H$_2$ molecules. The computations are carried out at the static and static-plus-polarization levels for describing the interaction forces and the correlation-polarization contributions are found to be an essential component for the correct description of low-energy cross section behavior. The local model potentials derived from density functional theory (DFT) and from the distributed positron model (DPM) are found to produce very high-quality agreement with existing measurements. On the other hand, the less satisfactory agreement between the R-matrix (RM) results and measured data shows the effects of the slow convergence rate of configuration-interaction (CI) expansion methods with respect to the size of the CI-expansion. To contrast the positron scattering findings, results for electron-C$_2$H$_2$ integral and differential cross sections, calculated with both a DFT model potential and the R-matrix method, are compared and analysed around the shape resonance energy region and found to produce better internal agreement

Estimated GFR Trajectories in Pediatric and Adult Nephrotic Syndrome: Results From the Nephrotic Syndrome Study Network (NEPTUNE)

56% and 16% had PNL 50%, respectively. In both adults and pediatric patients, higher baseline eGFR was associated with higher PNL, whereas longer follow-up time was associated with lower PNL. Higher urine protein-creatinine ratio and steroid use were also associated with higher PNL in adults. Higher percentages of tubular atrophy and foot-process effacement were associated with lower and higher PNLs, respectively, in adults. Limitations: Relatively short follow-up time, inability to assess acute kidney injury events, and variable eGFR measurement frequency across patients. Conclusions: Although increasing follow-up time resulted in more linear trajectories, nonlinear eGFR trajectories were common in this cohort. Future studies in nephrotic syndrome should consider novel outcomes that do not rely on linearity assumptions.Rationale & Objective: Surrogate outcomes for end-stage kidney disease often assume linear changes, which may not reflect true estimated glomerular filtration rate (eGFR) trajectories. This study's objective was to characterize nonlinear eGFR trajectories in nephrotic syndrome. Study Design: Observational cohort study. Setting & Participants: Nephrotic Syndrome Study Network (NEPTUNE) is a multicenter study of adult and pediatric patients with proteinuria enrolled at clinically indicated kidney biopsy or initial presentation of disease (pediatric only). Predictors: Patient demographic, clinical, and pathology variables at study enrollment and follow-up time. Outcome: eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (patients ≥ 18 years old) or modified Chronic Kidney Disease in Children Study–Schwartz (patients < 18 years) formulas. The probability of nonlinearity (PNL) was calculated for individual eGFR trajectories. Analytical Approach: Associations between predictors and PNL were assessed using multivariable linear regression. Results: 453 patients with ≥3 eGFR measurements and 1 or more year of follow-up were included (median follow-up, 3.6 years). Median PNL was 0.05

Blood Pressure and Visit-to-Visit Blood Pressure Variability among Individuals with Primary Proteinuric Glomerulopathies

Hypertension and blood pressure variability (BPV; SD and average real variability) in primary proteinuric glomerulopathies are not well described. Data were from 433 participants in the NEPTUNE (Nephrotic Syndrome Study Network). Hypertensive BP status was defined as previous history of hypertension or BP ≥140/90 mm Hg for adults/≥95th percentile for children at baseline. BPV was measured in participants with ≥3 visits in the first year. Two-hundred ninety-six adults (43 years [interquartile range, 32-57.8 years], 61.5% male) and 147 children (11 years [interquartile range, 5-14 years], 57.8% male) were evaluated. At baseline, 64.8% of adults and 46.9% of children were hypertensive. Histological diagnosis was associated with hypertensive status in adults (P=0.036). In adults, hypertensive status was associated with lower hazard of complete remission (hazard ratio, 0.36; 95% confidence interval, 0.19-0.68) and greater hazard of achieving the composite end point (end-stage renal disease or estimated glomerular filtration rate decline >40%; hazard ratio, 4.1; 95% confidence interval, 1.4-12). Greater systolic and diastolic SD and average real variability were also associated with greater hazard of reaching the composite end point in adults (all P<0.01). In children, greater BPV was an independent predictor of composite end point (determined by systolic SD and average real variability) and complete remission (determined by systolic and diastolic average real variability; all P<0.05). Hypertensive status was common among adults and children enrolled in NEPTUNE. Differences in hypertensive status prevalence, BPV, and treatment were found by age and histological diagnosis. In addition, hypertensive status and greater BPV were associated with poorer clinical outcomes

Origins of the Ambient Solar Wind: Implications for Space Weather

The Sun's outer atmosphere is heated to temperatures of millions of degrees, and solar plasma flows out into interplanetary space at supersonic speeds. This paper reviews our current understanding of these interrelated problems: coronal heating and the acceleration of the ambient solar wind. We also discuss where the community stands in its ability to forecast how variations in the solar wind (i.e., fast and slow wind streams) impact the Earth. Although the last few decades have seen significant progress in observations and modeling, we still do not have a complete understanding of the relevant physical processes, nor do we have a quantitatively precise census of which coronal structures contribute to specific types of solar wind. Fast streams are known to be connected to the central regions of large coronal holes. Slow streams, however, appear to come from a wide range of sources, including streamers, pseudostreamers, coronal loops, active regions, and coronal hole boundaries. Complicating our understanding even more is the fact that processes such as turbulence, stream-stream interactions, and Coulomb collisions can make it difficult to unambiguously map a parcel measured at 1 AU back down to its coronal source. We also review recent progress -- in theoretical modeling, observational data analysis, and forecasting techniques that sit at the interface between data and theory -- that gives us hope that the above problems are indeed solvable.Comment: Accepted for publication in Space Science Reviews. Special issue connected with a 2016 ISSI workshop on "The Scientific Foundations of Space Weather." 44 pages, 9 figure