Further information on the prehistoric representations of human hands in the cave of Gargas

This paper amends and adds recent information to Paul A. Janssens' earlier article on the prehistoric paintings of human hands in the cave of Gargas, France. Possible diagnoses for the deficiencies found in many of the hand pictures, and some non-medical theories of explanation, are reviewed. It is concluded that the hands used as stencils were mutilated and that the images were deliberately placed within the cave and were not the by-products of some other activity

Association Between Arkansas Cannabis Program Implentation and Drug Overdoses

Overdose rates have been on the rise in the United States. In 2018 Arkansas launched its medical cannabis program. The effects of cannabis are still not widely known due to limited research and legislation. Utilizing state issued reports, we examined if a state medical cannabis program had any impact on overdose rates between 2018 and 2020. Data was examined from the Arkansas Prescription Drug Monitoring Program and the Arkansas Medical Marijuana program to determine if a pattern could be recognized on the impact of state medical cannabis programs. Data was examined at a county level to determine if any change had occurred between 2018 and 2020. While largely inconclusive there is some evidence to suggest the state cannabis program could have a positive impact, but further and more detailed research is needed

Rules of Engagement: design attributes for social interactions

We present a taxonomy for the design of workplace “break” spaces. The taxonomy can be used to identify aspects of current spaces that are either successful or problematic. From this analysis, we demonstrate how the taxonomy can be used to identify opportunities for computer mediated augmentation of spaces, and how such designs can be validated against this taxonomy

The Prehistoric hand pictures at Gargas: attempts at simulation

A number of experimental methods of reconstructing prehistoric hand images like those in the cave of Gargas, France, are described and assessed. The results of experiments using these methods are evaluated from the point of view of the bearing they have on our knowledge about the creation of the original pictures in the cave

Serum osmolarity and haematocrit do not modify the association between the impedance index (Ht2/Z) and total body water in the very old: The Newcastle 85+ Study

Bioelectrical impedance is a non-invasive technique for the assessment of body composition; however, information on its accuracy in the very old (80+ years) is limited. We investigated whether the association between the impedance index and total body water (TBW) was modified by hydration status as assessed by haematocrit and serum osmolarity. This was a cross-sectional analysis of baseline data from the Newcastle 85+ Cohort Study. Anthropometric measurements [weight, height (Ht)] were taken and body mass index (BMI) calculated. Leg-to-leg bioimpedance was used to measure the impedance value (Z) and to estimate fat mass, fat free mass and TBW. The impedance index (Ht2/Z) was calculated. Blood haematocrit, haemoglobin, glucose, sodium, potassium, urea and creatinine concentrations were measured. Serum osmolarity was calculated using a validated prediction equation. 677 men and women aged 85 years were included. The average BMI of the population was 24.3±4.2kg/m2 and the prevalence of overweight and obesity was 32.6% and 9.5%, respectively. The impedance index was significantly associated with TBW in both men (n=274, r=0.76, p<0.001) and women (n=403, r=0.96, p<0.001); in regression models, the impedance index remained associated with TBW after adjustment for height, weight and gender, and further adjustment for serum osmolarity and haematocrit. The impedance index values increased with BMI and the relationship was not modified by hydration status in women (p=0.69) and only marginally in men (p=0.02). The association between the impedance index and TBW was not modified by hydration status, which may support the utilisation of leg-to-leg bioimpedance for the assessment of body composition in the very old

Dark Matter in the Coming Decade: Complementary Paths to Discovery and Beyond

In this report we summarize the many dark matter searches currently being pursued through four complementary approaches: direct detection, indirect detection, collider experiments, and astrophysical probes. The essential features of broad classes of experiments are described, each with their own strengths and weaknesses. The complementarity of the different dark matter searches is discussed qualitatively and illustrated quantitatively in two simple theoretical frameworks. Our primary conclusion is that the diversity of possible dark matter candidates requires a balanced program drawing from all four approaches.Comment: Report prepared for the Community Summer Study (Snowmass) 2013, on behalf of Cosmic Frontier Working Groups 1-4 (CF1: WIMP Dark Matter Direct Detection, CF2: WIMP Dark Matter Indirect Detection, CF3: Non-WIMP Dark Matter, and CF4: Dark Matter Complementarity); published versio

Omega-3 and polyunsaturated fat for prevention of depression and anxiety symptoms: a systematic review and meta-analysis of randomised trials

Background There is strong public belief that polyunsaturated fats protect against and ameliorate depression and anxiety. Aims To assess effects of increasing omega-3, omega-6 or total polyunsaturated fat on prevention and treatment of depression and anxiety symptoms. Method We searched widely (Central, Medline and EMBASE to April 2017, trial registers to September 2016, ongoing trials updated to August 2019), including trials of adults with or without depression or anxiety, randomised to increased omega-3, omega-6 or total polyunsaturated fat for ≥24 weeks, excluding multifactorial interventions. Inclusion, data extraction and risk of bias were assessed independently in duplicate, and authors contacted for further data. We used random-effects meta-analysis, sensitivity analyses, subgrouping and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment. Results We included 31 trials assessing effects of long-chain omega-3 (n = 41 470), one of alpha-linolenic acid (n = 4837), one of total polyunsaturated fat (n = 4997) and none of omega-6. Meta-analysis suggested that increasing long-chain omega-3 probably has little or no effect on risk of depression symptoms (risk ratio 1.01, 95% CI 0.92-1.10, I2 = 0%, median dose 0.95 g/d, duration 12 months) or anxiety symptoms (standardised mean difference 0.15, 95% CI 0.05-0.26, I2 = 0%, median dose 1.1 g/d, duration 6 months; both moderate-quality evidence). Evidence of effects on depression severity and remission in existing depression were unclear (very-low-quality evidence). Results did not differ by risk of bias, omega-3 dose, duration or nutrients replaced. Increasing alpha-linolenic acid by 2 g/d may increase risk of depression symptoms very slightly over 40 months (number needed to harm, 1000). Conclusions Long-chain omega-3 supplementation probably has little or no effect in preventing depression or anxiety symptoms. Declaration of interest L.H. and A.A. were funded to attend the World Health Organization Nutrition Guidance Expert Advisory Group (NUGAG) Subgroup on Diet and Health meetings and present review results. The authors report no other conflicts of interest

Clinical aspects of incorporating cord clamping into stabilisation of preterm infants

Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal resuscitation guidelines, comprehensive recommendations are available on supporting pulmonary transition and delaying clamping of the cord in preterm infants. Recent experimental studies demonstrated that the pulmonary and haemodynamic transition are intimately linked, could influence each other and that the timing of umbilical cord clamping should be incorporated into the respiratory stabilisation. We reviewed the current knowledge on how to incorporate cord clamping into stabilisation of preterm infants and the physiological-based cord clamping (PBCC) approach, with the infant's transitional status as key determinant of timing of cord clamping. This approach could result in optimal timing of cord clamping and has the potential to reduce major morbidities and mortality in preterm infants

Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

BACKGROUND: Observational research suggests that combined therapy with Vitamin C, thiamine and hydrocortisone may reduce mortality in patients with septic shock. METHODS AND DESIGN: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a multicenter, double-blind, adaptive sample size, randomized, placebo-controlled trial designed to test the efficacy of combination therapy with vitamin C (1.5 g), thiamine (100 mg), and hydrocortisone (50 mg) given every 6 h for up to 16 doses in patients with respiratory or circulatory dysfunction (or both) resulting from sepsis. The primary outcome is ventilator- and vasopressor-free days with mortality as the key secondary outcome. Recruitment began in August 2018 and is ongoing; 501 participants have been enrolled to date, with a planned maximum sample size of 2000. The Data and Safety Monitoring Board reviewed interim results at N = 200, 300, 400 and 500, and has recommended continuing recruitment. The next interim analysis will occur when N = 1000. This update presents the statistical analysis plan. Specifically, we provide definitions for key treatment and outcome variables, and for intent-to-treat, per-protocol, and safety analysis datasets. We describe the planned descriptive analyses, the main analysis of the primary end point, our approach to secondary and exploratory analyses, and handling of missing data. Our goal is to provide enough detail that our approach could be replicated by an independent study group, thereby enhancing the transparency of the study. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03509350. Registered on 26 April 2018