Rapid ocean acidification and protracted Earth system recovery followed the end-Cretaceous Chicxulub impact.

Mass extinction at the Cretaceous-Paleogene (K-Pg) boundary coincides with the Chicxulub bolide impact and also falls within the broader time frame of Deccan trap emplacement. Critically, though, empirical evidence as to how either of these factors could have driven observed extinction patterns and carbon cycle perturbations is still lacking. Here, using boron isotopes in foraminifera, we document a geologically rapid surface-ocean pH drop following the Chicxulub impact, supporting impact-induced ocean acidification as a mechanism for ecological collapse in the marine realm. Subsequently, surface water pH rebounded sharply with the extinction of marine calcifiers and the associated imbalance in the global carbon cycle. Our reconstructed water-column pH gradients, combined with Earth system modeling, indicate that a partial ∼50% reduction in global marine primary productivity is sufficient to explain observed marine carbon isotope patterns at the K-Pg, due to the underlying action of the solubility pump. While primary productivity recovered within a few tens of thousands of years, inefficiency in carbon export to the deep sea lasted much longer. This phased recovery scenario reconciles competing hypotheses previously put forward to explain the K-Pg carbon isotope records, and explains both spatially variable patterns of change in marine productivity across the event and a lack of extinction at the deep sea floor. In sum, we provide insights into the drivers of the last mass extinction, the recovery of marine carbon cycling in a postextinction world, and the way in which marine life imprints its isotopic signal onto the geological record.

Triple Isotope Fractionation Exponents of Elements Measured by MC-ICP-MS-An Example of Mg.

In most chemical reactions, stable isotopes are fractionated in a mass-dependent manner, yielding correlated isotope ratios in elements with three or more stable isotopes. The proportionality between isotope ratios is set by the triple isotope fractionation exponent θ that can be determined precisely for, e.g., sulfur and oxygen by IRMS, but not for metal(loid) elements due to the lower precision of MC-ICP-MS analysis and smaller isotopic variations. Here, using Mg as a test case, we compute a complete metrologically robust uncertainty budget for apparent θ values and, with reference to this, present a new measurement approach that reduces uncertainty on θ values by 30%. This approach, namely, direct educt-product bracketing (sample-sample bracketing), allows apparent θ values of metal(loid) isotopes to be determined precisely enough to distinguish slopes in three-isotope space. For the example of Mg, we assess appropriate quality control standards for interference-to-signal ratios and report apparent θ values of carbonate-seawater pairs. We determined apparent θ values for marine biogenic carbonates, where the foraminifera Globorotalia menardii yields 0.514 ± 0.005 (2 SD), the coral Porites, 0.515 ± 0.006 (2 SD), and two specimens of the giant clam Tridacna gigas, 0.508 ± 0.007 (2 SD) and 0.509 ± 0.006 (2 SD), documenting differences in the uptake pathway of Mg among marine calcifiers. The capability to measure apparent θ values more precisely adds a new dimension to metal(loid) δ values, with the potential to allow us to resolve different modes of fractionation in industrial and natural processes.

Sports medicine training and practice opportunities for emergency physicians.

BACKGROUND: There is growing interest among emergency physicians to seek additional training in Sports Medicine (SM) and to add it to their clinical practice. This presents unique training and practice management issues. The majority of Primary Care SM fellowship programs list that they will accept emergency physicians, and approximately one-third have already had an emergency physician as an SM fellow. OBJECTIVES: The objective of this article is to provide an overview of the key elements for emergency physicians to consider as they pursue SM career goals. DISCUSSION: Training needs such as continuity of care as it pertains to the athlete, SM skills development, and practice management are reviewed. Practice challenges such as malpractice insurance and billing issues are discussed. Examples of several practice models are presented. Evolving trends in SM practice and training opportunities for emergency physicians are discussed as well. CONCLUSIONS: Sports Medicine is a viable career option for emergency physicians and may complement their skills set in the management of acute injuries. Practice and training opportunities will continue to evolve as this pathway into the practice of SM gains further recognition.

Toward a Cenozoic history of atmospheric CO2.

The geological record encodes the relationship between climate and atmospheric carbon dioxide (CO2) over long and short timescales, as well as potential drivers of evolutionary transitions. However, reconstructing CO2 beyond direct measurements requires the use of paleoproxies and herein lies the challenge, as proxies differ in their assumptions, degree of understanding, and even reconstructed values. In this study, we critically evaluated, categorized, and integrated available proxies to create a high-fidelity and transparently constructed atmospheric CO2 record spanning the past 66 million years. This newly constructed record provides clearer evidence for higher Earth system sensitivity in the past and for the role of CO2 thresholds in biological and cryosphere evolution.

Electromyographic Characteristics of a Single Motion Shoulder Exercise: A Pilot Study Investigating a Novel Shoulder Exercise.

BACKGROUND: Shoulder exercises focused on strengthening the rotator cuff and scapular stabilizing muscles as well as addressing scapular dyskinesis and motor control have been shown to improve rotator cuff function and decrease shoulder pain. A single motion shoulder exercise that effectively activates the rotator cuff and scapular stabilizing muscles, engages the scapulohumeral rhythm, and includes eccentric contractions may be more effective and easier for patients to consistently perform as compared to multiple standard shoulder exercises. PURPOSE: To compare the electromyographic muscle activation of key shoulder complex muscles during a single motion exercise and individual exercises (standard exercises) typically included in shoulder rehabilitation protocols. STUDY DESIGN: Case-controlled, cohort study. METHODS: Nineteen healthy men and women without shoulder pain or dysfunction were studied. Muscle activity of the rotator cuff and scapular stabilizing muscles (supraspinatus, infraspinatus, teres minor, trapezius [upper, middle and lower], serratus anterior, middle deltoid) was measured using surface EMG while subjects performed, in a standing position, several standard shoulder exercises typically included in shoulder rehabilitation protocols (resisted shoulder flexion, abduction in the scapular plane/scaption, external rotation, extension) and a single motion shoulder exercise consisting of a continuous movement creating the shape of "Figure of 8" in the transverse plane. The subjects used a weight between 5-15 pounds that produced muscle activation at 40-60% maximum voluntary isometric contraction (MVIC) for shoulder external rotation. That weight was then used for all of the exercises performed by the subject. The single highest EMG reading for each of the eight muscles studied, expressed as a percentage of MVIC, at any point during the second, third and fourth repetitions in a five repetition set was used to compare the single motion shoulder exercise and each exercise in the standard exercises set. RESULTS: Ten men and nine women between 18-65 years of age were tested. No significant difference (p=.05) between the exercises was noted for the supraspinatus, infraspinatus, teres minor, serratus anterior, middle deltoid or upper trapezius. There was a significant difference favoring the standard exercises in the middle and lower trapezius. (p= 0.0109 and 0.0002 respectively). CONCLUSION: In this pilot study, muscle activation during the single motion, Figure of 8 pattern exercise was not significantly different from the standard shoulder exercises in six of eight key muscles that are usually included in shoulder rehabilitation protocols. The exceptions were the middle and lower trapezius which were activated to a significantly higher degree with the standard exercises. Further evaluation of the clinical effectiveness of the single motion shoulder exercise is needed. LEVEL OF EVIDENCE: Level 3b.

The PhanSST global database of Phanerozoic sea surface temperature proxy data.

Paleotemperature proxy data form the cornerstone of paleoclimate research and are integral to understanding the evolution of the Earth system across the Phanerozoic Eon. Here, we present PhanSST, a database containing over 150,000 data points from five proxy systems that can be used to estimate past sea surface temperature. The geochemical data have a near-global spatial distribution and temporally span most of the Phanerozoic. Each proxy value is associated with consistent and queryable metadata fields, including information about the location, age, and taxonomy of the organism from which the data derive. To promote transparency and reproducibility, we include all available published data, regardless of interpreted preservation state or vital effects. However, we also provide expert-assigned diagenetic assessments, ecological and environmental flags, and other proxy-specific fields, which facilitate informed and responsible reuse of the database. The data are quality control checked and the foraminiferal taxonomy has been updated. PhanSST will serve as a valuable resource to the paleoclimate community and has myriad applications, including evolutionary, geochemical, diagenetic, and proxy calibration studies.

On impact and volcanism across the Cretaceous-Paleogene boundary.

The cause of the end-Cretaceous mass extinction is vigorously debated, owing to the occurrence of a very large bolide impact and flood basalt volcanism near the boundary. Disentangling their relative importance is complicated by uncertainty regarding kill mechanisms and the relative timing of volcanogenic outgassing, impact, and extinction. We used carbon cycle modeling and paleotemperature records to constrain the timing of volcanogenic outgassing. We found support for major outgassing beginning and ending distinctly before the impact, with only the impact coinciding with mass extinction and biologically amplified carbon cycle change. Our models show that these extinction-related carbon cycle changes would have allowed the ocean to absorb massive amounts of carbon dioxide, thus limiting the global warming otherwise expected from postextinction volcanism.

Biogeochemical significance of pelagic ecosystem function: an end-Cretaceous case study.

Pelagic ecosystem function is integral to global biogeochemical cycling, and plays a major role in modulating atmospheric CO2 concentrations (pCO2). Uncertainty as to the effects of human activities on marine ecosystem function hinders projection of future atmospheric pCO2 To this end, events in the geological past can provide informative case studies in the response of ecosystem function to environmental and ecological changes. Around the Cretaceous-Palaeogene (K-Pg) boundary, two such events occurred: Deccan large igneous province (LIP) eruptions and massive bolide impact at the Yucatan Peninsula. Both perturbed the environment, but only the impact coincided with marine mass extinction. As such, we use these events to directly contrast the response of marine biogeochemical cycling to environmental perturbation with and without changes in global species richness. We measure this biogeochemical response using records of deep-sea carbonate preservation. We find that Late Cretaceous Deccan volcanism prompted transient deep-sea carbonate dissolution of a larger magnitude and timescale than predicted by geochemical models. Even so, the effect of volcanism on carbonate preservation was slight compared with bolide impact. Empirical records and geochemical models support a pronounced increase in carbonate saturation state for more than 500 000 years following the mass extinction of pelagic carbonate producers at the K-Pg boundary. These examples highlight the importance of pelagic ecosystems in moderating climate and ocean chemistry.

Nonsurgical sports medicine training in the United States: a survey of sports medicine fellowship graduates.

OBJECTIVE: To survey graduates of nonsurgical sports medicine fellowship training programs about the quality and content of their educational curriculum. DESIGN: Survey. PARTICIPANTS: Participants were year 2000 active members of the American Medical Society for Sports Medicine (AMSSM) and American Osteopathic Academy of Sports Medicine (AOASM) and all other attendees at the 2000 AOASM and AMSSM annual meetings. The survey also was sent to candidates sitting for the 1999 CAQ examination from the American Board of Family Practice, American Board of Internal Medicine, American College of Emergency Physicians, and American Academy of Pediatrics. RESULTS: A total of 1608 surveys were distributed; 612 were returned for a return rate of 43%. Of respondents, 294 were fellowship trained, and 318 considered themselves to be sports medicine physicians but were not fellowship trained. Sections of the survey completed only by fellowship-trained physicians and focusing on training curriculum are reported in this article. Categories of survey questions included clinical experience, curriculum, academic activities, research, teaching experiences, primary care skills, procedures, types of athletes seen during training, supervision, and benefits. General attitudes about fellowship training also were surveyed: 99% of graduates were satisfied with their training and would do a fellowship again, and 98% felt they their training prepared them for a career in sports medicine. Orthopaedic experiences and physical examination skills were rated the highest. Research experience, work with disabled athletes, and selected areas of nonorthopaedic medical training, such as sports ophthalmology and sports psychology, were rated the lowest. CONCLUSIONS: Overall, fellowship training in sports medicine seems to be satisfactory to fellowship graduates. Strengths and weaknesses in training programs were identified.

Physical activity, physiological, and psychomotor performance: a study of variously active older adult men.

This research examined varying levels of physical activity and psychomotor and physiological function in variously active older men. Very active moderately active, and low active participants were tested on simple (SRT) and choice reaction time (CRT), coincidence-anticipation timing (CAT), and VO2max. No significant differences for age or height were found, although percentage of fat, and weight were statistically different. Active groups were leaner and lighter. VO2max was significantly different between groups, as physically active groups yielded geater values. SRT and CAT also yielded significantly different results with more active participants showing better performance. No between-groups significant differences resulted for CRT. Generally, increased levels of physical activity were related to superior physiological outcomes and improved psychomotor peformance.

Position Statement. Violence and injury in ice hockey.

Ice hockey is a sport enjoyed by many men and women at the spectator and participant level. It is played with high intensity and often involves body contact. Although the women's games is far from injury free, it is the men's game that has drawn criticism for excessive violence. Much attention has been drawn to the serious injuries that have occurred in ice hockey, specifically spinal injuries, concussions, and eye injuries. Many such injuries are the result of illegal and violent acts such as checking from behind or a deliberate high stick. Because of this, some medical organizations have called for changes in the sport, such as minimum age requirements for body-checking. As a practical matter such changes are unlikely to be accepted by hockey governing boards. Many of those involved in the sport consider body-checking a fundamental component of the game. Furthermore, a distinction needs to be made between any kind of injury and a serious, catastrophic injury. For example, although a recent study found that body-checking accounted for up to 38% of ice hockey injuries, none were of the catastrophic type. With respect to catastrophic injuries such as spinal cord trauma or a blinded eye, legal body-checking accounts for significantly less than illegal body-checking (e.g., checking from behind) or violent stick work. To reduce serious injury in ice hockey, we offer 10 recommendations, key among them automatic game suspensions for certain rules violations, and recognition of the coach as the most important figure in promoting a clean, safe game.