Arctic puzzle: Pioneering a northern shrimp (Pandalus borealis) habitat model in Disko Bay, West Greenland.

Recent advancements in spatial modelling leverage remote sensing data and statistical species-environment relationships to forecast the distribution of a specific species. Our study focuses on Disko Bay in West Greenland, recognized as a significant marine biodiversity hotspot in the region. We conducted comprehensive analyses using multiple datasets spanning from 2010 to 2019, incorporating shrimp and fish surveys, commercial shrimp fishery catches, high-resolution (25 × 25 m) multibeam bathymetry and backscatter data along with a medium-resolution (200 × 200 m) bathymetric model, measured and modelled oceanographic data, and satellite chlorophyll data. Through multivariate regression analysis, we tested the significance of various physical factors (seafloor depth, sediment class, bottom water temperature, bottom water salinity, bottom current velocity, space, and time), biological factors (chlorophyll a, Greenland halibut (Reinhardtius hippoglossoides)), and anthropogenic impact (shrimp fishery; standardized catch per unit effort) on the density of northern shrimp in the area. Our results indicate a significant association between northern shrimp density, seafloor depth, and sediment class, explaining 36 % of the variation in shrimp density. Subsequently, we developed a high-resolution (optimized) spatial linear mixed-effect model to map the distribution of northern shrimp across Disko Bay, representing the first model of its kind developed for an Arctic area. The optimal habitat for northern shrimp is characterized by medium-deep waters (approximately 150-350 m), turbulent conditions, and mixed sediments, predominantly located in the northern and southern regions of Disko Bay. Notably, the northern region hosts a relatively diverse benthic community, with northern shrimp and sponges as the primary contributors of epibenthic biomass. This novel high-resolution model significantly enhances our understanding of the physical drivers and detailed spatial patterns influencing the distribution of northern shrimp in the Arctic.

Meeting the challenges of wound care in Danish home care.

OBJECTIVE: To evaluate a community-based educational intervention to improve wound-care practice, and thereby reduce the costs of care, in four communities in Denmark. METHOD: Annual wound care audits recorded patients' ages, the number and types of wounds being treated, wound duration (days unhealed), frequency of dressing changes and nurse time per dressing change. Data were available at year 1 and year 3 post-intervention. A statistical analysis was performed, testing for changes in a range of variables between these years. RESULTS: In the post-intervention period, significant reductions were found in the proportion of chronic wounds, the proportion of wounds requiring a daily dressing change, mean frequency of dressing change, mean nurse time spent in wound care per week, and the total cost of wound care per week. CONCLUSION: These results suggest that it is possible to improve wound-care practice and reduce the resource costs of wound care through a systematic programme of education and training, tailored to suit the needs of local communities.

[Os subtibiale: That odd ankle pain]. / Os subtibiale: esa rara molestia en el tobillo.

Os subtibiale is a low prevalence accessory bone of the ankle. This bone is located in the posterior colliculus of the tibial medial malleolus, both in paediatric and adult ages. It can cause pain, redness and/or swelling, which can lead to a mistaken diagnosis of avulsion fracture. Adequate anatomical knowledge is crucial. First, we present the case of a school-aged boy, seen at the outpatient clinic for a 2-month history of pain in both inner ankles after an injury. Second, we present the case of an adult patient with a 3-day history of right medial ankle pain, with no previous injury, evaluated at the Emergency Department. Accurate history-taking and physical examination are essential. The diagnosis is given by conventional radiology of both ankles, in antero-posterior and lateral load views. The initial treatment is conservative (splint or orthesis) to establish and maintain the function of the foot during loading activities. If there is no recovery after 6 months, surgical treatment can be considered.

Inhibitory influence of unstimulated rods in the human retina: evidence provided by examining cone flicker.

In the parafoveal retina of human observers, cone-mediated sensitivity to flicker decreases as rods become progressively more dark-adapted. This effect is greatest when a rod response to flicker is precluded. These results indicate that rods tonically inhibit cone pathways in the dark.

The bacterial aetiology of pleural empyema. A descriptive and comparative metagenomic study.

OBJECTIVES: The view of pleural empyema as a complication of bacterial pneumonia is changing because many patients lack evidence of underlying pneumonia. To further our understanding of pathophysiological mechanisms, we conducted in-depth microbiological characterization of empyemas in clinically well-characterized patients and investigated observed microbial parallels between pleural empyemas and brain abscesses. METHODS: Culture-positive and/or 16S rRNA gene PCR-positive pleural fluids were analysed using massive parallel sequencing of the 16S rRNA and rpoB genes. Clinical details were evaluated by medical record review. Comparative analysis with brain abscesses was performed using metagenomic data from a national Norwegian study. RESULTS: Sixty-four individuals with empyema were included. Thirty-seven had a well-defined microbial aetiology, while 27, all of whom had community-acquired infections, did not. In the latter subset, Fusobacterium nucleatum and/or Streptococcus intermedius was detected in 26 patients, of which 18 had additional facultative and/or anaerobic species in various combinations. For this group, there was 65.5% species overlap with brain abscesses; predisposing factors included dental infection, minor chest trauma, chronic obstructive pulmonary disease, drug abuse, alcoholism and diabetes mellitus. Altogether, massive parallel sequencing yielded 385 bacterial detections, whereas culture detected 38 (10%) and 16S rRNA gene PCR/Sanger-based sequencing detected 87 (23%). CONCLUSIONS: A subgroup of pleural empyema appears to be caused by a set of bacteria not normally considered to be involved in pneumonia. Such empyemas appear to have a similar microbial profile to oral/sinus-derived brain abscesses, supporting spread from the oral cavity, potentially haematogenously. We suggest reserving the term 'primary empyema' for these infections.

Violent trauma recidivism: Does all violence escalate?

PURPOSE: Rates of trauma patients presenting with history of prior trauma range from 25 to 44%. Outcomes involving recidivists in the setting of intentional trauma, especially penetrating trauma, are conflicting. We hypothesized that if violence does escalate with successive incidence, then injuries due to successive violence should escalate or become increasingly severe with successive admissions. METHODS: The trauma registry from an urban level I adult and pediatric trauma center was queried for injuries due to blunt assault, stabbing, and firearm injury. Primary outcome measures were mortality, injury mechanism, and injury severity for each successive trauma admission. RESULTS: Victims of blunt assault and stabbing were more likely to become recidivists than victims of gun violence (OR 1.53, p < 0.001 and OR 1.57, p < 0.001). Violent re-injury became increasingly severe only in victims of repeated gun violence. Patients with gunshot as the mechanism at every admission are at highest risk for mortality (OR 13.48, p < 0.001). All but one mortality (95.8%) in the recidivist population occurred within 180 days of discharge from a prior injury. CONCLUSION: Recidivism for interpersonal violence results in a significant number of admissions to trauma centers. In our patient cohort, injury associated with successive blunt assaults did not worsen with subsequent admissions. Recidivism for gunshot wounds tends to be more severe and have a worse prognosis with each successive admission compared to outcomes associated with repeated stab wounds. Focused efforts should include rehabilitation efforts early in the post-injury period, especially in patients with a history of gunshot wounds.

Predictors of retained hemothorax after trauma and impact on patient outcomes.

PURPOSE: Hemo/pneumothoraces are a common result of thoracic injury. Some of these injuries will be complicated by retained hemothorax (RH), which has previously been shown to be associated with longer hospitalizations. It has been proposed that early versus delayed intervention with video-assisted thoracoscopic surgery can reduce the duration of mechanical ventilation, hospital and ICU LOS, and costs in patients with RH. However, little is known regarding the effect of RH on these outcomes relative to patients with uncomplicated hemo/pneumothoraces. The aim of our study was to characterize factors present on admission that may be associated with RH and assess the impact of RH on outcomes. METHODS: A retrospective chart review was conducted and included all patients who underwent tube thoracostomy (TT) for traumatic hemo/pneumothorax admitted to a single urban adult and pediatric level I trauma center from January 2008 to September 2013. RESULTS: The study cohort included 398 patients, 17.6 % developed RH. RH was associated with significantly longer total duration of TT drainage (p < 0.001), hospital LOS (p < 0.001), and total hospital charges (p < 0.001). These associations remained significant in a subgroup analysis excluding patients with traumatic brain injury. Patients with bilateral injuries (OR 4.25, p < 0.001) and patients intubated on the day of admission (OR 2.30, p = 0.002) were significantly more likely to develop RH. There was also a small, but highly significant, association between increasing ISS and the development of RH (OR 1.07, p < 0.001). CONCLUSIONS: Our study suggests patients requiring ventilator support on admission and those with bilateral injuries are at increased risk of developing RH. Early identification of patients at risk for RH may allow for earlier intervention and potential benefits to the patient.

Improving outcome through two decades in childhood ALL in the Nordic countries: the impact of high-dose methotrexate in the reduction of CNS irradiation. Nordic Society of Pediatric Haematology and Oncology (NOPHO).

In this population-based material from the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), 2860 children below 15 years of age were diagnosed with acute lymphoblastic leukemia (ALL) from July 1981 to June 1998. The annual incidence was 3.9/100,000 children and was stable throughout the study period. The development from regional or national protocols to common Nordic treatment protocols for all risk groups was completed in 1992 through a successive intensification with multidrug chemotherapy, including pulses of methotrexate in high doses and avoidance of cranial irradiation in most children. The overall event-free survival (EFS) at 5 years has increased from 56.5 +/- 1.7% in the early 1980s to 77.6 +/- 1.4% during the 1990s. The main improvements were seen in children with non-high risk leukemia. In high-risk patients, progress has been moderate, especially in children with high WBC (> or =100 x 10(9)/l) at diagnosis. During the last time period (January 1992-June 1998), only 10% of the patients have received cranial irradiation in first remission, while 90% of the patients have received pulses of high dose methotrexate (5-8 g/m2) isolated or combined with high-dose cytosine arabinoside (total dose 12 g/m2) plus multiple intrathecal injections of methotrexate as CNS-targeted treatment, not translating into increased cumulative incidence of CNS relapse.

On the prognostic value of systemic methotrexate clearance in childhood acute lymphocytic leukemia.

The prognostic value of systemic methotrexate clearance (ClMTX) during high-dose therapy was evaluated in a cohort of 42 children with acute lymphocytic leukemia (ALL). As part of an extensive chemotherapy protocol, they had received a total of 293 methotrexate (MTX) infusions in the 6-8 g/m2 dose range. At the termination of the study, when they had all been followed up for 3.5 years or more, 26 of these patients were still in continuous complete remission, whereas 16 had suffered relapse. The intrapatient variability in ClMTX during the eight courses was up to six-fold. In 67% of the patients, the maximum level of ClMTX reached at least twice the minimum value. The coefficients of variation for the intra- and interindividual variability in ClMTX were 9-57% and 26-41%, respectively. The cumulative probability of relapse, estimated by the Kaplan-Meier procedure, was increased for patients with a high ClMTX during the initial treatment course, but the difference was not significant on a 5% level. There was no significant relationship between high individual median ClMTX and subsequent relapse of ALL. However, ClMTX during the initial infusion, the time-dependent mean for ClMTX, and the individual patient's median ClMTX, were significant predictors for event-free survival in a Cox proportional hazards regression analysis. The present study demonstrates gross pharmacokinetic variability and unpredictable values of ClMTX in subsequent courses after standardized administration of MTX to paediatric patients with ALL. In spite of the association between ClMTX and prognosis shown by some of the analyses, estimates of ClMTX rates may not necessarily be related to disease outcome in a way that can be exploited to the benefit of the individual patient.

Variability in methotrexate serum and cerebrospinal fluid pharmacokinetics in children with acute lymphocytic leukemia: relation to assay methodology and physiological variables.

Methotrexate (MTX) steady state concentrations were evaluated in 42 children who had received high-dose infusions (6-8 g/m2) for acute lymphocytic leukemia. Concentrations in serum and cerebrospinal fluid (CSF) measured by immunoassay were found to be highly variable. Reanalysis by a reference high-pressure liquid chromatography method ruled out analytical factors as a source of this variability. The correlation coefficient between the analytical methods was 0.77 for the serum data and 0.88 for the CSF data. The variability of serum and CSF concentrations was higher in younger patients (serum; P = 0.05 and CSF; P = 0.18), and the CSF concentration decreased with decreasing age and in later courses. Body surface area, body mass index, weight, and gender were not significantly related to MTX variability. We conclude that the pronounced pharmacokinetic variability seen during MTX infusions remains largely unexplained.

Refractive changes induced by intraocular lens tilt and longitudinal displacement.

There is a tendency for the posterior chamber intraocular lens to tilt about the points of insertion. This is found clinically and in postmortem studies of eyes that have had intraocular lenses surgically implanted. One end is often located in the lens capsule and the other end is located in the ciliary sulcus. The possibility of anteroposterior displacement also exists. Using a modified Gullstrand schematic model eye, we have computed the amount of spherical and cylindrical errors that are induced due to the tilt and/or displacement of the intraocular lens. If a cylindrical error of approximately 90 degrees from the axis of insertion (lens plus haptic loops) and/or axis of tilt is detected, further careful investigation is warranted.

Frequency dependence in scotopic flicker sensitivity.

Sensitivity to rod-mediated (scotopic) flicker was parametrically studied in the parafoveal retina of human observers. Confirming prior studies, the present results show that sensitivity to scotopic flicker has many similarities to that at photopic levels. Specifically, our results show that the frequency response function for scotopic flicker is characterized by both low- and high-frequency cutoffs and that sensitivity to low frequencies is described by Weber's law. Overall, however, scotopic flicker sensitivity is characterized by higher increment thresholds and lower frequency tuning than photopic flicker. The influences of spatial factors and the prevailing level of illuminance on sensitivity is sufficiently different for relatively low (less than 3 Hz) and relatively high (greater than 5 Hz) temporal frequencies to suggest that they may be mediated by different channels. This possibility is also suggested by selective adaptation experiments. These show that adaptation to flicker frequencies of 3, 5, and 7 Hz have a similar influence on sensitivity to subsequent flicker which is different from the influence on 1 Hz flicker adaptation. Results are compared with prior evidence for channeling within both the scotopic and photopic visual systems.

LEDs: convenient, inexpensive sources for visual experimentation.

This article presents the electrical and optical properties of LEDs for use as visual stimulators in neurophysiological and psychophysical research. one particular circuit is considered in detail which should enable an investigator with minimal technical expertise to build a high quality and versatile stimulator within a few hours and at a minimal cost. Improved circuits and anticipated developments in LED technology are discussed.

Discrimination of relative spatial position.

Subjects can accurately discriminate small changes in the relative position of features within a pattern. Simple patterns (intersected line segments) can undergo magnification and a variety of transformations without significantly affecting the discrimination thresholds. Features to be localized and compared need not be similar. We suggest that such relative position discriminations could support complex object identification.

Agency orientation and chronic musculoskeletal pain: effects of a group learning program based on the personal construct theory.

OBJECTIVE: This study evaluated the effects of a group learning program on patients with chronic musculoskeletal pain and high absenteeism and investigates what characterizes those patients who may benefit from such a program. The learning program was based on personal construct theory. The theory included the following: (1) participation in an educational program is related to a favorable outcome across the outcome measures (pain, pain coping, management of daily life, absenteeism, and use of health care), (2) patients with high agency orientation (i.e., inner-directed) cope with their pain and manage daily life in a better manner than do patients with low agency orientation (i.e., outer-directed), and (3) patients with high personal control, measured in terms of agency orientation, in terms of health locus of control, or in both terms, will benefit more from the educational program than will patients with low personal control. DESIGN: The study was a randomized controlled study. PATIENTS: One hundred and sixteen patients with chronic musculoskeletal pain and high absenteeism answered a questionnaire before and after the intervention program. The intervention group (n = 61) consisted of nine subgroups geographically spread through the eastern part of Norway and met for four hours every 2 weeks from February 1997 to October 1997. A total of 12 meetings were held. RESULTS: The intervention group reported a significantly higher score for the variable "management of everyday life" (p <0.005) and for the variable "health care consumption" (p <0.001) than did the control group. Patients with high agency orientation benefited more from the program with regard to pain reduction and improved pain coping than did those patients with low agency orientation (p <0.05). Patients with high agency orientation also reported less absenteeism than did those patients with low agency orientation (p <0.05).

A rate distortion optimal ECG coding algorithm.

Signal compression is an important problem encountered in many applications. Various techniques have been proposed over the years for addressing the problem. In this paper, we present a time domain algorithm based on the coding of line segments which are used to approximate the signal. These segments are fit in a way that is optimal in the rate distortion sense. Although the approach is applicable to any type of signal, we focus, in this paper, on the compression of electrocardiogram (ECG) signals. ECG signal compression has traditionally been tackled by heuristic approaches. However, it has been demonstrated [1] that exact optimization algorithms outperform these heuristic approaches by a wide margin with respect to reconstruction error. By formulating the compression problem as a graph theory problem, known optimization theory can be applied in order to yield optimal compression. In this paper, we present an algorithm that will guarantee the smallest possible distortion among all methods applying linear interpolation given an upper bound on the available number of bits. Using a varied signal test set, extensive coding experiments are presented. We compare the results from our coding method to traditional time domain ECG compression methods, as well as, to more recently developed frequency domain methods. Evaluation is based both on percentage root-mean-square difference (PRD) performance measure and visual inspection of the reconstructed signals. The results demonstrate that the exact optimization methods have superior performance compared to both traditional ECG compression methods and the frequency domain methods.

SLO radiant power and brightness.

Available output in the Scanning Laser Ophthalmoscope (SLO) may be expressed as radiant power at the beam pivot (SLO exit pupil), in units of microwatts (microW). This power corresponds to dimensions of brightness (like luminance and retinal illuminance) and to a range of related measures (like cd/m2, lm/m2, and the troland value) in both free and Maxwellian views. We demonstrate that the conversion factor power/troland=1.26*10(-3) microW and 3.15*10(-4) microW for SLO nominal visual angles 40 degrees and 20 degrees, respectively. The factor permits measured SLO power to be expressed in units of brightness and (inversely) brightnesses of everyday objects to be expressed in units of SLO power. Examples of both conversions are given. Reference to the literature demonstrates the importance of expressing SLO power in brightness terms common to everyday activities and to visual function-testing instruments besides the SLO.

SLO power calibration.

We present a method for calibrating the Scanning Laser Ophthalmoscope (SLO) that predicts radiant power at any of 256 grayscale values (gsv) and 12 polarized filter (polarizer) levels. Predicted power values, p(gsv), were determined by substitution into polynomials linearly transformed to old or new power at p(0) and p(255). This was compared with observed power values at 125 levels of attenuation/session. Prediction accuracy was the proportion of nonsignificant pairwise comparisons (t-test, p=0.0001). We found that power transformation between polarizers and within sessions has both linear and nonlinear characteristics. Within polarizer and between sessions, however, power transformation has linear characteristics. A 5th-degree polynomial was individually fit, at each polarizer, to session 1 power distributions of 9 gsv steps (0, 31, 63, 95, 127, 159, 191, 223, 255). When adjusted to p(255) and p(0) in new sessions, we obtained p(gsv) that predicted power at 25 gsv * 5 polarizers for 18 days with an accuracy of about 0.84. When only adjusted to p(255), predictive accuracy was 0.81.

Os subtibiale: esa rara molestia en el tobillo / Os subtibiale: That odd ankle pain

El os subtibiale es un hueso accesorio del tobillo, poco frecuente. Localizado en el colículo posterior del maléolo tibial interno, puede verse en edad pediátrica y adulta. Puede causar dolor, enrojecimiento y/o inflamación del tobillo, pudiendo llevar al diagnóstico erróneo de fractura avulsiva. Su conocimiento anatómico es crucial. Se presenta el caso de un paciente en edad escolar, valorado en consulta por dolor en la cara interna de ambos tobillos durante 2 meses tras traumatismo casual. En segundo lugar, un paciente adulto con dolor en la cara interna del tobillo derecho de 3 días de evolución, sin traumatismo, valorado en urgencias. Es imprescindible la correcta anamnesis y exploración física. El diagnóstico se realiza mediante radiología convencional de tobillos, proyección anteroposterior y lateral en carga. El tratamiento inicial es conservador (férulas u ortesis) para establecer y mantener las funciones del pie durante las actividades en carga. Si persiste tras 6 meses, se podría plantear tratamiento quirúrgico (AU)

Os subtibiale is a low prevalence accessory bone of the ankle. This bone is located in the posterior colliculus of the tibial medial malleolus, both in paediatric and adult ages. It can cause pain, redness and/or swelling, which can lead to a mistaken diagnosis of avulsion fracture. Adequate anatomical knowledge is crucial. First, we present the case of a school-aged boy, seen at the outpatient clinic for a 2-month history of pain in both inner ankles after an injury. Second, we present the case of an adult patient with a 3-day history of right medial ankle pain, with no previous injury, evaluated at the Emergency Department. Accurate history-taking and physical examination are essential. The diagnosis is given by conventional radiology of both ankles, in antero-posterior and lateral load views. The initial treatment is conservative (splint or orthesis) to establish and maintain the function of the foot during loading activities. If there is no recovery after 6 months, surgical treatment can be considered (AU)