Validation of climate model-inferred regional temperature change for late-glacial Europe

Comparisons of climate model hindcasts with independent proxy data are essential for assessing model performance in non-analogue situations. However, standardized palaeoclimate data sets for assessing the spatial pattern of past climatic change across continents are lacking for some of the most dynamic episodes of Earth’s recent past. Here we present a new chironomid-based palaeotemperature dataset designed to assess climate model hindcasts of regional summer temperature change in Europe during the late-glacial and early Holocene. Latitudinal and longitudinal patterns of inferred temperature change are in excellent agreement with simulations by the ECHAM-4 model, implying that atmospheric general circulation models like ECHAM-4 can successfully predict regionally diverging temperature trends in Europe, even when conditions differ significantly from present. However, ECHAM-4 infers larger amplitudes of change and higher temperatures during warm phases than our palaeotemperature estimates, suggesting that this and similar models may overestimate past and potentially also future summer temperature changes in Europe.

Edward I., 1275 - 1277

ed. by Hilary Jenkinson

The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study: protocol for an international multicentre randomised controlled trial

INTRODUCTION Postoperative delirium is one of the most common complications of major surgery, affecting 10-70% of surgical patients 60 years and older. Delirium is an acute change in cognition that manifests as poor attention and illogical thinking and is associated with longer intensive care unit (ICU) and hospital stay, long-lasting cognitive deterioration and increased mortality. Ketamine has been used as an anaesthetic drug for over 50 years and has an established safety record. Recent research suggests that, in addition to preventing acute postoperative pain, a subanaesthetic dose of intraoperative ketamine could decrease the incidence of postoperative delirium as well as other neurological and psychiatric outcomes. However, these proposed benefits of ketamine have not been tested in a large clinical trial. METHODS The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study is an international, multicentre, randomised controlled trial. 600 cardiac and major non-cardiac surgery patients will be randomised to receive ketamine (0.5 or 1 mg/kg) or placebo following anaesthetic induction and prior to surgical incision. For the primary outcome, blinded observers will assess delirium on the day of surgery (postoperative day 0) and twice daily from postoperative days 1-3 using the Confusion Assessment Method or the Confusion Assessment Method for the ICU. For the secondary outcomes, blinded observers will estimate pain using the Behavioral Pain Scale or the Behavioral Pain Scale for Non-Intubated Patients and patient self-report. ETHICS AND DISSEMINATION The PODCAST trial has been approved by the ethics boards of five participating institutions; approval is ongoing at other sites. Recruitment began in February 2014 and will continue until the end of 2016. Dissemination plans include presentations at scientific conferences, scientific publications, stakeholder engagement and popular media. REGISTRATION DETAILS The study is registered at clinicaltrials.gov, NCT01690988 (last updated March 2014). The PODCAST trial is being conducted under the auspices of the Neurological Outcomes Network for Surgery (NEURONS). TRIAL REGISTRATION NUMBER NCT01690988 (last updated December 2013).

Low correlation between self-report and medical record documentation of urinary tract infection symptoms.

BACKGROUND Correlations between symptom documentation in medical records and patient self-report (SR) vary depending on the condition studied. Patient symptoms are particularly important in urinary tract infection (UTI) diagnosis, and this correlation for UTI symptoms is currently unknown. METHODS This is a cross-sectional survey study in hospitalized patients with Escherichia coli bacteriuria. Patients were interviewed within 24 hours of diagnosis for the SR of UTI symptoms. We reviewed medical records for UTI symptoms documented by admitting or treating inpatient physicians (IPs), nurses (RNs), and emergency physicians (EPs). The level of agreement between groups was assessed using Cohen κ coefficient. RESULTS Out of 43 patients, 34 (79%) self-reported at least 1 of 6 primary symptoms. The most common self-reported symptoms were urinary frequency (53.5%); retention (41.9%); flank pain, suprapubic pain, and fatigue (37.2% each); and dysuria (30.2%). Correlation between SR and medical record documentation was slight to fair (κ, 0.06-0.4 between SR and IPs and 0.09-0.5 between SR and EDs). Positive agreement was highest for dysuria and frequency. CONCLUSION Correlation between self-reported UTI symptoms and health care providers' documentation was low to fair. Because medical records are a vital source of information for clinicians and researchers and symptom assessment and documentation are vital in distinguishing UTI from asymptomatic bacteriuria, efforts must be made to improve documentation.

Empowering Teachers as Leaders: A Hard Sell

Despite emphasis on preparing teachers as leaders, teacher educators realize that the transition of classroom practitioners into school leaders is fraught with many obstacles. This session addresses some of these obstacles, describes strategies and opportunities that we have used in our graduate master’s degree programs for teachers that support professionals as they make this change. The session will present evidence on the results of our efforts in terms of teachers’ performances within their programs and in the field after they graduate.

New insights into the role of the duodenal vitamin D receptor in calcium homeostasis

It is generally believed that 1,25(OH)2D3, bound to its receptor (VDR) contributes to calcium homeostasis by regulating active calcium absorption in the proximal small intestine. However, studying patients with hereditary vitamin D-resistant rickets (HVDRR) provided investigators with a better understanding of VDR's role in calcium homeostasis. HVDRR patients have inactivating mutations in the VDR, and as a consequence they develop hypocalcemia, hyperparathyroidism and severe rickets. However, these phenotypes can be corrected if the patients are given IV infusions of calcium or dietary calcium. This raises the question of what is the physiological significance of VDR-regulated active calcium absorption if calcium homeostasis can be restored independently of the VDR. ^ In order to distinguish the contribution of VDR in the proximal small intestine to overall calcium homeostasis, I generated transgenic mice expressing the human VDR (hVDR) exclusively in the proximal small intestine of mVDR-/- mice by using an hVDR-expressing transgene driven by the duodenal-specific adenosine deaminase enhancer (hVDR+/mVDR-/-). hVDR+/mVDR-/- mice expressed transcriptionally active hVDR only in the proximal small intestine and responded to 1,25(OH)2D3 by up-regulating expression of TRPV6 and calbindin D9K, genes involved in calcium absorption. Furthermore, ligated duodenal loop assays determined that calcium absorption in hVDR+/mVDR-/- mice was as responsive to 1,25(OH)2D3 as in WT mice. Despite having a functional hVDR in the proximal small intestine, hVDR+/mVDR-/- mice were hypocalcemic, had hyperparathyroidism, and were rachitic when fed a normal rodent diet at weaning, as were the mVDR-/- mice. However, when fed a high calcium, phosphorus, and lactose diet (rescue diet), the hVDR+/mVDR-/- mice responded more effectively than the mVDR-/- mice by down-regulation of parathyroid hormone production and by a greater increase in bone mineralization. Furthermore, when three-month-old rachitic mice were fed a rescue diet for 3 weeks, serum calcium and bone mineral content were normalized in hVDR+/mVDR-/- mice, but not in mVDR-/- mice. ^ In conclusion, hVDR expression enabled young mice to better use the rescue diet than mVDR-/- mice. Expression of transgenic hVDR also protected the ability of older mice to respond to the rescue diet despite the absence of the VDR elsewhere in the intestinal tract. I propose that because hVDR+/mVDR-/- mice responded better than mVDR-/- mice to the rescue diet, it is likely that VDR expression in the proximal small intestine is necessary in nutritional (insufficient dietary calcium) and physiological (age) conditions when passive calcium absorption is inadequate. ^

Childhood cancer survivor satisfaction with characteristics of clinical care

This study investigated the characteristics of a clinic that affect how satisfied survivors of childhood cancer are with their medical care. Questionnaire and interview data from the Passport for Care: Texas Implementation project collected between January 2011 to April 2012 were analyzed. Eleven clinics in Texas participated. Questionnaire respondents were childhood cancer survivor patients who had been off therapy for at least 2 years, or their parents. Interview respondents were clinical providers or research staff at the participating clinics. The outcomes evaluated were answers to a single question on satisfaction with care and a composite Percent Satisfaction Score created from seven other questionnaire items that were correlated (Spearman Rho >0.3) with the question on satisfaction. The following characteristics were also evaluated: sex, age, race, education, and type of cancer. The following clinic indicators were evaluated: type of clinic (general vs. dedicated cancer survivor clinics), number of providers, number of survivors, ratio of survivors/providers, distribution of handouts, distribution of treatment summaries, and use of Children's Oncology Group (COG) guidelines. ^ The only demographic characteristic that affected satisfaction was race. A Kruskal-Wallis test showed a statistically significant difference (Chi-square 6.129, 2 d.f., p = 0.0467). To analyze this further, Wilcoxon Rank Sum test of pairings of the three groups were performed. A Bonferroni correction for multiple testing was applied, with p = 0.017 indicating significance at alpha = 0.05. There was no significant difference between the White and Hispanic groups or between the Hispanic and "Other" groups. For the White and "Other" groups there was a significant difference for the satisfaction item (p = 0.0123) but not for the Percent Satisfaction Score (p = 0.0289). These results suggest that race may influence satisfaction and should be evaluated further in future studies. ^ None of the clinic indicators affected the Percent Satisfaction Score. Going to a clinic that distributed patient information handouts (Wilcoxon Rank Sum p = 0.048) and going to a clinic with >=100 survivors (Wilcoxon Rank Sum p = 0.021) were associated with increased satisfaction. The population of childhood cancer survivors is a growing group of individuals with special health needs. In the future survivors will likely seek medical care in a variety of clinical settings, so it is important to investigate features to improve patient satisfaction with clinical care.^

Distribution of planktonic foraminifera in Pleistocene sediments of the New Jersey margin, NW Atlantic Ocean

Abundance records of planktonic foraminifera (>150 µm) from the upper 520 m of ODP Site 1073 (Hole 1073A, Leg 174A, 639 m water depth) have been integrated with SPECMAP-derived isotope stratigraphy, percentage of calcium carbonate, and coarse sediment fraction data in order to investigate the Pleistocene climatic history of the New Jersey margin. Six planktonic taxonomic groups dominate the foraminiferal assemblage at Site 1073: Neogloboquadrina pachyderma (d) (mean 33.8%), Turborotalita quinqueloba (18.5%), N. pachyderma (s) (18.4%), Globigerina bulloides group (11.4%), Globorotalia inflata group (9.4%), and Globigerinita glutinata (4.1%). Based on the distributions of these six foraminiferal groups, the Pleistocene section can be divided into three paleoclimatic intervals: Interval I (intermediate) corresponds to the Quaternary sediments from sequence boundary pp1 to the seafloor (79.5-0 mbsf; Emiliania huxleyi acme [85 ka] at 72 mbsf); Interval II (warm) occurs between sequence boundaries pp3 and pp1 (325-79.5 mbsf; last occurrence of Pseudoemiliania lacunosa [460 ka] at 330 mbsf); and Interval III (coldest) occurs between sequence boundaries pp4 and pp3 (520-325 mbsf; Calcareous nannofossils and dinocysts in proximity to pp4 indicate that the sedimentary record for 0.9-1.7 Ma is either missing altogether or highly condensed within the basal few meters of the section). Neogloboquadrina pachyderma (d) displays eight peaks of abundance which correlate, for the most part, with depleted delta18O values, increases in calcium carbonate percentages, low coarse fraction percentages, increased planktonic fragmentation (greater dissolution), and low N. pachyderma (s) abundances. These intervals are interpreted as representing warmer/interglacial conditions. Neogloboquadrina pachyderma (s) displays seven peaks of abundance which correlate, for the most part, with delta18O increases, decreases in calcium carbonate percentages, increases in coarse fraction percentages, and low N. pachyderma (d) abundances. These intervals are interpreted as representing cooler/glacial conditions. In Interval III, a faunal response to relative changes in sea-surface temperature is reflected by abundance peaks in Neogloboquadrina pachyderma (d), followed by Turborotalita quinqueloba and then N. pachyderma (s) (proceeding from warmest to coolest, respectively). This tripartite response is consistent with the oxygen isotope record and, although not as clear, also occurs in Intervals I and II. Six peaks/peak intervals of Globigerina bulloides abundance are closely matched by peaks in Globigerinita glutinata and occur within oxygen isotope stage (OIS) 2 (latter part) 3, 4, 5, 8, 9, 13(?), 14(?), and 15(?). We speculate that these intervals reflect increased upwelling and nutrient levels during both glacials and interglacials. Eight peak intervals of Globorotalia inflata show a general inverse correlation with G. bulloides and may reflect lowered nutrient and warmer surface waters.

Sobre la compatibilidad entre realismo y relativismo conceptual : Un exámen de la tesis de Putnam, desde un punto de vista lógico

Las indagaciones en la pregunta por lo que hay permiten distinguir a grandes rasgos entre dos enfoques: uno, el de los pensadores que entendieron que el tema a investigar era la naturaleza y estructura del mundo, y otro, el de aquellos quienes, al sostener que describir el mundo no es simplemente copiarlo, atendieron a lo que se llamó esquema conceptual: esto es, al marco conceptual cuya forma toman las descripciones del mundo. La situación se puede plantear como un dilema, ninguno de cuyos cuernos permite alentar esperanzas de avances bien fundados. O bien se pretende describir el mundo, tal como es, sin contemplar el hecho de que esa descripción incluye elecciones conceptuales propias de un sujeto, o bien se centra la investigación en los rasgos de el/los esquema/s conceptual/es imprescindibles para construir una descripción del mundo, imposibilitando, con ello, el acceso a la realidad tal como ésta es. En el siglo XX se cuenta con recursos de sistemas de lógica considerablemente más desarrollados y abarcadores (en sus posibilidades de aplicación) que los anteriores. Tales recursos brindan nuevas posibilidades de abordaje de la pregunta por lo que hay, no sólo por los ámbitos que se clarifican mediante ellos, sino también por el sustento que ofrecen para la reflexión filosófica los resultados obtenidos. Los avances producidos en el ámbito de la lógica en algo más de un siglo tuvieron variadas repercusiones en el enfoque y el tratamiento de distintas cuestiones filosóficas. Así, se ha echado mano a conceptos y recursos de lógica al considerar preguntas acerca de la estructura del mundo. Para la determinación de los componentes de la realidad se ha recurrido a la lógica, desde diversas posiciones filosóficas. Por ejemplo, se ha entendido que la lógica subyacente a la teoría científica brinda en algún sentido elementos para determinar la ontología (o para descartar la posibilidad de hacerlo, o para establecer qué función cumple la noción de ontología en la teoría científica). También, desde una óptica más amplia, se ha intentado mostrar que el uso del lenguaje tiene consecuencias respecto de la ontología. Hilary Putnam ha sugerido la posibilidad de ser al mismo tiempo un realista y un relativista conceptual. Involucra consideraciones como las mencionadas, respecto de lógica y ontología. Su objetivo es el intento de hacer justicia a la realidad y al misterio de nuestro mundo de sentido común. Tomo esta tesis como una propuesta de trabajo. Me interesa pensar en cómo ofrecer algunos elementos de juicio para evaluar sus alcances. Para ello, examino la sugerencia de Putnam mediante un ejemplo construido con ese objetivo. Entiendo que se requerirán, al menos, dos esquemas conceptuales diferentes: al que surgiría de la lógica de orden 1, tal como la desarrolla Quine, y al que podría obtenerse a partir de la teoría de objetos no existentes de Castañeda. Se contará así con elementos de juicio más precisos que los habituales para evaluar las consecuencias que se seguirían para la ontología en caso de sostener ambos esquemas conceptuales, en consonancia con la propuesta de Putnam que se ha tomado como objetivo general del proyecto

Sobre la compatibilidad entre realismo y relativismo conceptual : Un exámen de la tesis de Putnam, desde un punto de vista lógico

Las indagaciones en la pregunta por lo que hay permiten distinguir a grandes rasgos entre dos enfoques: uno, el de los pensadores que entendieron que el tema a investigar era la naturaleza y estructura del mundo, y otro, el de aquellos quienes, al sostener que describir el mundo no es simplemente copiarlo, atendieron a lo que se llamó esquema conceptual: esto es, al marco conceptual cuya forma toman las descripciones del mundo. La situación se puede plantear como un dilema, ninguno de cuyos cuernos permite alentar esperanzas de avances bien fundados. O bien se pretende describir el mundo, tal como es, sin contemplar el hecho de que esa descripción incluye elecciones conceptuales propias de un sujeto, o bien se centra la investigación en los rasgos de el/los esquema/s conceptual/es imprescindibles para construir una descripción del mundo, imposibilitando, con ello, el acceso a la realidad tal como ésta es. En el siglo XX se cuenta con recursos de sistemas de lógica considerablemente más desarrollados y abarcadores (en sus posibilidades de aplicación) que los anteriores. Tales recursos brindan nuevas posibilidades de abordaje de la pregunta por lo que hay, no sólo por los ámbitos que se clarifican mediante ellos, sino también por el sustento que ofrecen para la reflexión filosófica los resultados obtenidos. Los avances producidos en el ámbito de la lógica en algo más de un siglo tuvieron variadas repercusiones en el enfoque y el tratamiento de distintas cuestiones filosóficas. Así, se ha echado mano a conceptos y recursos de lógica al considerar preguntas acerca de la estructura del mundo. Para la determinación de los componentes de la realidad se ha recurrido a la lógica, desde diversas posiciones filosóficas. Por ejemplo, se ha entendido que la lógica subyacente a la teoría científica brinda en algún sentido elementos para determinar la ontología (o para descartar la posibilidad de hacerlo, o para establecer qué función cumple la noción de ontología en la teoría científica). También, desde una óptica más amplia, se ha intentado mostrar que el uso del lenguaje tiene consecuencias respecto de la ontología. Hilary Putnam ha sugerido la posibilidad de ser al mismo tiempo un realista y un relativista conceptual. Involucra consideraciones como las mencionadas, respecto de lógica y ontología. Su objetivo es el intento de hacer justicia a la realidad y al misterio de nuestro mundo de sentido común. Tomo esta tesis como una propuesta de trabajo. Me interesa pensar en cómo ofrecer algunos elementos de juicio para evaluar sus alcances. Para ello, examino la sugerencia de Putnam mediante un ejemplo construido con ese objetivo. Entiendo que se requerirán, al menos, dos esquemas conceptuales diferentes: al que surgiría de la lógica de orden 1, tal como la desarrolla Quine, y al que podría obtenerse a partir de la teoría de objetos no existentes de Castañeda. Se contará así con elementos de juicio más precisos que los habituales para evaluar las consecuencias que se seguirían para la ontología en caso de sostener ambos esquemas conceptuales, en consonancia con la propuesta de Putnam que se ha tomado como objetivo general del proyecto

Sobre la compatibilidad entre realismo y relativismo conceptual : Un exámen de la tesis de Putnam, desde un punto de vista lógico

Las indagaciones en la pregunta por lo que hay permiten distinguir a grandes rasgos entre dos enfoques: uno, el de los pensadores que entendieron que el tema a investigar era la naturaleza y estructura del mundo, y otro, el de aquellos quienes, al sostener que describir el mundo no es simplemente copiarlo, atendieron a lo que se llamó esquema conceptual: esto es, al marco conceptual cuya forma toman las descripciones del mundo. La situación se puede plantear como un dilema, ninguno de cuyos cuernos permite alentar esperanzas de avances bien fundados. O bien se pretende describir el mundo, tal como es, sin contemplar el hecho de que esa descripción incluye elecciones conceptuales propias de un sujeto, o bien se centra la investigación en los rasgos de el/los esquema/s conceptual/es imprescindibles para construir una descripción del mundo, imposibilitando, con ello, el acceso a la realidad tal como ésta es. En el siglo XX se cuenta con recursos de sistemas de lógica considerablemente más desarrollados y abarcadores (en sus posibilidades de aplicación) que los anteriores. Tales recursos brindan nuevas posibilidades de abordaje de la pregunta por lo que hay, no sólo por los ámbitos que se clarifican mediante ellos, sino también por el sustento que ofrecen para la reflexión filosófica los resultados obtenidos. Los avances producidos en el ámbito de la lógica en algo más de un siglo tuvieron variadas repercusiones en el enfoque y el tratamiento de distintas cuestiones filosóficas. Así, se ha echado mano a conceptos y recursos de lógica al considerar preguntas acerca de la estructura del mundo. Para la determinación de los componentes de la realidad se ha recurrido a la lógica, desde diversas posiciones filosóficas. Por ejemplo, se ha entendido que la lógica subyacente a la teoría científica brinda en algún sentido elementos para determinar la ontología (o para descartar la posibilidad de hacerlo, o para establecer qué función cumple la noción de ontología en la teoría científica). También, desde una óptica más amplia, se ha intentado mostrar que el uso del lenguaje tiene consecuencias respecto de la ontología. Hilary Putnam ha sugerido la posibilidad de ser al mismo tiempo un realista y un relativista conceptual. Involucra consideraciones como las mencionadas, respecto de lógica y ontología. Su objetivo es el intento de hacer justicia a la realidad y al misterio de nuestro mundo de sentido común. Tomo esta tesis como una propuesta de trabajo. Me interesa pensar en cómo ofrecer algunos elementos de juicio para evaluar sus alcances. Para ello, examino la sugerencia de Putnam mediante un ejemplo construido con ese objetivo. Entiendo que se requerirán, al menos, dos esquemas conceptuales diferentes: al que surgiría de la lógica de orden 1, tal como la desarrolla Quine, y al que podría obtenerse a partir de la teoría de objetos no existentes de Castañeda. Se contará así con elementos de juicio más precisos que los habituales para evaluar las consecuencias que se seguirían para la ontología en caso de sostener ambos esquemas conceptuales, en consonancia con la propuesta de Putnam que se ha tomado como objetivo general del proyecto

Paleomagnetism of DSDP Leg 80 holes

Paleomagnetic results from sediments acquired from the continental margin at DSDP Sites 548, 549, 550, and 551 are described. Where possible, the results were used to construct a polarity reversal stratigraphy for the sections sampled, thus enabling the biostratigraphic dating of the sediments to be refined. Several sections in this study were found to be suitable for magnetostratigraphic work, in particular the upper Paleocene to middle Eocene sediments from Site 549, which contained rich faunal assemblages. These sediments are underlain by a thick sequence of Cretaceous sediments that formed during the Long Cretaceous normal polarity interval. Sediments that formed during the later part of this magnetically quiet interval were also recovered at Site 550. Three short reverse polarity intervals were also recovered at this site; they lie directly over basement and are thought to represent a mixed-polarity interval of late Albian age. They may therefore provide important evidence concerning the age of the earliest sediments at this site. In addition, measurements of the magnetic susceptibility and intensity of remanent magnetism proved to be of interest. A significant decrease in the susceptibility and intensity values close to the early/middle Eocene boundary was noted at Sites 548 and 549. This decrease may be correlated with the results from Holes 400A and 401, which were drilled on DSDP Leg 48 in the northeast Bay of Biscay. The decrease may represent an abrupt reduction in the supply of terrigenous material at the end of the early Eocene, reflecting, perhaps, a change in sediment transport processes at that time

Radiocarbon ages and diatom isotope data for Lake El'gygytgyn sediment core Lz1029

Determining the response of sites within the Arctic Circle to long-term climatic change remains an essential pre-requisite for assessing the susceptibility of these regions to future global warming and Arctic amplification. To date, existing records from North East Russia have demonstrated significant spatial variability across the region during the late Quaternary. Here we present diatom d18O and d30Si data from Lake El'gygytgyn, Russia, and suggest environmental changes that would have impacted across West Beringia from the Last Glacial Maximum to the modern day. In combination with other records, the results raise the potential for climatic teleconnections to exist between the region and sites in the North Atlantic. The presence of a series of 2-3 per mil decreases in d18Odiatom during both the Last Glacial and the Holocene indicates the sensitivity of the region to perturbations in the global climate system. Evidence of an unusually long Holocene thermal maximum from 11.4 ka BP to 7.6 ka BP is followed by a cooling trend through the remainder of the Holocene in response to changes in solar insolation. This is culminated over the last 900 years by a significant decrease in d18Odiatom of 2.3 per mil, which may be related to a strengthening and easterly shift of the Aleutian Low in addition to possible changes in precipitation seasonality.