Noise peaks influence communication in the operating room. An observational study

Noise peaks are powerful distractors. This study focuses on the impact of noise peaks on surgical teams' communication during 109 long abdominal surgeries. We related measured noise peaks during 5-min intervals to the amount of observed communication during the same interval. Results show that noise peaks are associated with less case-relevant communication; this effect is moderated by the level of surgical experience; case-relevant communications decrease under high noise peak conditions among junior, but not among senior surgeons. However, case-irrelevant communication did not decrease under high noise level conditions, rather there was a trend to more case-irrelevant communication under high noise peaks. The results support the hypothesis that noise peaks impair communication because they draw on attentional resources rather than impairing understanding of communication. As case-relevant communication is important for surgical performance, exposure to high noise peaks in the OR should be minimised especially for less experienced surgeons. Practitioner Summary: This study investigated whether noise during surgeries influenced the communication within surgical teams. During abdominal surgeries, noise levels were measured and communication was observed. Results showed that high noise peaks reduced the frequency of patient-related communication, but did not reduce patient-irrelevant communication. Noise may negatively affect team coordination in surgeries.

Chemical composition of Lake George (New York) iron-manganese nodules and underlying sediment

Lake George, New York, is the site of a new discovery of iron-manganese nodules. These nodules occur at a water depth between 21 and 36 m along a stretch of lake extending for about 5 mi north and south of the Narrows, a constricted island-dotted area which separates the north and south Lake George basins. Nodules occur on or within the uppermost 5 cm of a varved glacial clay. Some areas are solidly floored with a carpet of nodules in areas where active currents keep the nodules exposed. The nodules form around nuclei which consist of clay and less commonly of spore capsules, detrital particles, or bark. By their shape we recognize three types of nodules: spherical, discoidal, and lumps. On X-ray examination all nodules show small goethite peaks; in one nodule the manganese mineral birnessite was identified. Manganese and part of the iron appears to be in X-ray amorphous ferromanganese compounds. The Lake George nodules are enriched in iron with respect to marine nodules but are lower in manganese. They have a higher trace element concentration than nodules from other known freshwater lake occurrences, but a lower concentration than marine nodules.

¿Es relevantemente libre el trabajador en el capitalismo (contemporáneo)? : Observaciones sobre la perspectiva de Gerald Cohen

El artículo presenta en primer lugar la argumentación de Gerald Cohen, que minimiza el papel de la coacción que cada proletario experimenta debido a las circunstancias del trabajo asalariado, y en consecuencia niega el carácter opresivo de la explotación capitalista. En segundo término, examina algunas críticas que cuestionan tal argumentación o la veracidad de su premisa, así como las réplicas del autor. Finalmente, sostiene que Cohen no logra hacer convincente su tesis principal, debido a que no tiene en cuenta relevantes distinciones en torno al concepto de libertad, fragmentariamente formuladas por Marx y desarrolladas de forma consistente por Sen

¿Es relevantemente libre el trabajador en el capitalismo (contemporáneo)? : Observaciones sobre la perspectiva de Gerald Cohen

El artículo presenta en primer lugar la argumentación de Gerald Cohen, que minimiza el papel de la coacción que cada proletario experimenta debido a las circunstancias del trabajo asalariado, y en consecuencia niega el carácter opresivo de la explotación capitalista. En segundo término, examina algunas críticas que cuestionan tal argumentación o la veracidad de su premisa, así como las réplicas del autor. Finalmente, sostiene que Cohen no logra hacer convincente su tesis principal, debido a que no tiene en cuenta relevantes distinciones en torno al concepto de libertad, fragmentariamente formuladas por Marx y desarrolladas de forma consistente por Sen

¿Es relevantemente libre el trabajador en el capitalismo (contemporáneo)? : Observaciones sobre la perspectiva de Gerald Cohen

El artículo presenta en primer lugar la argumentación de Gerald Cohen, que minimiza el papel de la coacción que cada proletario experimenta debido a las circunstancias del trabajo asalariado, y en consecuencia niega el carácter opresivo de la explotación capitalista. En segundo término, examina algunas críticas que cuestionan tal argumentación o la veracidad de su premisa, así como las réplicas del autor. Finalmente, sostiene que Cohen no logra hacer convincente su tesis principal, debido a que no tiene en cuenta relevantes distinciones en torno al concepto de libertad, fragmentariamente formuladas por Marx y desarrolladas de forma consistente por Sen

Log-ratio of silica to aluminium counts (ln(Si/Al)) from ODP site 108-658

Growing evidence suggests that the low atmospheric CO2 concentration of the ice ages resulted from enhanced storage of CO2 in the ocean interior, largely as a result of changes in the Southern Ocean1. Early in the most recent deglaciation, a reduction in North Atlantic overturning circulation seems to have driven CO2 release from the Southern Ocean**2, 3, 4, 5, but the mechanism connecting the North Atlantic and the Southern Ocean remains unclear. Biogenic opal export in the low-latitude ocean relies on silicate from the underlying thermocline, the concentration of which is affected by the circulation of the ocean interior. Here we report a record of biogenic opal export from a coastal upwelling system off the coast of northwest Africa that shows pronounced opal maxima during each glacial termination over the past 550,000 years. These opal peaks are consistent with a strong deglacial reduction in the formation of silicate-poor glacial North Atlantic intermediate water**2 (GNAIW). The loss of GNAIW allowed mixing with underlying silicate-rich deep water to increase the silicate supply to the surface ocean. An increase in westerly-wind-driven upwelling in the Southern Ocean in response to the North Atlantic change has been proposed to drive the deglacial rise in atmospheric CO2 (refs 3, 4). However, such a circulation change would have accelerated the formation of Antarctic intermediate water and sub-Antarctic mode water, which today have as little silicate as North Atlantic Deep Water and would have thus maintained low silicate concentrations in the Atlantic thermocline. The deglacial opal maxima reported here suggest an alternative mechanism for the deglacial CO2 release**5, 6. Just as the reduction in GNAIW led to upward silicate transport, it should also have allowed the downward mixing of warm, low-density surface water to reach into the deep ocean. The resulting decrease in the density of the deep Atlantic relative to the Southern Ocean surface promoted Antarctic overturning, which released CO2 to the atmosphere.

Molecular dissolved organic matter composition in lakes across Sweden as relative intensities of FT-ICR-MS peaks and PARAFAC components and optical indices

Whether intrinsic molecular properties or extrinsic factors such as environmental conditions control the decomposition of natural organic matter across soil, marine and freshwater systems has been subject to debate. Comprehensive evaluations of the controls that molecular structure exerts on organic matter's persistence in the environment have been precluded by organic matter's extreme complexity. Here we examine dissolved organic matter from 109 Swedish lakes using ultrahigh-resolution mass spectrometry and optical spectroscopy to investigate the constraints on its persistence in the environment. We find that degradation processes preferentially remove oxidized, aromatic compounds, whereas reduced, aliphatic and N-containing compounds are either resistant to degradation or tightly cycled and thus persist in aquatic systems. The patterns we observe for individual molecules are consistent with our measurements of emergent bulk characteristics of organic matter at wide geographic and temporal scales, as reflected by optical properties. We conclude that intrinsic molecular properties are an important control of overall organic matter reactivity.