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.

SYSTEMIC TOXICITY IN RODENTS FOLLOWING ACUTE AND SUBCHRONIC INHALATION OF FORMALDEHYDE (FLOW CYTOMETRY, CELL CYCLE KINETICS, ALKALINE ELUTION)

Systemic toxicity was evaluated in Sprague-Dawley (SD) rats and A-strain mice exposed to HCHO inhalation at 0, 0.5, 3, or 15 ppm for six hours/day, five days/week for up to 24 weeks. Toxicity was measured by flow cytometry to detect changes in cell cycle RNA and DNA content and by alkaline elution to detect DNA protein cross-link (DPC) formation.^ A G(,2)M block was detected in SD rat marrow following one week of exposure to 0.5, 3, or 15 ppm HCHO, but this block did not persist. No effect was noticed in mouse marrow. Only a minimal increase in RNA content was detected in rat or mouse marrow while exfoliated lung cells showed a significant increase in RNA activity after one week of exposure.^ Acute exposure in SD rats for four hours/day for one or three days at 150 ppm showed an increase in RNA activity in exfoliated lung cells but not in the marrow after one day. On the third day, dead cells were detected in exfoliated lung cells.^ In alkaline elution studies, no DPC were detected in marrow of SD rats after 24 weeks exposure up to 15 ppm. During acute exposures, a dose response relationship was detected in SD rat exfoliated lung cells which yielded cross-linking factors of 0.954, 1.237, and 1.417 following a four hour exposure to 15, 50, or 150 ppm, respectively. No DPC were detected in the marrow at 150 ppm. In vitro exposures to HCHO of CHO and SHE cells and rat marrow cells revealed the production of DPC and DNA-DNA cross-links.^ Cytoxan treatment of SD rats was used to provide positive controls for flow cytometry and alkaline elution. A drastic reduction in RNA content and cycling cells occurred one day following treatment. After four days, RNA content was greatly increased; and on day eleven the marrow had regenerated. DPCs were detected in both the marrow and the exfoliated lung cells.^ The lack of significant responses in SD rats and A-strain mice below 15 ppm HCHO is explainable by host defense mechanisms. Apparently, the mucociliary apparatus and enzymatic detoxification are sufficient to reduce systemic toxicity to low level concentrations of formaldehyde. ^

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.

A link density clustering algorithm based on automatically selecting density peaks for overlapping community detection

Peer reviewed

(Table 1) Age and depth of reflectors of the 3.5-kHz and airgun seismic record and their corresponding depth of ash layers, carbonate peaks, and transition zones from DSDP Hole 83-504B

DSDP cores from areas of low (Site 505) and high heat flow (Site 504 B) near the Costa Rica Rift, together with seismic profiles from the Panama Basin, have been studied to determine the relationship between: (1) carbonate content and physical and acoustic properties; and (2) carbonate content, carbonate diagenesis and acoustic stratigraphy. Except for ash and chert layers, bulk density correlates strongly and linearly with carbonate content. Velocity is uniform downcore and only small variations at a small scale are measured. Thus an abrupt change in carbonate content will cause abrupt changes in acoustic impedance and should cause reflectors that can be detected acoustically. A comparison of seismic profiler reflection records with physical properties, carbonate content and reflection coefficients indicates that the main reflectors can be identified with ash layers, diagenetic boundaries, and carbonate content variations. Diagenesis of carbonate sediments is present at Site 504B in a 260 m-thick ooze-chalk-limestone/chert sequence. These diagenetic sequences occur in areas of higher heat flow (200 mW/m**2). Seismic profiler records can be used to map the extent and depth of these diagenetic boundaries.

Milankovitch frequency peaks of ODP Site 113-693 (Table 3)

The first well logs collected below the Antarctic circle were obtained during Leg 113 at Site 693 on the Dronning Maud Land Margin (Antarctica) in the Weddell Sea. Gamma-ray, resistivity, and sonic logs were collected between 108.0 and 439.0 mbsf. The downhole logs show good agreement with the data collected from cores and provide a continuous measurement of the sedimentary record. These continuous log records show that the rather uniform Tertiary lithology seen in cores is characterized by high-frequency variability in the log data. Several thin hard streaks are identified, the largest of which coincides with a major Miocene hiatus. Associated with this hiatus is a change to lower illite content (and correspondingly lower gamma-ray counts) and to a significant increase in diatom content. Spectral analysis of the logs was performed on the lower Pliocene through upper Oligocene interval (108.0-343.0 mbsf). Between 108.0 and 245.0 mbsf, average sedimentation rates (50 and 26 m/m.y.) are high enough to show that variance is present in the orbital eccentricity (~95 k.y.) and obliquity (~41 k.y.) bands. Between 253.0 and 343.0 mbsf, the sedimentation rate (8 m/m.y.) is too low to resolve high frequency variations. The Milankovitch frequencies are best developed in the resistivity logs. Resistivity is responding to changes in porosity, which in these sediments is controlled by the abundance of biosiliceous sediments, particularly diatoms. The orbital forcing suggested by the Milankovitch frequencies may be influencing diatom productivity by inducing oscillations in upwelling, ice coverage, pack ice, and/or polynya. Although variations in diatom abundance were observed in the cores, they were not attributed to a Milankovitch signal, and therefore in this environment, downhole logs are an important contribution to the detection and understanding of orbitally influenced changes in sedimentation.