988 resultados para Ne bis in idem


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Critically ill and injured patients require pain relief and sedation to reduce the body's stress response and to facilitate painful diagnostic and therapeutic procedures. Presently, the level of sedation and analgesia is guided by the use of clinical scores which can be unreliable. There is therefore, a need for an objective measure of sedation and analgesia. The Bispectral Index (BIS) and Patient State Index (PSI) were recently introduced into clinical practice as objective measures of the depth of analgesia and sedation. ^ Aim. To compare the different measures of sedation and analgesia (BIS and PSI) to the standard and commonly used modified Ramsay Score (MRS) and determine if the monitors can be used interchangeably. ^ Methods. MRS, BIS and PSI values were obtained in 50 postoperative cardiac surgery patients requiring analgesia and sedation from June to December 2004. The MRS, BIS and PSI values were assessed hourly for up to 6-h by a single observer. ^ The relationship between BIS and PSI values were explored using scatter plots and correlation between MRS, BIS and PSI was determined using Spearman's correlation coefficient. Intra-class correlation (ICC) was used to determine the inter-rater reliability of MRS, BIS and PSI. Kappa statistics was used to further evaluate the agreement between BIS and PSI at light, moderate and deep levels of sedation. ^ Results. There was a positive correlation between BIS and PSI values (Rho = 0.731, p<0.001). Intra-class correlation between BIS and PSI was 0.58, MRS and BIS 0.43 and MRS and PSI 0.27. Using Kappa statistics, agreement between MRS and BIS was 0.35 (95% CI: 0.27â0.43) and for MRS and PSI was 0.21 (95% CI: 0.15â0.28). The kappa statistic for BIS and PSI was 0.45 (95% CI: 0.37â0.52). Receiver operating characteristics (ROC) curves constructed to detect undersedation indicated an area under the curve (AUC) of 0.91 (95% CI = 0.87 to 0.94) for the BIS and 0.84 (95% CI = 0.79 to 0.88) for the PSI. For detection of oversedation, AUC for the BIS was 0.89 (95% CI = 0.84 to 0.92) and 0.80 (95% CI = 0.75 to 0.85) for the PSI. ^ Conclusions. There is a statistically significant positive correlation between the BIS and PSI but poor correlation and poor test agreement between the MRS and BIS as well as MRS and PSI. Both the BIS and PSI demonstrated a high level of prediction for undersedation and oversedation; however, the BIS and PSI can not be considered interchangeable monitors of sedation. ^

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Although the climate development over the Holocene in the Northern Hemisphere is well known, palaeolimnological climate reconstructions reveal spatiotemporal variability in northern Eurasia. Here we present a multi-proxy study from north-eastern Siberia combining sediment geochemistry, and diatom and pollen data from lake-sediment cores covering the last 38,000 cal. years. Our results show major changes in pyrite content and fragilarioid diatom species distributions, indicating prolonged seasonal lake-ice cover between ~13,500 and ~8,900 cal. years BP and possibly during the 8,200 cal. years BP cold event. A pollen-based climate reconstruction generated a mean July temperature of 17.8°C during the Holocene Thermal Maximum (HTM) between ~8,900 and ~4,500 cal. years BP. Naviculoid diatoms appear in the late Holocene indicating a shortening of the seasonal ice cover that continues today. Our results reveal a strong correlation between the applied terrestrial and aquatic indicators and natural seasonal climate dynamics in the Holocene. Planktonic diatoms show a strong response to changes in the lake ecosystem due to recent climate warming in the Anthropocene. We assess other palaeolimnological studies to infer the spatiotemporal pattern of the HTM and affirm that the timing of its onset, a difference of up to 3,000 years from north to south, can be well explained by climatic teleconnections. The westerlies brought cold air to this part of Siberia until the Laurentide ice-sheet vanished 7,000 years ago. The apparent delayed ending of the HTM in the central Siberian record can be ascribed to the exceedance of ecological thresholds trailing behind increases in winter temperatures and decreases in contrast in insolation between seasons during the mid to late Holocene as well as lacking differentiation between summer and winter trends in paleolimnological reconstructions.

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Sediment trap samples from OMEX 2 (49°N, 13°W) provide a continuous record of the seasonal succession of planktonic foraminifera in the midlatitude North Atlantic and reveal a complex relationship between periods of production and specific hydrographic conditions. Neogloboquadrina pachyderma dextral coiling (d.), Globigerina bulloides, and Globorotalia inflata are found in great numbers during both the spring and summer seasons, whereas Globigerina quinqueloba, Globorotalia hirsuta, Globorotalia scitula, and Globigerinita glutinata are associated predominantly with the increase in productivity during the spring bloom. Globigerinella aequilateralis, Orbulina universa, and Globigerinoides sacculifer are restricted to late summer conditions following the establishment of a warm, well-stratified surface ocean. An annually integrated fauna from the sediment trap, comprising ~13,000 individuals, is used to evaluate the accuracy of five faunal-based statistical methods of paleotemperature estimation. All of the temperature reconstruction techniques produce estimates of ~16°C and ~11°C for summer and winter surface temperature, respectively, which are in excellent agreement with regional hydrographic data and suggest that the sediment trap assemblage is well represented in the core top faunas. Analysis of the key species that dominate the OMEX 2 sediment trap fauna, G. bulloides, G. inflata, and N. pachyderma d., based on d18O derived temperatures from North Atlantic core top samples, suggests that seasonal variations in planktonic foraminiferal production are nonuniform across the midlatitudes and that this is likely to complicate reconstructing past seasonal hydrographic dynamics using these taxa.

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To gain information on the physical parameters of the water masses in the area of the Coral Patch seamount (NE Atlantic), one CTD measurement was accomplished in close vicinity to the seamount (station GeoB 12761: 34°31.210'N, 11°08.510'W, 4430m water depth). CTD measurement were conducted during R/V PELAGIA expedition 64PE284 in spring 2008 (Hebbeln and cruise participants, 2008, urn:nbn:de:gbv:46-ep000103738). The CTD measurement of the water column down to a maximum water depth of 2500m was conducted using a SEABIRD "SBE 9 plus" underwater unit and a SEABIRD "SBE 11 plus" deck unit. The vertical profile over the water column provided standard data for conductivity, temperature and pressure. Additionally, the CTD was equipped with sensors for optical backscatter (turbidity), fluorescence (chlorophyll) and dissolved oxygen. Conductivity and temperature data were used to compute salinity.

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Die Paläozeanographie versucht die Klimageschichte des Quartärs zu rekonstruieren und die Zusammenhänge zwischen Klimaänderungen und ozeanischer Zirkulation besser zu verstehen. Ein wichtiges Hilfsmittel stellen die planktischen Foraminiferen dar. Die Analyse planktischer Foraminiferengemeinschaften hat gezeigt, daß die Verbreitung dieser Protozoa durch die Umweltbedingungen in den OberflächenwasserstrÃmen bestimmt wird (BoLTOVSKOY, 1969; CIFELLI& BENIER, 1976; OTIENS, 1991). Durch ihre Ablagerung und Erhaltung am Meeresboden speichern sie diese Informationen und bilden einen Indikator für Wassermassen und Oberflächenwassertemperaturschichtung. Zeitliche und räumliche Veränderungen der Faunenvergesellschaftungen und der Verhältnisse stabiler Sauerstoff- und Kohlenstoffisotope einzelner Foraminiferenarten haben damit einen maßgeblichen Beitrag zur Kenntnis der spätquartären Temperatur- und Zirkulationsänderungen der OberflächenstrÃme geliefert (SHACKLETON & OPDYKE, 1973; BE et al., 1976; RUDDIMAN & McooYRE, 1976; VINCENT & BERGER, 1981; CLIMAP, 1981; RA VELO et al., 1990). Mit Hilfe der planktischen Foraminiferen soll diese Arbeit einen Beitrag zur Rekonstruktion der spätquartären Ozeanographie des Südatlantiks liefern. Die OberflächenstrÃme des Südatlantiks sind das Bindeglied im Wärmeaustausch zwischen niederen und hohen Breiten. Durch den Südäquatorialstrom (SEC) werden warme Wassermassen, die sich aufgrund der hohen Sonneneinstrahlung im tropischen Atlantik gebildet haben, in den Nordatlantik transportiert. Die Wärme wird im Nordatlantik unter Bildung des Nordatlantischen-Tiefenwassers (NADW) an die Atmosphäre abgegeben. Durch dieses Ereignis wird maßgeblich das nordeuropäische Klima beeinflußt (BROECKER & DENTON, 1989). Die Intensität des SEC wird durch den saisonal variierenden SE-, NE-Passat gesteuert, der hauptsächlich durch die Präzession der geneigten Erdachse bzw. durch die Insolation auf der Nordhalbkugel kontrolliert wird (Mc OOYRE et aI., 1989; MOLFINO & Mc INTYRE, 1990). Der SEC fließt entlang des Ãquators von Ost nach West und kalte, nährstotfreiche, tiefere Wassermassen (Südatlantisches-Zentralwasser (SACW)) steigen vor allem im Osten auf und erzeugen das hochproduktive äquatoriale Auftriebsgebiet. Im Osten ist der Temperaturgradient in der Wassersäule steiler, und die Thermoklinentiefe nimmt von Ost nach West zu. Die Lage der Thermokline ist damit ein wesentlicher Faktor, der den Wärmehaushalt im Atlantik mitbestimmt. So wird z. B. im äquatorialen Auftriebsgebiet und im Auftriebsgebiet des küstennahen Benguela-Stroms, wo die Thermoklinentiefe durch aufsteigende kalte Wassermassen gering ist, eine Wärmezunahme von 100 W/qm im Wärmehaushalt erreicht (PETERSON & STRAMMA, 1991). Zur spätquartären Rekonstruktion des Wärmeflusses und der Oberflächenzirkulation im Südostatlantik ist es daher wichtig, auch die zeitlichen und räumlichen Veränderungen tieferer Wasserschichten (bis 300 m) zu erfassen.

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In order to document changes in Holocene glacier extent and activity in NE Greenland (~73° N) we study marine sediment records that extend from the fjords (PS2631 and PS2640), across the shelf (PS2623 and PS2641), to the Greenland Sea (JM07-174GC). The primary bedrock geology of the source areas is the Caledonian sediment outcrop, including Devonian red beds, plus early Neoproterozoic gneisses and early Tertiary volcanics. We examine the variations in colour (CIE*), grain size, and bulk mineralogy (from X-ray diffraction of the <2 mm sediment fraction). Fjord core PS2640 in Sofia Sund, with a marked red hue, is distinct in grain size, colour and mineralogy from the other fjord and shelf cores. Five distinct grain-size modes are distinguished of which only one is associated with a coarse ice-rafting signal - this mode is rare in the mid- and late Holocene. A sediment unmixing program (SedUnMixMC) is used to characterize down-core changes in sediment composition based on the upper late Holocene sediments from cores PS2640 (Sofia Sund), PS2631 (Kaiser Franz Joseph Fjord) and PS2623 (south of Shannon Is), and surface samples from the Kara Sea (as an indicator of transport from the Russian Arctic shelves). Major changes in mineral composition are noted in all cores with possible coeval shifts centred c. 2.5, 4.5 and 7.5 cal. ka BP (±0.5 ka) but are rarely linked with changes in the grain-size spectra. Coarse IRD (>2 mm) and IRD-grain-size spectra are rare in the last 9-10 cal. ka BP and, in contrast with areas farther south (~68° N), there is no distinct IRD signal at the onset of neoglaciation. Our paper demonstrates the importance of the quantitative analysis of sediment properties in clarifying source to sink changes in glacial marine environments.