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Observations from CMET (Controlled Meteorological) balloons are analyzed in combination with mesoscale model simulations to provide insights into tropospheric meteorological conditions (temperature, humidity, wind-speed) around Svalbard, European High Arctic. Five Controlled Meteorological (CMET) balloons were launched from Ny-Ålesund in Svalbard over 5-12 May 2011, and measured vertical atmospheric profiles above Spitsbergen Island and over coastal areas to both the east and west. One notable CMET flight achieved a suite of 18 continuous soundings that probed the Arctic marine boundary layer over a period of more than 10 h. The CMET profiles are compared to simulations using the Weather Research and Forecasting (WRF) model using nested grids and three different boundary layer schemes. Variability between the three model schemes was typically smaller than the discrepancies between the model runs and the observations. Over Spitsbergen, the CMET flights identified temperature inversions and low-level jets (LLJ) that were not captured by the model. Nevertheless, the model largely reproduced time-series obtained from the Ny-Ålesund meteorological station, with exception of surface winds during the LLJ. Over sea-ice east of Svalbard the model underestimated potential temperature and overestimated wind-speed compared to the CMET observations. This is most likely due to the full sea-ice coverage assumed by the model, and consequent underestimation of ocean-atmosphere exchange in the presence of leads or fractional coverage. The suite of continuous CMET soundings over a sea-ice free region to the northwest of Svalbard are analysed spatially and temporally, and compared to the model. The observed along-flight daytime increase in relative humidity is interpreted in terms of the diurnal cycle, and in the context of marine and terrestrial air-mass influences. Analysis of the balloon trajectory during the CMET soundings identifies strong wind-shear, with a low-level channeled flow. The study highlights the challenges of modelling the Arctic atmosphere, especially in coastal zones with varying topography, sea-ice and surface conditions. In this context, CMET balloons provide a valuable technology for profiling the free atmosphere and boundary layer in remote regions where few other observations are available for model validation. [ABSTRACT FROM AUTHOR]

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A response by the authors to a letter to the editor about their article "Leech therapy in the treatment of median nerve compression due to forearm haematoma," that was published in a 2005 issue of the "Journal of Neurology, Neurosurgery and Psychiatry" is presented.

Frequency and intensity of warm and moist air-mass intrusions into the Arctic have increased over the past decades and have been related to sea ice melt. During our year-long expedition in the remote central Arctic Ocean, a record-breaking increase in temperature, moisture and downwelling-longwave radiation was observed in mid-April 2020, during an air-mass intrusion carrying air pollutants from northern Eurasia. The two-day intrusion, caused drastic changes in the aerosol size distribution, chemical composition and particle hygroscopicity. Here we show how the intrusion transformed the Arctic from a remote low-particle environment to an area comparable to a central-European urban setting. Additionally, the intrusion resulted in an explosive increase in cloud condensation nuclei, which can have direct effects on Arctic clouds' radiation, their precipitation patterns, and their lifetime. Thus, unless prompt actions to significantly reduce emissions in the source regions are taken, such intrusion events are expected to continue to affect the Arctic climate., (© 2022. The Author(s).)

The COVID-19 pandemic has focused public attention on occupational groups that ensure the maintenance of critical infrastructure, provision of medical care and supply of essential goods. This paper examines the working conditions in critical jobs based on representative data from the German BAuA Working Time Survey 2019. Our analyses reveal that essential workers are more likely to perform unskilled or semiskilled activities and work in cleaning, transport and logistics, health care occupations as well as IT and natural science services. Regarding the working conditions, essential workers are paid comparatively less and are more physically proximate to others at work than nonessential workers. They more often work atypical hours, such as day and night shifts and on weekends, and have less autonomy in their working time. Additionally, critical jobs are characterised by muscular and skeletal strain due to working positions and carrying heavy loads significantly more often. Thus, our findings strongly suggest that work-related risks accumulate in critical jobs., Supplementary Information: The online version contains supplementary material available at 10.1186/s12651-022-00315-6., Competing Interests: Competing interestsThe author declares that he has no competing interests., (© The Author(s) 2022.)

To what extent do regional characteristics influence employment trajectories? Do regional factors diversely affect the employment careers of different sociodemographic groups? By investigating these questions, we extend current life course research in two ways: First, from a conceptual perspective, we use approaches from regional economics in addition to established sociological labour market theories to gain insights into the effects of regional determinants on individual labour market outcomes. Second, from a methodological point of view, we conduct event history analyses based on a German dataset that contains information on individuals, firms and regions. Our results show that there are considerable regional heterogeneities regarding population density and the amount of human capital endowment, both of which influence working careers differently. Regional agglomeration predominantly offers opportunities in terms of employment trajectories, while regional human capital accumulation increases employment risks. Additionally, our findings indicate that group-specific inequalities with respect to employment careers can be weakened or even strengthened by regional frame conditions. Female and foreign employees benefit most from denser regions and from a higher human capital endowment. By contrast, the unemployment risks of workers who previously experienced unemployment periods during their working lives are increased by both of these regional characteristics. Findings regarding education level are mixed: Workers with occupational qualifications profit from regional agglomeration to a greater extent than do low or even generally qualified workers. However, a high local human capital endowment leads to skill segregation between vocationally trained and highly qualified employees., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: A key issue in the treatment of periprosthetic joint infection (PJI) is the correct diagnosis. The main problem is lack of diagnostic tools able to diagnose a PJI with high accuracy. Alpha-defensin has been proposed as a possible solution, but in the current literature, there is a lack of independent validation., Questions/purposes: We performed a prospective study to determine (1) what is the sensitivity, specificity, and positive and the negative predictive values of the alpha-defensin immunoassay test in diagnosing PJI; and (2) which clinical features may be responsible for false-positive and false-negative results?, Methods: Preoperative aspiration was performed in all patients presenting with a painful hip/knee arthroplasty, including both primary and revision implants. Metallosis, other inflammatory comorbidities, and previous/concomitant antibiotic therapy were not considered as exclusion criteria. An inadequate amount of synovial fluid for culture was an exclusion criterion. A total of 156 patients (65 knees, 91 hips) were included in this prospective study. At the time of revision, synovial fluid samples were taken to perform the alpha-defensin assay. During surgical débridement of tissue, samples for cultures and histologic evaluation were taken, and samples were cultured until positive or until negative at 14 days. A diagnosis of PJI was confirmed in 29 patients according to the International Consensus Group on PJI., Results: The sensitivity of the alpha-defensin immunoassay was 97% (95% confidence interval [CI], 92%-99%), the specificity was 97% (95% CI, 92%-99%), the positive predictive value was 88% (95% CI, 81%-92%), and the negative predictive value was 99% (95% CI, 96%-99%). Among four false-positive patients, two had metallosis and one had polyethylene wear. The false-negative case presented with a draining sinus, and intraoperative cultures were also negative., Conclusions: Alpha-defensin assay appears to be a reliable test, but followup evaluation is needed to estimate longer term performance of the test. The authors believe that alpha-defensin has demonstrated itself to be sufficiently robust that PJI diagnostic criteria now should include this test. Future studies are needed to compare the differences among the diagnostic capability of the available tests, in particular when metallosis is present, because metallosis may predispose the test to a false-positive result., Level of Evidence: Level I, diagnostic study.

Object: The authors evaluated the characteristics of patients with idiopathic intracranial hypertension (IIH), and compared laser scanning tomography (LST) measurements of papilledema with the clinical parameters and cerebrospinal fluid (CSF) opening pressures obtained., Methods: Twenty-four patients were included in this study; these individuals included 21 women and three men with a mean age of 35.5 +/- 9.7 years and a mean body mass index (BMI) of 35.4 +/- 8.3 kg/m2. The authors conducted a prospective follow-up study over a period of 12 months through a series of four consultations with each patient. These patients had a mean time to treatment of 6.2 +/- 7.9 months and, at the time of diagnosis, suffered a mean of 2.8 +/- 1.3 symptoms each. Laser scanning tomography of the optic disc revealed a mean global rim volume of 1.693 +/- 1.662 mm3 and a mean height of 0.604 +/- 0.306 mm. The mean CSF opening pressure was 31.3 +/- 6.3 cm H2O., Results: During the follow-up period, all patients improved significantly with regard to clinical parameters (p < 0.001), BMI reduction (p < 0.001), and reduction of visual field deficits (p = 0.007); visual acuity remained unchanged. In all patients at each successive consultation, the CSF opening pressure was lower than it had been at the previous consultation (p = 0.001). Laser scanning tomography measurements demonstrated a statistically significant reduction in both optic disc parameters over the follow-up period (global rim volume, p = 0.044; mean height, p = 0.019). The CSF opening pressure and the LST measurements correlated significantly with the number of symptoms (CSF opening pressure, p < 0.001; global rim volume, p = 0.001; mean height, p < 0.001). The mean area under the receiver operating characteristic curve in detecting the presence of clinical symptoms was 0.87 for CSF opening pressure, 0.7 for rim volume, and 0.81 for mean optic disc height., Conclusions: Laser scanning tomography measurements are useful for evaluating the degree of papilledema in patients with IIH and correspond well with clinical data and measurements of CSF opening pressure. If a diagnosis of IIH is established, LST measurements may replace repeated CSF opening pressure measurements in follow-up monitoring.

A 42-year-old woman was surgically treated for carpal tunnel syndrome, revealing schwannoma of the median nerve. A year later, she developed a tarsal tunnel syndrome. At time of this diagnosis, hereditary neuropathy with liability to pressure palsies (HNPP) was diagnosed genetically and a schwannoma of the medial plantar nerve was treated surgically. The occurrence of HNPP and schwannomas in the same patient might be purely coincidental, but it is tempting to speculate that they share a common genetic basis.

Changes of cardiovascular function are frequent in temporal lobe epilepsy (TLE). The baroreflex - the most important reflex for cardiovascular stability - has not been studied systematically in TLE. We evaluated cardiovascular variability and baroreflex function in TLE. In 22 TLE patients and 20 controls, we continuously monitored heart rate (HR) and blood pressure (BP). Time-domain parameters were derived from recordings at rest and from standard cardiovascular reflex tests. Spectral analysis determined sympathetic and parasympathetic modulation of HR and BP in the low (LF-power) and high frequency range (HF-power). We calculated the relative LF- and HF-powers of HR in relation to the sum of LF- and HF-powers. LF/HF-ratio of HR was assessed as a parameter of sympatheticovagal balance. LF-transfer function gain between BP and HR determined baroreflex function.Time-domain parameters did not differ between TLE patients and controls. Spectral analysis showed decreased absolute LF- and HF-powers but increased relative LF-power and LF/HF-ratio of HR in TLE. LF-transfer function gain between BP and HR was reduced in TLE (p<0.05). The reduction of absolute LF- and HF-powers indicates decreased total autonomic variability in TLE. However, increased relative LF-power and LF/HF-ratio of HR in TLE show a relative increase of sympathetic tone. Most importantly, we demonstrate an impaired baroreflex function in TLE. These cardiovascular autonomic abnormalities may contribute to cardiac arrhythmia in TLE.

Patent foramen ovale is considered as a potential risk factor for stroke owing to paradoxic embolism, leading to the question "to close or not to close the patent foramen ovale". We report a 26-year-old woman with chest pain, dyspnoea, sudden severe pain in both legs and paraplegia. Thoracic and abdominal computed tomography revealed massive pulmonary embolism and complete obstruction of the abdominal aorta. Interventional removal of the aortic thrombus was undertaken using the Fogarty catheter technique via the femoral arterial approach. As a result of worsening of cardiopulmonary function during the procedure, additional local thrombolysis, with a total of 50 mg recombinant tissue plasminogen activator, and fragmentation of the thrombus in the right pulmonary artery were performed via a femoral vein approach. Ultrasound studies revealed a patent foramen ovale of about 12 mm diameter with a significant right to left shunt. Under favourable conditions, a patent foramen ovale may allow the escape of a thrombus, sufficient to cause a potentially fatal pulmonary embolism, into the arterial system, where it can be removed by interventional manoeuvres.

Dysfunction of the peripheral and central autonomic nervous system is common in many neurological and general medical diseases. The quantitative assessment of sympathetic and parasympathetic function is essential to confirm the diagnosis of autonomic failure, to provide the basis for follow-up examinations, and potentially to monitor successful treatment. Various procedures have been described as useful tools to quantify autonomic dysfunction. The most important tests evaluate cardiovascular and sudomotor autonomic function. In this review, we therefore focus on standard tests of cardiovascular and sudomotor function such as heart-rate variability at rest and during deep breathing, active standing, and the Valsalva maneuver, and on the sympathetic skin response. These tests are widely used for routine clinical evaluation in patients with peripheral neuropathies. Refined methods of studying heart-rate variability, baroreflex testing, and detailed measures of sweat output are mostly used for research purposes. In this context, we describe the spectral analysis of slow modulation of heart rate or blood pressure, reflecting sympathetic and parasympathetic influences, and consider various approaches to baroreflex testing, the thermoregulatory sweat test, and the quantitative sudomotor axon reflex test. Finally, we discuss microneurography as a technique of direct recording of muscle sympathetic nerve activity.