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The article focuses on the urgent assessment and management of sudden weakness in the legs. Topics discussed include the importance of history-taking, examination, and the need for emergent referral and management in cases of acute spinal cord compression, as well as other causes of acute ascending paralysis.

The accumulation of gases into our atmosphere is a growing global concern that requires considerable quantification of the emission rates and mitigate the accumulation of gases in the atmosphere, especially the greenhouse gases (GHG). In agriculture there are many sources of GHG that require attention in order to develop practical mitigation strategies. Measuring these GHG sources often rely on highly technical instrumentation originally designed for applications outside of the emissions research in agriculture. Although the open-path laser (OPL) and open-path Fourier transform infrared (OP-FTIR) spectroscopic techniques are used in agricultural research currently, insight into their contributing error to emissions research has not been the focus of these studies. The objective of this study was to assess the applicability and performance (accuracy and precision) of OPL and OP-FTIR spectroscopic techniques for measuring gas concentration from agricultural sources. We measured the mixing ratios of trace gases methane (CH4), nitrous oxide (N2O), and ammonia (NH3), downwind of point and area sources with known release rates. The OP-FTIR provided the best performance regarding stability of drift in stable conditions. The CH4 OPL accurately detected the low background (free-air) level of CH4; however, the NH3 OPL was unable to detect the background values < 10 ppbv. [ABSTRACT FROM AUTHOR]

Our objectives were to identify the experiences of people with MND in receiving the diagnosis and to determine which aspects of breaking this bad news were associated with greater satisfaction with the way the diagnosis was delivered to them. An anonymous postal survey was facilitated by all MND associations in Australia, in 2014, and centred on the SPIKES protocol for communicating bad news. Of the patients (n = 248, response rate 29%), 36% were dissatisfied with the delivery of the diagnosis and gave low ratings on the ability/skills of their neurologists to deliver the diagnosis. It was evident that the longer the patients spent with their neurologists during breaking such bad news, the more they were satisfied and the higher they rated the neurologists’ abilities/skills. The largest significant differences between neurologists rated as having high or low skills in delivering the diagnosis were in four domains: 1) responding empathically to the feelings of patient/family; 2) sharing the information and suggesting realistic goals; 3) exploring what patient/family are expecting or hoping for; and 4) making a plan and following through. In conclusion, with over one-third of patients dissatisfied with their experience, there is room for improvement in the practice of neurologists in specified areas that could form the basis for changing practice, and the development of standards and protocols likely to have implications at the international level. [ABSTRACT FROM PUBLISHER]

Soil denitrification fluxes and nitrous oxide (N2O) emissions from the soil surface simulated by a Water and Nitrogen Management Model (WNMM), with three different gas modules, are compared to measurement data sets from two irrigated wheat-maize systems at two locations in the North China Plain (NCP) (2 years of measurement at the Luancheng site and 1 year of measurement at the Fengqiu site). The three gas modules are the WNMM gas module, the DAYCENT gas module, and the DNDC gas module. The term gas module used in this paper refers to the model component which simulates N2O emission from the processes of soil nitrification and denitrification. Soil water, temperature, organic matter decomposition, other nitrogen (N) transformations, such as mineralization and immobilization, and crop growth are simulated by the WNMM platform. For the 2-year data set from Luancheng, the three gas modules generate similar soil mineral N dynamics in the 0-20 cm topsoil. The daily time step, simply structured WNMM gas module consistently performs the best among the three gas modules for predicting soil denitrification fluxes (R² = 0.28, n = 39, p = 0.0006) and N2O emissions (R² = 0.45, n = 36, p < 0.0001). Up to 73, 43, and 22% of total N2O emissions are nitrification-induced as simulated by the DNDC, DAYCENT, and WNMM gas modules respectively, in this well-drained loam soil during the 2-year simulation. When applied to the 1-year data set at the Fengqiu site, the WNMM gas module consistently performs better in estimating N2O emissions (R² = 0.54, n = 35, p < 0.0001) compared to the other two modules. Simulations using the DNDC and DAYCENT gas modules explain over 40% of the temporal variation of N2O emission from the soil. Further testing on different soils and different agroecosystems is needed to confirm the superior performance of the WNMM gas module observed in this simulation study. [ABSTRACT FROM AUTHOR]