Antarctic ozone recovery

Since 1976, and more so since 1985, the Antarctic ozone level has suffered considerable depletion (termed as Antarctic ozone hole), attributed to the destructive effects of CFC compounds leaking into the atmosphere from man-made gadgets. The 12-month running means of South Pole Dobson ozone (monthly means, upto 1999 end only) were subjected to spectral analysis, which showed considerable, significant amplitudes for QBO (Quasi-biennial, 2-3 years) and QTO (Quasi-triennial, 3-4 years) oscillations, with a total range of 20-30 DU. When subtracted from the original values, a fairly smooth variation was seen, with a decrease from ~260 DU in 1986 to ~230 DU in 1996 (~12% decrease in 12-month running means), and an almost steady level thereafter. Thus, the net ozone variation at South Pole consists of two parts, (i) a long-term monotonically downward trend upto 1996 and a steady level thereafter and (ii) a superposed QBO-QTO oscillation. The chemical destruction effect is not likely to disappear soon, and may even increase if greenhouse effects, major volcanic eruptions or enhanced stratospheric cooling intervene. If the long-term level (i) remains steady, an extrapolation of the QBO-QTO patterns indicates that the ozone level is due for an increase from about 1999 end to about 2001 beginning. The purpose of the present analysis is to point out that, if such an increase of 20-30 DU occurs, it should not be misinterpreted as due to a decrease in chemical destruction, which scientists are eagerly awaiting due to the indication of a reduction in the halogen load in recent years due to adherence to the Montreal Protocol. After one or two years (in 2002), the extrapolated QBO-QTO oscillation may bring down the ozone level back again to the 1999 end level, and the apparent recovery may turn out to be a false signal.

Critical care for concomitant severe traumatic brain injury and acute spinal cord injury in the polytrauma patient: illustrative case

BACKGROUND The occurrence of traumatic brain injury with spinal cord injury (SCI) in polytrauma patients is associated with significant morbidity. Clinicians face challenges from a decision-making and rehabilitative perspective. Management is complex and understudied. Treatment should be systematic beginning at the scene, focusing on airway resuscitation and hemodynamic stabilization, immobilization, and timely transport. Early operative interventions should be provided, followed by minimizing secondary pathophysiology. The authors present a case to delineate decision-making in the treatment of combined cranial and spinal trauma. OBSERVATIONS A 19-year-old man presented as a level I trauma patient after falling 30 feet as the result of scaffolding collapse. The patient was unresponsive and was intubated; he had an initial Glasgow Coma Scale score of 4. Computed tomography revealed multicompartmental bleeding and herniation, for which supra- and infratentorial decompressive craniectomies were performed. The patient also suffered from thoracic SCI that resulted in complete paraplegia. Multimodality monitoring was used. After stabilization and lengthy rehabilitation, the patient obtained significant functional improvement. LESSONS The approach to initial management of concomitant head and spine trauma is to establish intracranial stability followed by intraspinal stability. Patients can make considerable recovery, particularly younger patients, who are more likely to benefit from early aggressive interventions and medical treatment.

Laparoscopy in the Evaluation of Blunt Abdominal Injury in Level-I and II Pediatric Trauma Centers

Introduction An American College of Surgeons (ACS) Level-I (L-I) pediatric trauma center demonstrated successful laparoscopy without conversion to laparotomy in ∼65% of trauma cases. Prior reports have demonstrated differences in outcomes based on ACS level of trauma center. We sought to compare laparoscopy use for blunt abdominal trauma at L-I compared to Level-II (L-II) centers. Methods The Pediatric Trauma Quality Improvement Program was queried (2014-2016) for patients ≤16 years old who underwent any abdominal surgery. Bivariate analyses comparing patients undergoing abdominal surgery at ACS L-I and L-II centers were performed. Results 970 patients underwent abdominal surgery with 14% using laparoscopy. Level-I centers had an increased rate of laparoscopy (15.6% vs 9.7%, P = .019 ); however they had a lower mean Injury Severity Score (16.2 vs 18.5, P = .002) compared to L-II centers. Level-I and L-II centers had similar length of stay ventilator days, and SSIs (all P > .05). Conclusion While use of laparoscopy for pediatric trauma remains low, there was increased use at L-I compared to L-II centers with no difference in LOS or SSIs. Future studies are needed to elucidate which pediatric trauma patients benefit from laparoscopic surgery.

Yoga inner beauty as a lifestyle women in Ghanta Yoga Asram Kertalangu Village, East Denpasar

Balinese women today want to feel more beautiful and acceptable in society. Therefore, women do yoga inner beauty which makes practitioners healthy, someone's beauty will shine clearly, and lead to a healthy and harmonious life. In addition, women also need their self-actualization in the form of a career path for them. This study uses a qualitative-analytic method with an interactive approach. The results obtained are as follows. First, the reason why women choose inner beauty yoga at the Ghanta Yoga Asram Denpasar is because women believe that doing inner beauty yoga and meditation every day can radiate inner beauty energy, making the body healthy, beautiful, and youthful. Second, the process of applying inner beauty yoga for women at the Ghanta Yoga Asram Denpasar is starting from socialization, initiation process, worship, the yoga implementation process is carried out from level I to level V and level of purification. Third, the implication of the application of yoga inner beauty for women at the Ghanta Yoga Asram Denpasar is that after participating in yoga, women become more patient, healthier, more beautiful, more harmonious, and more sincere in accepting the situation, and full of confidence.

Dynamic Linkages among Saudi Market Sectors Indices

This study aims to test the causal relationship between Saudi stock market index (TASI) and sectoral indices throughout the period from 2016–2020. The study data were extracted through the main index of the Saudi market and the indices of the available data of 19 sectors out of 21 sectors. The unit root test was used along with the Granger causality test, in addition to multiple regression tests in order to analyze the study hypotheses. The study shows that all index series were stationary at the zero level I (0), and the results also show that there were bidirectional and unidirectional causal relationships between TASI and sectoral indices, and that TASI effectively mirrors all the changes that occur in the Saudi stock market.

Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers

ObjectivesThe onset of the national stay-at-home orders accompanied by a surge in firearm sales has elevated the concerns of clinicians and public health authorities. The purpose of this study was to examine the impact of the stay-at-home orders among gunshot wound (GSW) trauma admissions.MethodsThis was a retrospective cohort study at six level I trauma centers across four states. Patients admitted after the onset of COVID-19 restrictions (March 16, 2020–June 30, 2020) were compared with those admitted during the same period in 2019. We compared (1) rate of patients with GSW and (2) characteristics of patients with GSW, by period using Χ2 tests or Fisher’s exact tests, as appropriate.ResultsThere were 6996 trauma admissions across the study period; 3707 (53%) in 2019 and 3289 (47%) in 2020. From 2019 to 2020, there was a significant increase in GSW admissions (4% vs. 6%, p=0.001); 4 weeks specifically had significant increases (March 16–March 23: 4%, April 1–April 8: 5%, April 9–April 16: 6%, and May 11–May 18: 5%). Of the 334 GSWs, there were significant increases in patients with mental illness (5% vs. 11%, p=0.03), alcohol use disorder (2% vs. 10%, p=0.003), substance use disorder (11% vs. 25%, p=0.001), and a significant decrease in mortality (14% vs. 7%, p=0.03) in 2020. No other significant differences between time periods were identified.ConclusionOur data suggest that trauma centers admitted significantly more patients with GSW following the national guidelines, including an increase in those with mental illness and substance use-related disorders. This could be attributable to the stay-at-home orders.Level of evidenceLevel III, retrospective study.

Implementation and initial analysis of Cardiff Model data collection procedures in a level I trauma adult emergency department

ObjectivesOur understanding of community violence is limited by incomplete information, which can potentially be resolved by collecting violence-related injury information through healthcare systems in tandem with prior data streams. This study assessed the feasibility of implementing Cardiff Model data collection procedures in the emergency department (ED) setting to improve multisystem data sharing capabilities and create more representative datasets.DesignInformation collection fields were incorporated into the ED electronic health record (EHR), which gathered additional information from patients reporting assaultive injuries. ED nurses were surveyed to evaluate implementation and feasibility of information collection. Logistic regression was performed to determine associations between missing location information and patient demographic data.Setting60-bed academic level I trauma adult ED in a large Midwestern city.Participants2648 patients screened positive for assault injuries between 2017 and 2020. 198 patients were omitted due to age outside the range served by this ED. Unselected inclusion of 150 ED nurses was surveyed.Main outcome measuresMain outcomes include nursing staff survey responses and ORs for providing complete injury information across various patient demographics.ResultsMost ED nurses believed that information collection aligned with the hospital’s mission (92%), wanted information collection to continue (88%), did not believe that information collection impacted their workflow (88%), and reported taking under 1 min to screen and document violence information (77%). 825 patients (31.2%) provided sufficient information for geospatial mapping. Likelihood of providing complete location information was significantly associated with patient gender, race, arrival means, accompaniment, trauma type and year.ConclusionsIt is feasible to implement information collection procedures about location-based, assault-related injuries through the EHR in the adult ED setting. Nurses reported being receptive to collecting information. Analyses suggest patient-level and time variables impact information collection completeness. The geospatial information collected can greatly improve preexisting law enforcement and emergency medical systems datasets.

Empirical Investigation to assess the impact of ICT deployment in SCM using SEM

The adoption of Information & Communication Technology (ICT) is becoming increasingly ubiquitous and it is prominent in Supply Chain too. The objective of this paper is to perform an empirical investigation to assess the impact of ICT in Supply Chain Management (SCM) using Structural Equation Modeling (SEM). A Survey questionnaire was administered and collected from 200+ SCM professionals in sectors such as manufacturing, services, MSMEs, international companies as well as SCM/ERP professionals working as domain experts in IT and service companies. Confirmatory Factor Analysis was used to validate the suggested empirical model & hypothesis based on the impact of ICT deployment on SCOR Level I metrics/indicators as constructs. This research appends to the literature on supply chain performance measures and addresses a recognized gap in terms of rubrics, constructs, assessment frameworks and metrics of these ICT benefits and capabilities in SCM. This framework can be used by any enterprise irrespective of the geography or country, vertical or domain, manufacturing or services.