Evidence of wet-dry cycles and mega-droughts in the Eemian climate of southeast Australia.

Understanding past climate variability is critical to informing debate of likely impacts of global warming on weather and climate, and water resources. Here we present a near annual resolution reconstruction of climate developed from a speleothem that spans the Eemian [Marine Isotope Stage 5e (MIS 5e)] from 117,500 to 123,500 years BP-the most recent period in the Earth's history when temperatures were similar to those of today. Using  Mg, Sr, and Ba as proxies, we show the first indication of solar and teleconnection cyclic forcing of Eemian climate in southeast Australia, a region at present often affected by severe drought and bushfires.

Serum Magnesium Measurements After Parathyroidectomy for Primary Hyperparathyroidism: Should It be Routine?

Background: Parathyroidectomy is the treatment of choice in primary hyperparathyroidism (PHPT). Following surgery, significant changes in bone and mineral metabolism may follow, but routine magnesium monitoring is not standard practice. The occurrence of significant clinical events linked to hypomagnesaemia in 3 patients after parathyroidectomy led to our evaluation of magnesium levels after surgery for PHPT.

A systematic review of trends in the selective exclusion of older participant from randomised clinical trials.

Introduction: The unjustified exclusion of older participants from clinical trials creates research populations that are non-representative, in turn creating difficulties applying research to the target populations. The aim of this study was to assess the proportion of randomised control trials (RCTs) that have unexplained upper age limits and review whether this proportion is reducing over time.

Methods: All RCTs in BMJ, Lancet, JAMA and NEJM from 1998 to 2015 were reviewed to identify any specified upper-age cut off and, if so, whether this exclusion criterion had an explanation in the text.

Can medical students accurately predict their learning? A study comparing perceived and actual performance in neuroanatomy.

It is important that clinicians are able to adequately assess their level of knowledge and competence in order to be safe practitioners of medicine. The medical literature contains numerous examples of poor self-assessment accuracy amongst medical students over a range of subjects however this ability in neuroanatomy has yet to be observed. Second year medical students attending neuroanatomy revision sessions at the University of Southampton and the competitors of the National Undergraduate Neuroanatomy Competition were asked to rate their level of knowledge in neuroanatomy.

Decreasing troponin turnaround time in the emergency department using the central laboratory: A process improvement study.

Objectives: To implement collaborative process improvement measures to reduce emergency department (ED) troponin turnaround time (TAT) to less than 60min using central laboratory.

Design And Methods: This was an observational, retrospective data study. A multidisciplinary team from the ED and laboratory identified opportunities and developed a new workflow model.

Assessment and management of older people with sarcopenia.

Sarcopenia, the loss of skeletal muscle mass and function with age, is common in older people. It is associated with increased morbidity and mortality, and a greater risk of admission to hospital and care homes. This article identifies the risk factors and consequences of sarcopenia, and describes how nurses and GPs can recognise patients at particular risk of developing the condition.