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The article presents a study which investigates the approach in database selection in addressing outcomes research questions on critical care and health services. The study used data from the narrative review of medical literature. Study reveals the significant role of secondary analyses in critical care practice.

The Arctic is currently undergoing dramatic environmental transformations, but it remains largely unknown how these changes compare with long-term natural variability. Here we present a lake sediment sequence from the Canadian Arctic that records warm periods of the past 200,000 years, including the 20th century. This record provides a perspective on recent changes in the Arctic and predates by approximately 80,000 years the oldest stratigraphically intact ice core recovered from the Greenland Ice Sheet. The early Holocene and the warmest part of the Last Interglacial (Marine Isotope Stage or MIS 5e) were the only periods of the past 200,000 years with summer temperatures comparable to or exceeding today's at this site. Paleoecological and geochemical data indicate that the past three interglacial periods were characterized by similar trajectories in temperature, lake biology, and lakewater pH, all of which tracked orbitally-driven solar insolation. In recent decades, however, the study site has deviated from this recurring natural pattern and has entered an environmental regime that is unique within the past 200 millennia. [ABSTRACT FROM AUTHOR]

We present unambiguous records of preindustrial atmospheric mercury (Hg) pollution, derived from lake-sediment cores collected near Huancavelica, Peru, the largest Hg deposit in the New World. Intensive Hg mining first began Ca. 1400 BC, predating the emergence of complex Andean societies, and signifying that the region served as a locus for early Hg extraction. The earliest mining targeted cinnabar (HgS) for the production of vermillion. Pre- Colonial Hg burdens peak Ca. 500 BC and Ca. 1450 AD, corresponding to the heights of the Chavin and Inca states, respectively. During the Inca, Colonial, and industrial intervals, Hg pollution became regional, as evidenced by a third lake record ≈225 km distant from Huancavelica. Measurements of sediment-Hg speciation reveal that cinnabar dust was initially the dominant Hg species deposited, and significant increases in deposition were limited to the local environment. After conquest by the Inca (Ca. 1450 AD), smelting was adopted at the mine and Hg pollution became more widely circulated, with the deposition of matrix-bound phases of Hg predominating over cinnabar dust. Our results demonstrate the existence of a major Hg mining industry at Huancavelica spanning the past 3,500 years, and place recent Hg enrichment in the Andes in a broader historical context. [ABSTRACT FROM AUTHOR]

The article reports on the results of a study of predictors of hospital mortality in a population-based cohort of patients with acute lung injury. A description of the experimental set-up and measurement methods is presented. The study concluded that predictors of mortality in patients with acute lung injury are similar to those predictive of mortality in the general intensive care unit population.