Description: A Holocene Gulf of Guinea record of riverine runoff, based on Ba/Ca in tests of a shallow-dwelling planktic foraminifer, and sea surface temperature (SST), based on Mg/Ca, reveals centennial-scale instabilities in West African monsoon (WAM) precipitation and eastern equatorial Atlantic (EEA) thermal conditions. The long-term Holocene climate trend is characterized by a warm and wet early-mid Holocene and gradual drying and cooling during the late Holocene. Superimposed on this trend are numerous centennial scale drops in precipitation during the early-mid Holocene. The greatest declines in early Holocene monsoon precipitation were accompanied by significant SST cooling in the EEA and correlate with drops in air temperature over Greenland and fresh water outbursts into the North Atlantic (NA). This observation suggests that early Holocene climate instabilities in the NA were closely linked to changes in the WAM. The strong imprint of NA events in summer monsoon precipitation suggests that these events were not confined to winter-time. The late Holocene does not show large amplitude changes in riverine runoff at the centennial level. The relatively stable late Holocene conditions likely reflect a weakening and stabilization of the monsoon system, probably due to diminished influence of the NA region due to a reduction in ice sheet.

Description: Background: Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Methods: Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. Results: The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1).The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 -- 95.5) % and 58.5 (95% CI: 51.1 -- 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 -- 88.6) % and 98.9 (95% CI: 98.3 -- 99.3) %. Conclusions: The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week.

Description: Background: This pilot study (ClinicalTrials.gov ID: NCT01507701) assessed the feasibility and safety of clonidine in adolescent chronic fatigue syndrome (CFS). Specifically, we assessed clonidine dosage in relation to a) plasma concentration levels, b) orthostatic cardiovascular responses, and c) possible adverse effects.FindingsFive adolescent CFS patients (14-19 years old) received 50 mug clonidine twice per day during 14 days in an open, uncontrolled design. Plasma concentration of clonidine was assayed by standard laboratory methods. Changes in orthostatic cardiovascular responses were assessed by a 20o head-up tilt-test (HUT). Adverse effects were mapped by a questionnaire.After 14 days, C0 median (range) of clonidine was 0.21 (0.18-0.36) mug/L, and Cmax median (range) of clonidine was 0.41 (0.38-0.56) mug/L. Also, supine blood pressures and heart rate were lower during clonidine treatment, and the HUT response was closer to the normal response. No serious adverse effects were registered. Conclusion: Clonidine 50 mug BID seems to be safe enough to proceed from a pilot study to a controlled trial in a select group of adolescents with CFS (ClinicalTrials.gov ID: NCT01040429).