Background and Purpose-Patients who have sustained a neurological injury and then improved may experience transient reemergence of their syndromes when given benzodiazepines. As a step toward assessing whether neurotransmitter systems underlie poststroke clinical improvement, we selected midazolam, a ␥-aminobutyric acid A (GABA A ) agonist, for systemic administration to measure general or stroke-specific effects in patients. Methods-Eight patients with image-verified stroke (5 with left-sided and 3 with right-sided cerebral lesions) participated.The strokes had occurred from 7 days to 6 years earlier, with patients showing clinical improvement from their initial syndromes. Each patient underwent baseline testing for motor function, aphasia, and left hemispatial neglect, after which intravenous midazolam was delivered until mild drowsiness was detected. Patients were tested during this period and again after 2 hours when sedation had dissipated. Results-After

Lacustrine and alluvial carbonate facies have been investigated in Middle Miocene successions of the western side of the Madrid Basin in order to evaluate paleoenvironments in which carbonates formed. Carbonate facies are varied and include: (I) calcrete and dolocrete; (2) pond deposits; (3) lake margin dolostone; (4) mudflat carbonate; and (5) open-lake carbonate facies. The dominant mineralogy of these is dolomite and/ or low-Mg calcite. No high-Mg calcite or aragonite have been detected in any sample. 8 1 8 0-and 8 13 C-values range from-8.20 to-1.80%0 PDB and-10.25 to-0.70%0 PBD, respectively. More negative 8 18 0-and 8 13 C-values correspond to predominantly calcite calcretes and to carbonate deposited in ponds at the foot of arkosic alluvium. Higher 8 18 0-val ues are from both lacustrine carbonate and dolocrete. This latter lithofacies has strong geochemical similarities to dolostones deposited in a lake margin environment. Mudflat carbonate, deposited on shallow platforms subject to lake water oscillation, shows great heterogeneity in both stable isotope value and trace-element content. The mineralogy of these carbonates is dominated by calcite and the limestones contain molds of gypsum. Occurrence of calcitized dolomite textures in these facies suggests the influence of fresher water during expanding lacustrine cycles or further interaction with less saline groundwater. Trace-element contents are considered to be potential indicators of the different carbonate facies types, thus aiding the paleoenvironmental interpretation. However, discrimination among carbonate facies on the basis of trace-element contents appears to be dependent on the statistical method utilized for treatment of data. More information is needed to ascertain their use as paleoenvironmental indicators.

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Repetitive sequences of carbonate deposits, occurrence include in the lower part of the Paleogene Carbonate Unit (northeast border of the Madrid Basin), have been studied, defining regressive lacustrine sequences and early diagenetic processes.Binocular microscopic examination, scanning electron microscopic/energy dispersive X-ray observations, and X-ray diffi-action analyses joint to isotopic studies dolomite precipitating -waters. The cherts included in palustrine limestones show j180 values of quartz that record more evaporated waters than those of the general stages of silicification.

Evidence-based standardization of the perioperative management of patients undergoing complex spine surgery can improve outcomes such as enhanced patient satisfaction, reduced intensive care and hospital length of stay, and reduced costs. The Society for Neuroscience in Anesthesiology and Critical Care (SNACC) tasked an expert group to review existing evidence and generate recommendations for the perioperative management of patients undergoing complex spine surgery, defined as surgery on 2 or more thoracic and/or lumbar spine levels. Institutional clinical management protocols can be constructed based on the elements included in these clinical practice guidelines, and the evidence presented.

Casa Montero is a mining complex located outside Madrid (Spain), dated from the Early Neolithic (c. 5400–5000 cal bc). An area of some 4 ha has been investigated and some 4000 shafts recorded, of which 324 have been excavated. The characterization of its raw flint materials and the establishment of its diagnostic features are indispensable in the reconstruction of the distribution of the mine's products beyond the immediate site. This work reports the geological study of the mine's Miocene flint layers and their petrological characterization. Archaeological samples from the mine's shafts were classified according to macroscopic features and petrological characteristics.