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A major subglacial lake, Lake Snow Eagle (LSE), was identified in East Antarctica by airborne geophysical surveys. LSE, contained within a subglacial canyon, likely hosts a valuable sediment record of the geological and glaciological changes of interior East Antarctica. Understanding past lake activity is crucial for interpreting this record. Here, we present the englacial radiostratigraphy in the LSE area mapped by airborne ice-penetrating radar, which reveals a localized high-amplitude variation in ice unit thickness that is estimated to be ∼12 ka old. Using an ice-flow model that simulates englacial stratigraphy, we investigate the origin of this feature and its relationship to changes in ice dynamical boundary conditions. Our results reveal that local snowfall redistribution initiated around the early Holocene is likely the primary cause, resulting from a short-wavelength (∼10 km) high-amplitude (∼20 m) ice surface slope variation caused by basal lubrication over a large subglacial lake. This finding indicates an increase in LSE water volume during the Holocene, illustrating the sensitivity in volume of a major topographically constrained subglacial lake across a single glacial cycle. This study demonstrates how englacial stratigraphy can provide valuable insight into subglacial hydrological changes before modern satellite observations, both for LSE and potentially at other locations.
In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
Methods:
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
Results:
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
Conclusion:
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
Sediments from depths to 670 m in the Barbados accretionary complex and transecting the décollement zone have been studied by transmission and analytical electron microscopy (TEM/AEM). The sediments consist of claystone and mudstone intercalated with layers of volcanic ash. Smectite comprises the bulk of the noncalcareous sediments and forms a continuous matrix enveloping sparse, irregular, large grains of illite, chlorite, kaolinite and mixed-layer illite/chlorite of detrital origin at all depths. The detrital origin of illite is implied by illite-smectite textural relations, well-ordered 2M polytypism, and a muscovite-like composition. K is the dominant interlayer cation in smectite at all depths, in contrast to the Na and Ca that are normally present in similar rocks.
Deeper samples associated with the décollement zone contain small (up to 100 Å thick) illite packets included within still-dominant subparallel layers of contiguous smectite. AEM analyses of these packets imply illite-like compositions. Selected area electron diffraction (SAED) patterns show that this illite is the 1Md polytype. Packets display step-like terminations like those seen in illite of hydrothermal origin. The data collectively demonstrate that smectite transforms progressively to illite via a dissolution-recrystallization process within a depleting matrix of smectite, and not by a mechanism of layer replacement. This illite seems to form at depths as shallow as 500 m and temperatures of 20°-30°C, which is in marked contrast to the much higher temperature conditions normally assumed for this transformation. This implies that the high water/rock ratios associated with the décollement zone are significant in promoting reaction.
Monitoring parrot populations is of high importance because there is a general lack of quantified population trends for one of the most threatened avian orders. We surveyed parrots in Nicaragua in 1995, 1999, 2004, and 2013 at a minimum of 227 points within 56 sites stratified among the Pacific, Central Highlands, and Caribbean biogeographical regions to assess population trends. From point-count data we calculated encounter rate, flock rate, and flock size metrics and we used presence/absence data to generate species-specific occupancy estimates. Encounter rate, flock rate, and flock size data suggested family-level declines from 1995 to 2004 with some recovery between 2004 and 2013. Patterns of parrot occupancy varied among species with four decreasing, five increasing, and two with no detectable change. Six species of conservation concern are identified, including the Critically Endangered Great Green Macaw and Yellow-naped Parrot, additionally Olive-throated Parakeet, Scarlet Macaw, Brown-hooded Parrot, and White-crowned Parrot, only listed as Least Concern. All six are likely suffering from deforestation and potential unchecked trade activity in the Caribbean. Differing population trends of the regionally disjunct Yellow-naped Parrot subspecies suggest a link to variable deforestation and trade pressure experienced between the Pacific and Caribbean. Our results highlight the importance of actively monitoring changing parrot populations, even when considered Least Concern, so that directed conservation actions can be taken if needed.
Politicians engage in, and the media amplifies, social constructions of welfare recipients as undeserving. Such messaging seeks to influence mass public opinion, but what are the effects on the target population receiving welfare benefits? We test if deservingness messaging affects welfare recipients' mental health. To do so, we exploit a quasi-experiment entailing a dramatic shift in deservingness messaging after a welfare recipient in Denmark became the subject of a national debate, utilizing detailed administrative data on the ensuing consumption of antidepressants by other welfare recipients. We find evidence that welfare recipients experienced worse mental health outcomes after being exposed to deservingness messaging, reflected in a 1.2-percentage-point increase in the use of antidepressants in the weeks following the airing of a critical interview. Deservingness messaging particularly affected more vulnerable groups who had a history of mental health problems.
Background: RSV is underrecognized in hospitalized adults. A better understanding of RSV in this population could help prioritize targeted viral-testing resources. Hospitalization and in-hospital outcomes are widely accepted as markers of clinical severity with respect to acute respiratory illness (ARI). We compared characteristics and clinical outcomes between adults hospitalized with ARI from October 2016 through May 2019. Methods: All hospitalized adults (≥ 18 years) who met a standardized case definition of ARI were prospectively enrolled across 3 respiratory seasons from 9 hospitals participating in the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN). Demographic data were collected during enrollment interviews, and electronic medical records (EMRs) were reviewed to extract comorbidity data. Throat and nasal swabs collected at enrollment were tested for ARI pathogens using real-time PCR assays at respective HAIVEN research laboratory sites. Characteristics and clinical outcomes of participants were compared using χ2 or nonparametric tests where appropriate. Multivariable logistic regression models were used to test associations between infection status, characteristics, and clinical outcomes, adjusting for age, sex, race, Charlson comorbidity index (CCI), body mass index (BMI), site, season, and days to admission. Results: In total, 10,311 adults were included, 22.3% (n = 2,300) were aged 18–49 years, 33.2% (n = 3,423) were aged 50–64 years, and 44.5% (n = 4,588) were aged ≥65 years. Moreover, 6% of adults tested positive for RSV (n = 622), 18.8% positive for influenza (n = 1,940), and 75.1% negative for both (n = 7,749). Obesity and age ≥65 years were significantly associated with RSV detection when compared with participants negative for both RSV and influenza. Patients aged 18–49 years and ≥65 years with RSV had significantly higher median CCI scores compared to patients with influenza (Fig. 1.). The proportion of adults with CHF or COPD was significantly (p-value Conclusions: Severe RSV illness may differ from severe influenza illness, and those infected with RSV may have different characteristics than those infected with influenza. Hospitalized adults with RSV infection were more likely to have underlying cardiopulmonary comorbidities and higher CCI scores as well as experience an extended length of hospital stay and need for mechanical ventilation. These data highlight the importance of retaining testing for RSV in older adults hospitalized with ARI.
Are diets with a greater environmental impact less healthy? This is a key question for nutrition policy, but previous research does not provide a clear answer. To address this, our objective here was to test whether American diets with the highest carbon footprints predicted greater population-level mortality from diet-related chronic disease than those with the lowest.
Design:
Baseline dietary recall data were combined with a database of greenhouse gases emitted in the production of foods to estimate a carbon footprint for each diet. Diets were ranked on their carbon footprints and those in the highest and lowest quintiles were studied here. Preventable Risk Integrated Model (PRIME), an epidemiological modelling software, was used to assess CVD and cancer mortality for a simulated dietary change from the highest to the lowest impact diets. The diet–mortality relationships used by PRIME came from published meta-analyses of randomised controlled trials and prospective cohort studies.
Setting:
USA.
Participants:
Baseline diets came from adults (n 12 865) in the nationally representative 2005–2010 National Health and Nutrition Examination Survey.
Results:
A simulated change at the population level from the highest to the lowest carbon footprint diets resulted in 23 739 (95 % CI 20 349, 27 065) fewer annual deaths from CVD and cancer. This represents a 1·83 % (95 % CI 1·57 %, 2·08 %) decrease in total deaths. About 95 % of deaths averted were from CVD.
Conclusions:
Diets with the highest carbon footprints were associated with a greater risk of mortality than the lowest, suggesting that dietary guidance could incorporate sustainability information to reinforce health messaging.
Many institutions are attempting to implement patient-reported outcome (PRO) measures. Because PROs often change clinical workflows significantly for patients and providers, implementation choices can have major impact. While various implementation guides exist, a stepwise list of decision points covering the full implementation process and drawing explicitly on a sociotechnical conceptual framework does not exist.
Methods:
To facilitate real-world implementation of PROs in electronic health records (EHRs) for use in clinical practice, members of the EHR Access to Seamless Integration of Patient-Reported Outcomes Measurement Information System (PROMIS) Consortium developed structured PRO implementation planning tools. Each institution pilot tested the tools. Joint meetings led to the identification of critical sociotechnical success factors.
Results:
Three tools were developed and tested: (1) a PRO Planning Guide summarizes the empirical knowledge and guidance about PRO implementation in routine clinical care; (2) a Decision Log allows decision tracking; and (3) an Implementation Plan Template simplifies creation of a sharable implementation plan. Seven lessons learned during implementation underscore the iterative nature of planning and the importance of the clinician champion, as well as the need to understand aims, manage implementation barriers, minimize disruption, provide ample discussion time, and continuously engage key stakeholders.
Conclusions:
Highly structured planning tools, informed by a sociotechnical perspective, enabled the construction of clear, clinic-specific plans. By developing and testing three reusable tools (freely available for immediate use), our project addressed the need for consolidated guidance and created new materials for PRO implementation planning. We identified seven important lessons that, while common to technology implementation, are especially critical in PRO implementation.
Radar sounding is a powerful geophysical approach for characterizing the subsurface conditions of terrestrial and planetary ice masses at local to global scales. As a result, a wide array of orbital, airborne, ground-based, and in situ instruments, platforms and data analysis approaches for radioglaciology have been developed, applied or proposed. Terrestrially, airborne radar sounding has been used in glaciology to observe ice thickness, basal topography and englacial layers for five decades. More recently, radar sounding data have also been exploited to estimate the extent and configuration of subglacial water, the geometry of subglacial bedforms and the subglacial and englacial thermal states of ice sheets. Planetary radar sounders have observed, or are planned to observe, the subsurfaces and near-surfaces of Mars, Earth's Moon, comets and the icy moons of Jupiter. In this review paper, and the thematic issue of the Annals of Glaciology on ‘Five decades of radioglaciology’ to which it belongs, we present recent advances in the fields of radar systems, missions, signal processing, data analysis, modeling and scientific interpretation. Our review presents progress in these fields since the last radio-glaciological Annals of Glaciology issue of 2014, the context of their history and future prospects.
Radio-echo sounding (RES) can be used to understand ice-sheet processes, englacial flow structures and bed properties, making it one of the most popular tools in glaciological exploration. However, RES data are often subject to ‘strip noise’, caused by internal instrument noise and interference, and/or external environmental interference, which can hamper measurement and interpretation. For example, strip noise can result in reduced power from the bed, affecting the quality of ice thickness measurements and the characterization of subglacial conditions. Here, we present a method for removing strip noise based on combined wavelet and two-dimensional (2-D) Fourier filtering. First, we implement discrete wavelet decomposition on RES data to obtain multi-scale wavelet components. Then, 2-D discrete Fourier transform (DFT) spectral analysis is performed on components containing the noise. In the Fourier domain, the 2-D DFT spectrum of strip noise keeps its linear features and can be removed with a ‘targeted masking’ operation. Finally, inverse wavelet transforms are performed on all wavelet components, including strip-removed components, to restore the data with enhanced fidelity. Model tests and field-data processing demonstrate the method removes strip noise well and, incidentally, can remove the strong first reflector from the ice surface, thus improving the general quality of radar data.
OBJECTIVES/SPECIFIC AIMS: The purpose of this study was to characterize the pharmacokinetics of phosphatidylethanol (PEth) 16:0/20:4 homolog in uncoagulated, human blood samples taken from 18 participants in a clinical laboratory setting after consumption of 2 doses of ethanol. METHODS/STUDY POPULATION: Male and female participants received either 0.4 or 0.8 g/kg oral doses of ethanol during a 15-minute period. Blood samples were collected before and throughout 6 hours immediately after alcohol administration, then after 2, 4, 7, 11, and 14 days of administration day. PEth 16:0/20:4 levels were quantified by liquid mass spectrometry. Breath ethanol concentrations were measure concurrently with each blood collection during the administration day, as well as transdermal ethanol concentrations monitored constantly before, during and after ethanol administration day. RESULTS/ANTICIPATED RESULTS: (1) Single doses of 0.4 and 0.8 g ethanol/kg produced proportional increases in BrAC and PEth 16:0/20:4 levels; (2) the increase of Peth 16:0/20:4 from base line to Cmax was less than either PEth 16:0/18:1 or PEth 16:0/18:2 during the 6-hour period after ethanol administration; (3) the mean rate of formation of PEth 16:0/20:4 was lower than those of the other 2 homologs; (4) the mean half-life of PEth 16:0/20:4 was 2.18 days, which was shorter than that of either PEth 16:0/18:1 and PEth 16:0/18:2, which were 6.80 and 6.62, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of this study further confirm that PEth homologs are a sensitive biomarker for ethanol consumption. The measurement of three PEth homologs appears to provide additional information about the level and time frame of drinking.
Hemorrhage remains the major cause of preventable death after trauma. Recent data suggest that earlier blood product administration may improve outcomes. The purpose of this study was to determine whether opportunities exist for blood product transfusion by ground Emergency Medical Services (EMS).
Methods
This was a single EMS agency retrospective study of ground and helicopter responses from January 1, 2011 through December 31, 2015 for adult trauma patients transported from the scene of injury who met predetermined hemodynamic (HD) parameters for potential transfusion (heart rate [HR]≥120 and/or systolic blood pressure [SBP]≤90).
Results
A total of 7,900 scene trauma ground transports occurred during the study period. Of 420 patients meeting HD criteria for transfusion, 53 (12.6%) had a significant mechanism of injury (MOI). Outcome data were available for 51 patients; 17 received blood products during their emergency department (ED) resuscitation. The percentage of patients receiving blood products based upon HD criteria ranged from 1.0% (HR) to 5.9% (SBP) to 38.1% (HR+SBP). In all, 74 Helicopter EMS (HEMS) transports met HD criteria for blood transfusion, of which, 28 patients received prehospital blood transfusion. Statistically significant total patient care time differences were noted for both the HR and the SBP cohorts, with HEMS having longer time intervals; no statistically significant difference in mean total patient care time was noted in the HR+SBP cohort.
Conclusions
In this study population, HD parameters alone did not predict need for ED blood product administration. Despite longer transport times, only one-third of HEMS patients meeting HD criteria for blood administration received prehospital transfusion. While one-third of ground Advanced Life Support (ALS) transport patients manifesting HD compromise received blood products in the ED, this represented 0.2% of total trauma transports over the study period. Given complex logistical issues involved in prehospital blood product administration, opportunities for ground administration appear limited within the described system.
MixFM, ZielinskiMD, MyersLA, BernsKS, LukeA, StubbsJR, ZietlowSP, JenkinsDH, SztajnkrycerMD. Prehospital Blood Product Administration Opportunities in Ground Transport ALS EMS – A Descriptive Study. Prehosp Disaster Med. 2018;33(3):230–236.
Satellite altimetric time series allow high-precision monitoring of ice-sheet mass balance. Understanding elevation changes in these regions is important because outlet glaciers along ice-sheet margins are critical in controlling flow of inland ice. Here we discuss a new airborne altimetry dataset collected as part of the ICECAP (International Collaborative Exploration of the Cryosphere by Airborne Profiling) project over East Antarctica. Using the ALAMO (Airborne Laser Altimeter with Mapping Optics) system of a scanning photon-counting lidar combined with a laser altimeter, we extend the 2003–09 surface elevation record of NASA’s ICESat satellite, by determining cross-track slope and thus independently correcting for ICESat’s cross-track pointing errors. In areas of high slope, cross-track errors result in measured elevation change that combines surface slope and the actual Δz/Δt signal. Slope corrections are particularly important in coastal ice streams, which often exhibit both rapidly changing elevations and high surface slopes. As a test case (assuming that surface slopes do not change significantly) we observe a lack of ice dynamic change at Cook Ice Shelf, while significant thinning occurred at Totten and Denman Glaciers during 2003–09.
Following foliar application of 14C-bentazon [3-isopropyl-1H-2,1,3-benzothiadiazin-(4)3H-one 2,2-dioxide], a promising selective postemergence herbicide for the control of broadleaf weeds in soybean [Glycine max (L.) Merr.] and navy bean (Phaseolus vulgaris L.), the movement of the 14C-label was primarily acropetal in both species, with some basipetal movement. Metabolism was more rapid in the trifoliate navy bean leaf than in the unifoliate navy bean leaf and the trifoliate soybean leaf. Prior treatment with several other herbicides did not decrease metabolism of bentazon in navy bean. The metabolites in navy bean and soybean appeared similar. Four apparent 14C-conjugates were isolated from soybean plants harvested at full maturity.
The trifoliate leaf of tolerant navy bean (Phaseolus vulgaris L.) retained less bentazon [3-isopropyl-1H-2,1,3-benzothiadiazin-(4)3H-one 2,2-dioxide] from foliar applications than the unifoliate leaf, or the leaves from susceptible cocklebur (Xanthium pensylvanicum Wallr.) and moderately susceptible black nightshade (Solarium nigrum L.) seedlings. The 14C from 14C-bentazon applied to the foliage of black nightshade moved throughout the entire plant. In cocklebur, the 14C moved throughout the treated leaf, whereas, in the trifoliate leaf of navy bean, very little acropetal movement occurred from the site of application. However, in the unifoliate leaf of navy bean, acropetal and basipetal movement of 14C from the leaf was observed. The species differed in the 14C-metabolites formed from 14C-bentazon 1 and 5 days after treatment. The rapid metabolism of bentazon in the trifoliate leaf of navy bean appears to be related to tolerance.
Reports of unacceptable shattercane (Sorghum bicolor) control with acetolactate synthase (ALS)-inhibiting herbicides prompted the investigation of 29 fields in central and south-central Nebraska for ALS-resistant (ALSr) shattercane. These fields were located in three distinct geographical areas designated C, G, and P. Shattercane from 13 fields spanning all three areas was resistant to 80 g ai ha−1 (2 X field rate) primisulfuron. Accessions C and G were more resistant than accession P to primisulfuron and nicosulfuron. Accessions C and G were susceptible to imazethapyr, whereas accession P was resistant. The ALS resistance was associated with alterations in the ALS enzyme. Primisulfuron I50 values for ALS from ROX (forage sorghum), C, G, and P were 7, 8,510, 8,870, and 714 nM, respectively; nicosulfuron I50 values were 647, 4,110, 4,070, and 1,460 nM, respectively; and imazethapyr I50 values were 5,440, 13,100, 11,800, and 51,700 nM, respectively. Based on cross-resistance and enzyme sensitivities, at least two biotypes are represented in the three accessions of ALSr shattercane. Shattercane individuals from accessions C, G, and P were intercrossed to determine if the ALSr genes in each of the accessions were at independent loci. All the F2 populations were resistant to 80 g ai ha−1 primisulfuron, suggesting that the ALSr alleles in the three accessions are at the same locus or possibly linked loci. When the C, G, and P accessions were crossed with the wild type (WT), comparisons between the F1, susceptible, and resistant populations showed that primisulfuron resistance was expressed as a dominant, partially dominant, and additive trait for the C, G, and P accessions, respectively. The differences in ALSr allelic interactions indicate that primisulfuron resistance developed independently in each of the three accessions.
MR is a powerful modality. At its most advanced, it can be used not just to image anatomy and pathology, but to investigate organ function, to probe in vivo chemistry, and even to visualise the brain thinking. However, clinicians, technologists and scientists struggle with the study of the subject. The result is sometimes an obscurity of understanding, or a dilution of scientific truth, resulting in misconceptions. This is why MRI from Picture to Proton has achieved its reputation for practical clarity. MR is introduced as a tool, with coverage starting from the images, equipment and scanning protocols and traced back towards the underlying physics theory. With new content on quantitative MRI, MR safety, multi-band excitation, Dixon imaging, MR elastography and advanced pulse sequences, and with additional supportive materials available on the book's website, this new edition is completely revised and updated to reflect the best use of modern MR technology.