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Effect of Coronavirus Disease 2019 (Covid-19), a Nationwide Mass Casualty Disaster on Intensive Care Units: Clinical Outcomes and Associated Cost-of-Care
- Allison M. Henning, Neal J. Thomas, Duane C. Williams, David M. Shore, Michelle E. Memmi, Li Wang
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
- Published online by Cambridge University Press:
- 15 June 2022, e249
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Objective:
The COVID-19 pandemic resulted in millions of deaths worldwide and is considered a significant mass-casualty disaster (MCD). The surge of patients and scarcity of resources negatively impacted hospitals, patients and medical practice. We hypothesized ICUs during this MCD had a higher acuity of illness, and subsequently had increased lengths of stay (LOS), complication rates, death rates and costs of care. The purpose of this study was to investigate those outcomes.
Methods:This was a multicenter, retrospective study that compared intensive care admissions in 2020 to those in 2019 to evaluate patient outcomes and cost of care. Data were obtained from the Vizient Clinical Data Base/Resource Manager (Vizient Inc., Irvine, Texas, USA).
Results:Data included the number of ICU admissions, patient outcomes, case mix index and summary of cost reports. Quality outcomes were also collected, and a total of 1304981 patients from 333 hospitals were included. For all medical centers, there was a significant increase in LOS index, ICU LOS, complication rate, case mix index, total cost, and direct cost index.
Conclusion:The MCD caused by COVID-19 was associated with increased adverse outcomes and cost-of-care for ICU patients.
Ten new insights in climate science 2021: a horizon scan
- Maria A. Martin, Olga Alcaraz Sendra, Ana Bastos, Nico Bauer, Christoph Bertram, Thorsten Blenckner, Kathryn Bowen, Paulo M. Brando, Tanya Brodie Rudolph, Milena Büchs, Mercedes Bustamante, Deliang Chen, Helen Cleugh, Purnamita Dasgupta, Fatima Denton, Jonathan F. Donges, Felix Kwabena Donkor, Hongbo Duan, Carlos M. Duarte, Kristie L. Ebi, Clea M. Edwards, Anja Engel, Eleanor Fisher, Sabine Fuss, Juliana Gaertner, Andrew Gettelman, Cécile A.J. Girardin, Nicholas R. Golledge, Jessica F. Green, Michael R. Grose, Masahiro Hashizume, Sophie Hebden, Helmke Hepach, Marina Hirota, Huang-Hsiung Hsu, Satoshi Kojima, Sharachchandra Lele, Sylvia Lorek, Heike K. Lotze, H. Damon Matthews, Darren McCauley, Desta Mebratu, Nadine Mengis, Rachael H. Nolan, Erik Pihl, Stefan Rahmstorf, Aaron Redman, Colleen E. Reid, Johan Rockström, Joeri Rogelj, Marielle Saunois, Lizzie Sayer, Peter Schlosser, Giles B. Sioen, Joachim H. Spangenberg, Detlef Stammer, Thomas N.S. Sterner, Nicola Stevens, Kirsten Thonicke, Hanqin Tian, Ricarda Winkelmann, James Woodcock
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- Journal:
- Global Sustainability / Volume 4 / 2021
- Published online by Cambridge University Press:
- 18 October 2021, e25
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- Article
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Non-technical summary
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2 factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.
Technical summaryA synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
Social media summaryHow do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
Contributors
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- By Ghazi Al-Rawas, Vazken Andréassian, Tianqi Ao, Stacey A. Archfield, Berit Arheimer, András Bárdossy, Trent Biggs, Günter Blöschl, Theresa Blume, Marco Borga, Helge Bormann, Gianluca Botter, Tom Brown, Donald H. Burn, Sean K. Carey, Attilio Castellarin, Francis Chiew, François Colin, Paulin Coulibaly, Armand Crabit, Barry Croke, Siegfried Demuth, Qingyun Duan, Giuliano Di Baldassarre, Thomas Dunne, Ying Fan, Xing Fang, Boris Gartsman, Alexander Gelfan, Mikhail Georgievski, Nick van de Giesen, David C. Goodrich, Hoshin V. Gupta, Khaled Haddad, David M. Hannah, H. A. P. Hapuarachchi, Hege Hisdal, Kamila Hlavčová, Markus Hrachowitz, Denis A. Hughes, Günter Humer, Ruud Hurkmans, Vito Iacobellis, Elena Ilyichyova, Hiroshi Ishidaira, Graham Jewitt, Shaofeng Jia, Jeffrey R. Kennedy, Anthony S. Kiem, Robert Kirnbauer, Thomas R. Kjeldsen, Jürgen Komma, Leonid M. Korytny, Charles N. Kroll, George Kuczera, Gregor Laaha, Henny A. J. van Lanen, Hjalmar Laudon, Jens Liebe, Shijun Lin, Göran Lindström, Suxia Liu, Jun Magome, Danny G. Marks, Dominic Mazvimavi, Jeffrey J. McDonnell, Brian L. McGlynn, Kevin J. McGuire, Neil McIntyre, Thomas A. McMahon, Ralf Merz, Robert A. Metcalfe, Alberto Montanari, David Morris, Roger Moussa, Lakshman Nandagiri, Thomas Nester, Taha B. M. J. Ouarda, Ludovic Oudin, Juraj Parajka, Charles S. Pearson, Murray C. Peel, Charles Perrin, John W. Pomeroy, David A. Post, Ataur Rahman, Liliang Ren, Magdalena Rogger, Dan Rosbjerg, José Luis Salinas, Jos Samuel, Eric Sauquet, Hubert H. G. Savenije, Takahiro Sayama, John C. Schaake, Kevin Shook, Murugesu Sivapalan, Jon Olav Skøien, Chris Soulsby, Christopher Spence, R. ‘Sri’ Srikanthan, Tammo S. Steenhuis, Jan Szolgay, Yasuto Tachikawa, Kuniyoshi Takeuchi, Lena M. Tallaksen, Dörthe Tetzlaff, Sally E. Thompson, Elena Toth, Peter A. Troch, Remko Uijlenhoet, Carl L. Unkrich, Alberto Viglione, Neil R. Viney, Richard M. Vogel, Thorsten Wagener, M. Todd Walter, Guoqiang Wang, Markus Weiler, Rolf Weingartner, Erwin Weinmann, Hessel Winsemius, Ross A. Woods, Dawen Yang, Chihiro Yoshimura, Andy Young, Gordon Young, Erwin Zehe, Yongqiang Zhang, Maichun C. Zhou
- Edited by Günter Blöschl, Technische Universität Wien, Austria, Murugesu Sivapalan, University of Illinois, Urbana-Champaign, Thorsten Wagener, University of Bristol, Alberto Viglione, Technische Universität Wien, Austria, Hubert Savenije, Technische Universiteit Delft, The Netherlands
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- Book:
- Runoff Prediction in Ungauged Basins
- Published online:
- 05 April 2013
- Print publication:
- 18 April 2013, pp ix-xiv
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FOLIAR APPLICATIONS OF BEAUVERIA BASSIANA (BALSAMO) VUILLEMIN FOR CONTROL OF THE COLORADO POTATO BEETLE, LEPTINOTARSA DECEMLINEATA (SAY) (COLEOPTERA: CHRYSOMELIDAE): AN OVERVIEW OF PILOT TEST RESULTS FROM THE NORTHERN UNITED STATES
- Ann E. Hajek, Richard S. Soper, Donald W. Roberts, Thomas E. Anderson, K. Duane Biever, David N. Ferro, Roger A. LeBrun, Richard H. Storch
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- Journal:
- The Canadian Entomologist / Volume 119 / Issue 11 / November 1987
- Published online by Cambridge University Press:
- 31 May 2012, pp. 959-974
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An overview of data from five research groups participating in a 3-year pilot test on the efficacy of foliar applications of Beauveria bassiana (Balsamo) Vuillemin for control of Colorado potato beetle, Leptinotarsa decemlineata (Say), populations in the northern United States is presented. Four treatments were used at each site: high and low B. bassiana dosages (5 × 1013 colony forming units (CFU) per hectare (ha) and 5 × 1012 CFU/ha), the recommended insecticide for each region, and an untreated check. The primary response variable was potato yield. For analyses considering test sites as replicates, during all 3 years the highest yields were produced in plots treated with insecticides. Within test sites, yields from plots receiving B. bassiana applications were greater than control plot yields in 8 of 24 trials but in only two of these instances, B. bassiana plot yields also did not differ from insecticide plot yields. Evaluating 1983 data from all states together, no differences were found between either high or low B. bassiana treatments and controls. The 1983 study design allowed no plot replication within states. In 1985, an altered plot design providing within-site replication demonstrated increased yield with increased dosage of B. bassiana when initial egg density was used as a covariate.
Potato yields greater than control plot yields were noted with a minimum of 5.39 and 6.62 × 1011 CFU/ha B. bassiana. The lowest B. bassiana concentration producing yields not significantly different from insecticide plot yields was 6.62 × 1012 CFU/ha (Rhode Island, 1984). Defoliation ratings did not differ between B. bassiana treatments and controls in 1984 and 1985, although variability was found between yields.
Contributors
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- By John Andrzejowski, Joseph E. Arrowsmith, Sam Bass, Clare Bates, Dominic Bell, David Bogod, Tim M. Cook, Mike Coupe, Mark Dougherty, Derek Duane, Peter Faber, Fay J. Gilder, Helen Goddard, Tom Holmes, Victoria Howell, James Hoyle, Aoibhin Hutchinson, Alison Kavanagh, Andrew A. Klein, Nick Lees, Benias Mugabe, Jurgens Nortje, Felicity Plaat, Saxon Ridley, Andrew Roscoe, Martin Shields, Alistair Steel, Jane Sturgess, Rajinikanth Sundararajan, Kasia Szypula, Dafydd Thomas, Hamish Thomson, Kamen Valchanov, A. James Varley, Stephen T. Webb, Matt Wilkner, Nick Woodall
- Edited by Kamen Valchanov, Stephen T. Webb, Jane Sturgess
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- Book:
- Anaesthetic and Perioperative Complications
- Published online:
- 07 October 2011
- Print publication:
- 22 September 2011, pp ix-x
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The impact of classroom aggression on the development of aggressive behavior problems in children
- DUANE E. THOMAS, KAREN L. BIERMAN, THE CONDUCT PROBLEMS PREVENTION RESEARCH GROUP
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- Journal:
- Development and Psychopathology / Volume 18 / Issue 2 / June 2006
- Published online by Cambridge University Press:
- 28 March 2006, pp. 471-487
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Prior research suggests that exposure to elementary classrooms characterized by high levels of student aggression may contribute to the development of child aggressive behavior problems. To explore this process in more detail, this study followed a longitudinal sample of 4,907 children and examined demographic factors associated with exposure to high-aggression classrooms, including school context factors (school size, student poverty levels, and rural vs. urban location) and child ethnicity (African American, European American). The developmental impact of different temporal patterns of exposure (e.g., primacy, recency, chronicity) to high-aggression classrooms was evaluated on child aggression. Analyses revealed that African American children attending large, urban schools that served socioeconomically disadvantaged students were more likely than other students to be exposed to high-aggressive classroom contexts. Hierarchical regressions demonstrated cumulative effects for temporal exposure, whereby children with multiple years of exposure showed higher levels of aggressive behavior after 3 years than children with primacy, less recent, and less chronic exposure, controlling for initial levels of aggression. Implications are discussed for developmental research and preventive interventions.
Members of the Conduct Problems Prevention Research Group include Karen L. Bierman, Pennsylvania State University; John D. Coie, Duke University; Kenneth A. Dodge, Duke University; E. Michael Foster, Pennsylvania State University; Mark T. Greenberg, Pennsylvania State University; John E. Lochman, University of Alabama; Robert J. McMahon, University of Washington; and Ellen E. Pinderhughes, Tufts University. This research was supported by the National Institute of Mental Health Grants R18MH48083, R18MH50951, R18MH50952, and R18MH50953. The Center for Substance Abuse Prevention, Department of Education, and the National Institute for Drug Abuse also provided support for FAST Track through a memorandum of support with the NIMH. Support has also come from the Department of Education grant S184430002, NIMH Grants K05MH00797 and K05MH01027, and a research grant from the Harry Frank Guggenheim Foundation. Appreciation is expressed to the parents, teachers, students, and school district personnel who supported this research in the Durham, NC, Nashville, TN, central Pennsylvania, and Seattle, WA areas. The first author thanks Drs. Nicholas Ialongo and Shani Harris-Peterson, Johns Hopkins University, for their input on earlier drafts of this manuscript, as well as Drs. Chi-Ming Kam and Brenda Heinrichs, Pennsylvania State University, and Dr. Sharon Smith, National Institute on Alcohol Abuse and Alcoholism, for their statistical consultation with this project.
Nematode diversity in the Gulf of Maine, USA, and a Web-accessible, relational database
- Eyualem Abebe, Raymond E. Grizzle, Duane Hope, William K. Thomas
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 84 / Issue 6 / December 2004
- Published online by Cambridge University Press:
- 23 November 2004, pp. 1159-1167
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Nematode assemblages were studied from four sublittoral sites at 50–56 m depth in the Gulf of Maine, north-eastern coast of the USA, within the context of an open ocean aquaculture experimental site. All four sites, two potential impact and two control sites, had a similar muddy–sand bottom and low organic content. Seventy genera in 27 families were recorded from a total of 1072 individuals. All but one taxa could be related to known genera. Family Comesomatidae was the most dominant with close to a third (27·6%) of the total individuals. At the genus level Sabatieria and Setosabatieria were most dominant with a quarter of the total number of individuals. Composition of dominant families from the Gulf of Maine differed from all hitherto reported sublittoral or deep-sea communities from both sides of the Atlantic, and most similar with European estuaries.
Nematode diversity at the genus-level was reasonably high and was comparable with Mediterranean samples. Most diversity indices ordered the four sites similarly with Site 2 as the most diverse followed by Site 5 and then Site 6. By contrast the relative diversity of Site 4 depended on the index employed and its k-dominance curve crossed that of the others. Furthermore based on clustering the community at Site 4 was least similar to the others. Although these observations could be related to the fact that Site 4 is within the expected impact zone of the fish cage, the low number of fish introduced by the time of sampling and the lack of any difference in the maturity index among all the sites argue that these results can be considered before-impact data for further monitoring of the open ocean aquaculture experiment.
A new paradigm where morphological information is documented and communicated using digital multifocal images is introduced. Each video image is comparable with visualization of a specimen under a microscope where the movie can be played back and forth to mimic focusing through a specimen. Web-based and openly accessible digital multifocal images were used to document and effectively communicate the morphology of all the identified genera in this study. This approach for documenting and communicating survey results is proposed as a benchmark for future similar studies that would enhance standardization and quality control of meiofaunal taxonomy, ecology and biodiversity studies.