286,470 research outputs found

    Regional variability in use of a novel assessment of thoracolumbar spine fractures: United States versus international surgeons

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    <p>Abstract</p> <p>Background</p> <p>Considerable variability exists in clinical approaches to thoracolumbar fractures. Controversy in evaluation and nomenclature contribute to this confusion, with significant differences found between physicians, between different specialties, and in different geographic regions. A new classification system for thoracolumbar injuries, the Thoracolumbar Injury Severity Score (TLISS), was recently described by Vaccaro. No assessment of regional differences has been described. We report regional variability in use of the TLISS system between United States and non-US surgeons.</p> <p>Methods</p> <p>Twenty-eight spine surgeons (8 neurosurgeons and 20 orthopedic surgeons) reviewed 56 clinical thoracolumbar injury case histories, which included pertinent imaging studies. Cases were classified and scored using the TLISS system. After a three month period, the case histories were re-ordered and the physicians repeated the exercise; 22 physicians completed both surveys and were used to assess intra-rater reliability. The reliability and treatment validity of the TLISS was assessed. Surgeons were grouped into US (n = 15) and non-US (n = 13) cohorts. Inter-rater (both within and between different geographic groups) and intra-rater reliability was assessed by percent agreement, Cohen's kappa, kappa with linear weighting, and Spearman's rank-order correlation.</p> <p>Conclusion</p> <p>Non-US surgeons were found to have greater inter-rater reliability in injury mechanism, while agreement on neurological status and posterior ligamentous complex integrity tended to be higher among US surgeons. Inter-rater agreement on management was moderate, although it tended to be higher in US-surgeons. Inter-rater agreement between US and non-US surgeons was similar to within group inter-rater agreement for all categories. While intra-rater agreement for mechanism tended to be higher among US surgeons, intra-rater reliability for neurological status and PLC was slightly higher among non-US surgeons. Intra-rater reliability for management was substantial in both US and non-US surgeons. The TLISS incorporates generally accepted features of spinal injury assessment into a simple patient evaluation tool. The management recommendation of the treatment algorithm component of the TLISS shows good inter-rater and substantial intra-rater reliability in both non-US and US based spine surgeons. The TLISS may improve communication between health providers and may contribute to more efficient management of thoracolumbar injuries.</p

    A review of Australian approaches for monitoring, assessing and reporting estuarine condition: I. International context and evaluation criteria

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    © 2016 Elsevier Ltd Given the immeasurable value of estuaries and their severe and growing pressures, sound understanding and reporting of estuarine condition is essential for their effective management and sustainable development. In light of this, we aim to provide a timely and comprehensive three-part review of the approaches currently employed for monitoring, assessing and reporting estuarine condition, focussing on Australian systems. Here, in Part 1, we establish the national and international context of our review and define globally-relevant evaluation criteria against which to assess Australian progress. We achieve this by examining effective monitoring, assessment and reporting programs from around the world and characterising ‘best practice’. We then highlight the Australian historical context and consider recent policies, frameworks, guidelines and legislation relating to the monitoring and reporting of estuarine condition nationwide

    A review of Australian approaches for monitoring, assessing and reporting estuarine condition: III. Evaluation against international best practice and recommendations for the future

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    In this final component of a three-part review, we present a national synthesis and evaluation of approaches for monitoring, assessing and reporting estuarine condition across Australia. Progress is evaluated against objective criteria that together provide a model of international best practice. We critically assess the limitations, inconsistencies and gaps that are evident across Australian jurisdictions, and identify common obstacles to future progress. Major strengths and successes are also highlighted, together with specific examples of best practice from around Australia that are transferable to other States and beyond. Significant obstacles to greater national coordination of monitoring and reporting practices include inconsistent spatial scales of management, pluralistic governance structures and the lack of any overarching legislation. Nonetheless, many perceptible advances have been made over the last decade across Australia in estuarine monitoring and health assessment, and there is great potential for further progress. Finally, we provide a list of recommendations to address some of the most pressing limitations and gaps, and support improved future monitoring, assessment and reporting for Australian estuaries

    An objective framework to test the quality of candidate indicators of good environmental status

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    Large efforts are on-going within the EU to prepare the Marine Strategy Framework Directive's (MSFD) assessment of the environmental status of the European seas. This assessment will only be as good as the indicators chosen to monitor the 11 descriptors of good environmental status (GEnS). An objective and transparent framework to determine whether chosen indicators actually support the aims of this policy is, however, not yet in place. Such frameworks are needed to ensure that the limited resources available to this assessment optimize the likelihood of achieving GEnS within collaborating states. Here, we developed a hypothesis-based protocol to evaluate whether candidate indicators meet quality criteria explicit to the MSFD, which the assessment community aspires to. Eight quality criteria are distilled from existing initiatives, and a testing and scoring protocol for each of them is presented. We exemplify its application in three worked examples, covering indicators for three GEnS descriptors (1, 5, and 6), various habitat components (seaweeds, seagrasses, benthic macrofauna, and plankton), and assessment regions (Danish, Lithuanian, and UK waters). We argue that this framework provides a necessary, transparent and standardized structure to support the comparison of candidate indicators, and the decision-making process leading to indicator selection. Its application could help identify potential limitations in currently available candidate metrics and, in such cases, help focus the development of more adequate indicators. Use of such standardized approaches will facilitate the sharing of knowledge gained across the MSFD parties despite context-specificity across assessment regions, and support the evidence-based management of European seas

    Joint Report of Peer Review Panel for Numeric Nutrient Criteria for the Great Bay Estuary New Hampshire Department of Environmental Services June, 2009

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    This peer review was authorized through a collaborative agreement sponsored by the New Hampshire Department of Environmental Services (DES) and the Cities of Dover, Rochester and Portsmouth, New Hampshire. The purpose was to conduct an independent scientific peer review of the document entitled, “Numeric Nutrient Criteria for the Great Bay Estuary,” dated June, 2009 (DES 2009 Report)

    An Independent Review of USGS Circular 1370: An Evaluation of the Science Needs to Inform Decisions on Outer Continental Shelf Energy Development in the Chukchi and Beaufort Seas, Alaska

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    Reviews the U.S. Geological Survey's findings and recommendations on Alaska's Arctic Ocean, including geology, ecology and subsistence, effect of climate change on, and impact of oil spills. Makes recommendations for data management and other issues

    Identifying Advantages and Disadvantages of Variable Rate Irrigation – An Updated Review

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    Variable rate irrigation (VRI) sprinklers on mechanical move irrigation systems (center pivot or lateral move) have been commercially available since 2004. Although the number of VRI, zone or individual sprinkler, systems adopted to date is lower than expected there is a continued interest to harness this technology, especially when climate variability, regulatory nutrient management, water conservation policies, and declining water for agriculture compound the challenges involved for irrigated crop production. This article reviews the potential advantages and potential disadvantages of VRI technology for moving sprinklers, provides updated examples on such aspects, suggests a protocol for designing and implementing VRI technology and reports on the recent advancements. The advantages of VRI technology are demonstrated in the areas of agronomic improvement, greater economic returns, environmental protection and risk management, while the main drawbacks to VRI technology include the complexity to successfully implement the technology and the lack of evidence that it assures better performance in net profit or water savings. Although advances have been made in VRI technologies, its penetration into the market will continue to depend on tangible and perceived benefits by producers

    Quantify resilience enhancement of UTS through exploiting connect community and internet of everything emerging technologies

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    This work aims at investigating and quantifying the Urban Transport System (UTS) resilience enhancement enabled by the adoption of emerging technology such as Internet of Everything (IoE) and the new trend of the Connected Community (CC). A conceptual extension of Functional Resonance Analysis Method (FRAM) and its formalization have been proposed and used to model UTS complexity. The scope is to identify the system functions and their interdependencies with a particular focus on those that have a relation and impact on people and communities. Network analysis techniques have been applied to the FRAM model to identify and estimate the most critical community-related functions. The notion of Variability Rate (VR) has been defined as the amount of output variability generated by an upstream function that can be tolerated/absorbed by a downstream function, without significantly increasing of its subsequent output variability. A fuzzy based quantification of the VR on expert judgment has been developed when quantitative data are not available. Our approach has been applied to a critical scenario (water bomb/flash flooding) considering two cases: when UTS has CC and IoE implemented or not. The results show a remarkable VR enhancement if CC and IoE are deploye

    PICES Press, Vol. 18, No. 2, Summer 2010

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    •The 2010 Inter-sessional Science Board Meeting: A Note from the Science Board Chairman (pp. 1-3) •2010 Symposium on “Effects of Climate Change on Fish and Fisheries” (pp. 4-11) •2009 Mechanism of North Pacific Low Frequency Variability Workshop (pp. 12-14) •The Fourth China-Japan-Korea GLOBEC/IMBER Symposium (pp. 15-17, 23) •2010 Sendai Ocean Acidification Workshop (pp. 18-19, 31) •2010 Sendai Coupled Climate-to-Fish-to-Fishers Models Workshop (pp. 20-21) •2010 Sendai Salmon Workshop on Climate Change (pp. 22-23) •2010 Sendai Zooplankton Workshop (pp. 24-25, 28) •2010 Sendai Workshop on “Networking across Global Marine Hotspots” (pp. 26-28) •The Ocean, Salmon, Ecology and Forecasting in 2010 (pp. 29, 44) •The State of the Northeast Pacific during the Winter of 2009/2010 (pp. 30-31) •The State of the Western North Pacific in the Second Half of 2009 (pp. 32-33) •The Bering Sea: Current Status and Recent Events (pp. 34-35, 39) •PICES Seafood Safety Project: Guatemala Training Program (pp. 36-39) •The Pacific Ocean Boundary Ecosystem and Climate Study (POBEX) (pp. 40-43) •PICES Calendar (p. 44

    PICES Press, Vol. 21, No. 1, Winter 2013

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    •2012 PICES Science: A Note from the Science Board Chairman (pp. 1-6) ◾2012 PICES Awards (pp. 7-9) ◾GLOBEC/PICES/ICES ECOFOR Workshop (pp. 10-15) ◾ICES/PICES Symposium on “Forage Fish Interactions” (pp. 16-18) ◾The Yeosu Declaration, the Yeosu Declaration Forum and the Yeosu Project (pp. 19-23) ◾2013 PICES Calendar (p. 23) ◾Why Do We Need Human Dimensions for the FUTURE Program? (pp. 24-25) ◾New PICES MAFF-Sponsored Project on “Marine Ecosystem Health and Human Well-Being” (pp. 26-28) ◾The Bering Sea: Current Status and Recent Trends (pp. 29-31) ◾Continuing Cool in the Northeast Pacific Ocean (pp. 32, 35) ◾The State of the Western North Pacific in the First Half of 2012 (pp. 33-35) ◾New Leadership in PICES (pp. 36-39
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