Estimated Groundwater Withdrawals from Principal Aquifers in the United States, 2015

In 2015, about 84,600 million gallons per day (Mgal/d) of groundwater were withdrawn in the United States for various uses including public supply, self-supplied domestic, industrial, mining, thermoelectric power, aquaculture, livestock, and irrigation. Of this total, about 94 percent (79,200 Mgal/d) was withdrawn from principal aquifers, which are defined as regionally extensive aquifers or aquifer systems that have the potential to be used as sources of water of suitable quality and quantity to meet various needs. The remaining 6 percent (5,400 Mgal/d) was withdrawn from other, nonprincipal aquifers in the United States. Sixty-six principal aquifers belonging to 5 major lithologic groups have been identified and delineated in the United States, including Puerto Rico and the U.S. Virgin Islands. Of the water withdrawn from principal aquifers in 2015, 81 percent (63,900 Mgal/d) was from the unconsolidated and semiconsolidated sand and gravel lithologic group, 7.1 percent (5,630 Mgal/d) was from the igneous and metamorphic-rock lithologic group, 6.8 percent (5,360 Mgal/d) was from the carbonate-rock lithologic group, 3.4 percent (2,680 Mgal/d) was from the sandstone lithologic group, and 2.2 percent (1,710 Mgal/d) was from the sandstone and carbonate-rock lithologic group. The most heavily pumped of the 24 principal aquifers and aquifer systems within the unconsolidated and semiconsolidated sand and gravel lithologic group were the High Plains aquifer (12,300 Mgal/d), Mississippi River Valley alluvial aquifer (12,100 Mgal/d), Central Valley aquifer system (11,100 Mgal/d), and Basin and Range basin-fill aquifers (7,390 Mgal/d). Withdrawals for irrigation were 48,100 Mgal/d and accounted for 75 percent of the total withdrawals from this lithologic group. Although unconsolidated sand and gravel aquifers are widely distributed and were used as sources of water in all States except Hawaii and the U.S. Virgin Islands, 56 percent of the total withdrawn from unconsolidated and semiconsolidated sand and gravel aquifers was in just four States: California (15,600 Mgal/d), Arkansas (9,560 Mgal/d), Nebraska (5,570 Mgal/d), and Texas (4,830 Mgal/d). The most heavily pumped of the seven principal aquifers within the igneous and metamorphic-rock lithologic group were the Snake River Plain (2,930 Mgal/d) and Columbia Plateau basaltic-rock aquifers (1,080 Mgal/d), which are located in the northwestern United States and together accounted for 71 percent of the water withdrawn from this lithologic group. Withdrawals for irrigation were 4,190 Mgal/d and accounted for more than 74 percent of the total withdrawals from this lithologic group. Seventy-eight percent of the withdrawals from igneous and metamorphic-rock aquifers were in three States: Idaho (3,230 Mgal/d), Washington (614 Mgal/d), and Oregon (528 Mgal/d). The most heavily pumped of the 15 principal aquifers and aquifer systems within the carbonate-rock lithologic group were the Floridan aquifer system (3,180 Mgal/d) and the Biscayne aquifer (679 Mgal/d), which are in the southeastern United States and together accounted for almost 72 percent of the withdrawals from this lithologic group. Withdrawals for public supply (2,440 Mgal/d) and irrigation (1,610 Mgal/d) together accounted for almost 76 percent of the total withdrawals from this lithologic group. Although water was withdrawn from carbonate-rock aquifers in 35 States, 71 percent of the total withdrawn was in Florida (3,020 Mgal/d) and Georgia (785 Mgal/d). The most heavily pumped of the 15 principal aquifers within the sandstone lithologic group was the Cambrian- Ordovician aquifer system (921 Mgal/d), which is in the north-central United States and accounted for 34 percent of the water withdrawn from this lithologic group. Withdrawals for public supply were 1,030 Mgal/d and accounted for 38 percent of the total withdrawals from this lithologic group. Although sandstone aquifers were used as sources of water in 32 States, 45 percent of the total withdrawn from sandstone aquifers was in five States: Minnesota (321 Mgal/d), Wisconsin (319 Mgal/d), Kansas (193 Mgal/d), Illinois (187 Mgal/d), and Pennsylvania (179 Mgal/d). The most heavily pumped of the five principal aquifers and aquifer systems within the sandstone and carbonate rock lithologic group were the Edwards-Trinity aquifer system (661 Mgal/d) in the south-central United States and the Valley and Ridge aquifers (551 Mgal/d) of the eastern United States, which together accounted for 71 percent of total withdrawals from this lithologic group. Withdrawals from sandstone and carbonate-rock aquifers for public-supply (713 Mgal/d), irrigation (469 Mgal/d), and self-supplied domestic (253 Mgal/d) uses accounted for about 84 percent of the total withdrawals from this lithologic group. Although water was withdrawn from sandstone and carbonate-rock aquifers in 25 States, 65 percent of the total withdrawn was in Texas (651 Mgal/d), Pennsylvania (238 Mgal/d), and Florida (223 Mgal/d)

Compliance with surgical care improvement project blood glucose--a marker for euglycemia, but does it put our patients at risk?

To improve outcomes in open heart surgery (OHS) patients, the Surgical Care Improvement Project (SCIP) requires 6 am postoperative day (POD) 1 and 2 blood glucose (BG) to be ≤200mg/dL. This study examined risk factors for SCIP noncompliance when using an insulin infusion protocol (IIP) and evaluated this SCIP metric as a surrogate for glycemic control. The authors divided 99 consecutive OHS patients, all subjected to 1 uniform IIP, into 2 groups: Group 1-SCIP compliant (n=79) and Group 2-SCIP noncompliant (n=20). They determined mean BG for the first 48 postoperative hours, percent of total time with hyperglycemia (% time BG \u3e200mg/dL) for each group, and assessed risk of SCIP noncompliance as relates to multiple risk factors including intensity of IIP application, and switching to subcutaneous (SQ) insulin prior to 6 am on POD 2. Group 1 had lower mean BG than Group 2 and percent of total time with hyperglycemia,

Social Difficulties in Youth with Autism With and Without Anxiety and ADHD Symptoms

Social difficulties inherent to autism spectrum disorder are often linked with co‐occurring symptoms of anxiety and attention deficit hyperactivity disorder (ADHD). The present study sought to examine the relation between such co‐occurring symptoms and social challenges. Parents of adolescents with autism (N = 113) reported upon social challenges via the social responsiveness scale (SRS) and anxiety and ADHD symptomatology via the Child Behavior Checklist. Results revealed differences in SRS scores across co‐occurring symptom subgroups (Anxiety, ADHD, Both, Neither)—namely, adolescents with autism and anxiety as well as those with autism, anxiety, and ADHD showed greater scores on the SRS than the other groups. Implications for research and clinical practice are discussed and recommendations are offered. Lay Summary Anxiety and attention deficit hyperactivity disorder (ADHD) symptoms are related to greater social challenges for adolescents with autism spectrum disorder. The present study found that autism with anxiety and autism with anxiety and ADHD, was related to greater social difficulties than autism alone. Findings provide further support for the intertwined nature of anxiety and ADHD symptoms in autism. What this may mean for research and clinical practice is considered and recommendations are suggested

Social Difficulties in Youth with Autism With and Without Anxiety and ADHD Symptoms

Social difficulties inherent to autism spectrum disorder are often linked with co‐occurring symptoms of anxiety and attention deficit hyperactivity disorder (ADHD). The present study sought to examine the relation between such co‐occurring symptoms and social challenges. Parents of adolescents with autism (N = 113) reported upon social challenges via the social responsiveness scale (SRS) and anxiety and ADHD symptomatology via the Child Behavior Checklist. Results revealed differences in SRS scores across co‐occurring symptom subgroups (Anxiety, ADHD, Both, Neither)—namely, adolescents with autism and anxiety as well as those with autism, anxiety, and ADHD showed greater scores on the SRS than the other groups. Implications for research and clinical practice are discussed and recommendations are offered. Lay Summary Anxiety and attention deficit hyperactivity disorder (ADHD) symptoms are related to greater social challenges for adolescents with autism spectrum disorder. The present study found that autism with anxiety and autism with anxiety and ADHD, was related to greater social difficulties than autism alone. Findings provide further support for the intertwined nature of anxiety and ADHD symptoms in autism. What this may mean for research and clinical practice is considered and recommendations are suggested

Weather and Climate Change Drive Annual Variation of Reproduction by an Aerial Insectivore

For many bird species, but especially aerial insectivores, reproduction depends on weather. Climate change is likely to intensify effects, but with uncertain consequences. We report 22 years of data on Eastern Kingbird (Tyrannus tyrannus) reproduction for two populations located in different hygric environments undergoing climate change; mesic central New York, USA, (NY; 12 years) and xeric southeastern Oregon, USA, (OR: 10 years). Laying date became earlier with increasing temperature in the 30-day period preceding laying in identical fashion at both sites, and in years of early laying, clutch size was larger, length of laying season increased, and failed initial nesting attempts were more often replaced. High temperature in the 10-days preceding mean laying date was associated with shorter laying seasons, while a site by 10-day temperature interaction reflected an increase and decrease of clutch size with increasing 10-day temperature in NY and OR, respectively. Seasonal rate of clutch size decline was higher when the laying season was short but also slowed in xeric OR when rain was abundant in the 10-days prior to mean laying date. Nest predation drove annual variation in young fledged/nest, but the latter also increased and decreased with increasing maximum temperature during the nestling phase in mesic NY and xeric OR, respectively. Potential effects of climate change on kingbird populations are thus high given the dependence of reproduction on weather, and climate change likely contributed to declines of kingbirds in OR. Declines of kingbirds in NY appear unrelated to warming climates because higher temperatures advanced laying dates and yielded greater nest productivity. However, length of laying season declined across years at both sites, and thus early season gains may be negated by poor conditions late in the season that may be causing shorter laying seasons. Further work is needed to identify causes for the latter changes

Palliative care needs-assessment and measurement tools used in patients with heart failure:a systematic mixed-studies review with narrative synthesis

Patients with heart failure have comparable illness burden and palliative care needs to those with cancer. However, few of them are offered timely palliative care. One main barrier is the difficulty in identifying those who require palliative care. Several palliative care needs-assessment/measurement tools were used to help identify these patients and assess/measure their needs, but it is not known which one is the most appropriate for this population. This review aimed to identify the most appropriate palliative care needs-assessment/measurement tools for patients with heart failure. Cochrane Library, MEDLINE Complete, AMED, PsycINFO, CINAHL Complete, EMBASE, EThOS, websites of the identified tools, and references and citations of the included studies were searched from inception to 25 June 2020. Studies were included if they evaluated palliative care needs-assessment/measurement tools for heart failure populations in terms of development, psychometrics, or palliative care patient/needs identification. Twenty-seven papers were included regarding nineteen studies, most of which were quantitative and observational. Six tools were identified and compared according to their content and context of use, development, psychometrics, and clinical applications in identifying patients with palliative care needs. Despite limited evidence, the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF) is the most appropriate palliative care needs-assessment tool for use in heart failure populations. It covers most of the patient needs and has the best psychometric properties and evidence of identification ability and appropriateness. Psychometric testing of the tools in patients with heart failure and evaluating the tools to identify those with palliative care needs require more investigation.4

Anatomy and Three-Dimensional Reconstructions of the Brain of the White Whale (Delphinapterus leucas) From Magnetic Resonance Images

Magnetic resonance imaging offers a means of observing the internal structure of the brain where traditional procedures of embedding, sectioning, staining, mounting, and microscopic examination of thousands of sections are not practical. Furthermore, internal structures can be analyzed in their precise quantitative spatial interrelationships, which is difficult to accomplish after the spatial distortions often accompanying histological processing. For these reasons, magnetic resonance imaging makes specimens that were traditionally difficult to analyze, more accessible. In the present study, images of the brain of a white whale (Beluga) Delphinapterus leucas were scanned in the coronal plane at 119 antero-posterior levels. Fromthese scans, a computer-generated three-dimensional model was constructed using the programs VoxelViewand VoxelMath (Vital Images, Inc.). This model, wherein details of internal and external morphology are represented in three-dimensional space, was then resectioned in orthogonal planes to produce corresponding series of “virtual” sections in the horizontal and sagittal planes. Sections in all three planes display the sizes and positions of such structures as the corpus callosum, internal capsule, cerebral peduncles, cerebral ventricles, certain thalamic nuclear groups, caudate nucleus, ventral striatum, pontine nuclei, cerebellar cortex and white matter, and all cerebral cortical sulci and gyri