The impact of Hurricane Sandy on the shoreface and inner shelf of Fire Island, New York : large bedform migration but limited erosion

© The Author(s), 2015. This is the author's version of the work. It is posted here by permission of Elsevier for personal use, not for redistribution.. The definitive version was published in Continental Shelf Research 98 (2015): 13-25, doi:10.1016/j.csr.2015.03.001.We investigate the impact of superstorm Sandy on the lower shoreface and inner shelf offshore the barrier island system of Fire Island, NY using before-and-after surveys involving swath bathymetry, backscatter and CHIRP acoustic reflection data. As sea level rises over the long term, the shoreface and inner shelf are eroded as barrier islands migrate landward; large storms like Sandy are thought to be a primary driver of this largely evolutionary process. The “before” data were collected in 2011 by the U.S. Geological Survey as part of a long-term investigation of the Fire Island barrier system. The “after” data were collected in January, 2013, ~two months after the storm. Surprisingly, no widespread erosional event was observed. Rather, the primary impact of Sandy on the shoreface and inner shelf was to force migration of major bedforms (sand ridges and sorted bedforms) 10’s of meters WSW alongshore, decreasing in migration distance with increasing water depth. Although greater in rate, this migratory behavior is no different than observations made over the 15-year span prior to the 2011 survey. Stratigraphic observations of buried, offshore-thinning fluvial channels indicate that long-term erosion of older sediments is focused in water depths ranging from the base of the shoreface (~13-16 m) to ~21 m on the inner shelf, which is coincident with the range of depth over which sand ridges and sorted bedforms migrated in response to Sandy. We hypothesize that bedform migration regulates erosion over these water depths and controls the formation of a widely observed transgressive ravinement; focusing erosion of older material occurs at the base of the stoss (upcurrent) flank of the bedforms. Secondary storm impacts include the formation of ephemeral hummocky bedforms and the deposition of a mud event layer.This work was funded primarily by a rapid response grant from the Jackson School of Geosciences, The University of Texas/Austi

Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease

We identified rare coding variants associated with Alzheimer’s disease (AD) in a 3-stage case-control study of 85,133 subjects. In stage 1, 34,174 samples were genotyped using a whole-exome microarray. In stage 2, we tested associated variants (P<1×10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, an additional 14,997 samples were used to test the most significant stage 2 associations (P<5×10-8) using imputed genotypes. We observed 3 novel genome-wide significant (GWS) AD associated non-synonymous variants; a protective variant in PLCG2 (rs72824905/p.P522R, P=5.38×10-10, OR=0.68, MAFcases=0.0059, MAFcontrols=0.0093), a risk variant in ABI3 (rs616338/p.S209F, P=4.56×10-10, OR=1.43, MAFcases=0.011, MAFcontrols=0.008), and a novel GWS variant in TREM2 (rs143332484/p.R62H, P=1.55×10-14, OR=1.67, MAFcases=0.0143, MAFcontrols=0.0089), a known AD susceptibility gene. These protein-coding changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified AD risk genes. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to AD development

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

“Come and Take a Walk”: Listening to Early Head Start Parents on School-Readiness as a Matter of Child, Family, and Community Health

We explored the perspectives and experiences of low-income, predominantly African American families regarding children’s school-readiness. Our research, which involved qualitative interviews, ethnographic case studies, and “photovoice” methods, focused on families participating in the national evaluation of Early Head Start. While valuing academic skills, study parents emphasized the importance of social and emotional health in regard to both children’s and parents’ readiness to begin school. These developments are especially critical given the challenges parents perceive in local school environments. On the basis of a social ecology framework, we argue that psychological and environmental dimensions of school-readiness are public health matters and that understanding the perspectives of low-income and minority parents on such issues is a critical aspect of health communication dedicated to eliminating health disparities