The Western Sand Cherry

This Bulletin is intended to be a preliminary report and announcement of progress and not a complete monograph. The story of the work at this Station is told mainly by the twenty cuts illustrating these pages. But as the Western Sand Cherry is a new fruit just passing from its native prairie home over the fence· into the cultivated garden, it will be of interest to give some of the main facts in the history of its development. No claim is made as to completeness. An effort, however, has been made to give the salient points

An Illustrated Flora of the Northern United States, Canada and the British Possessions

v.2 (1897

Decreasing Hospital-Related Complications Using Hourly Nurse Rounding Focused on the 4 P\u27s

This review of literature sought to find the best practice for nurse rounding in hospitals in an effort to reduce hospital-related complication (falls, pressure ulcers) and improve patient satisfaction. Current research shows a growing trend toward hourly rounding centered on addressing basic patient needs, also known as the 4 P\u27s (pain, potty, position and presence). See abstract for more details

Responses of intertidal invertebrates to rising sea surface temperatures in the southeastern Indian Ocean

Introduction: The west coast of Western Australia (WA) is a global hotspot for increasing sea surface temperatures and marine heatwaves. Methods: We used visual survey transects to compare mollusc and echinoderm populations on three coastal intertidal platform reefs on the Perth shoreline with two intertidal platforms at the west end of Rottnest Island (32°S) which are under the influence of the southward flowing Leeuwin Current. Results: In 1983, temperate species dominated Perth coastal molluscan diversity, but the tropical mussel Brachidontes sculptus dominated density. Species richness on coastal platforms remained constant in 2007 and 2021, but total densities were lower in 2007 as B. sculptus declined; partial recovery occurred on coastal platforms in 2021. Tropical species were a significant component of mollusc diversity and density at Rottnest Island in 1982 and 2007. Total mollusc density declined by 98% at the island sites of Radar Reef and 86% at Cape Vlamingh and total echinoderm density by 52% and 88% respectively from 2007 to 2021; species diversity also declined sharply. Discussion: Tropical species have moved southward in WA subtidal environments, but tropical, temperate and WA endemic species all suffered losses of biodiversity and catastrophic declines in density of 90% or more on the two Rottnest Island intertidal platforms. Data presented here provide a sound basis for exploring the possible causes of the catastrophic mortality at the west end of Rottnest Island and monitoring for recovery

Disseminated Effects in Agent Based Models: A Potential Outcomes Framework and Application to Inform Pre-Exposure Prophylaxis Coverage Levels for HIV Prevention

Pre-exposure prophylaxis (PrEP) for HIV prevention may not only benefit the individual who uses it, but also their uninfected sexual risk contacts. We developed an agent-based model using a novel trial emulation approach to quantify disseminated effects of PrEP use among men who have sex with men in Atlanta, USA from 2015 to 2017. Components (subsets of agents connected through partnerships in a sexual network, but not sharing partnerships with any other agents) were first randomized to an intervention coverage level or control, then within intervention components, eligible agents were randomized to PrEP. We estimated direct and disseminated (indirect) effects using randomization-based estimators and reported corresponding 95% simulation intervals across scenarios ranging from 10% to 90% coverage in the intervention components. A population of 11,245 agents was simulated with an average of 1,551 components identified. Comparing agents randomized to PrEP in 70% coverage components to control agents, there was a 15% disseminated risk reduction in HIV incidence (95% simulation intervals = 0.65, 1.05). Individuals not on PrEP may receive a protective benefit by being in a sexual network with higher PrEP coverage. Agent-based models are useful to evaluate possible direct and disseminated effects of HIV prevention modalities in sexual networks

A cost-effectiveness analysis of newborn screening for severe combined immunodeficiency in the UK

Severe combined immunodeficiency (SCID) can be detected through newborn bloodspot screening. In the UK, the National Screening Committee (NSC) requires screening programmes to be cost-effective at standard UK thresholds. To assess the cost-effectiveness of SCID screening for the NSC, a decision-tree model with lifetable estimates of outcomes was built. Model structure and parameterisation were informed by systematic review and expert clinical judgment. A public service perspective was used and lifetime costs and quality-adjusted life years (QALYs) were discounted at 3.5%. Probabilistic, one-way sensitivity analyses and an exploratory disbenefit analysis for the identification of non-SCID patients were conducted. Screening for SCID was estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,222 with a reduction in SCID mortality from 8.1 (5–12) to 1.7 (0.6–4.0) cases per year of screening. Results were sensitive to a number of parameters, including the cost of the screening test, the incidence of SCID and the disbenefit to the healthy at birth and false-positive cases. Screening for SCID is likely to be cost-effective at £20,000 per QALY, key uncertainties relate to the impact on false positives and the impact on the identification of children with non-SCID T Cell lymphopenia