Reef-Top Sediment Bodies: Windward O‘ahu, Hawai‘i.

v. ill. 23 cm.QuarterlyHawaiian fringing reefs display sand bodies on their surfaces that are potentially important components of littoral sediment budgets. This work provides a regional survey of modern reef-top sediment storage and investigated geologic controls on sediment storage potential. Sand bodies are formed when sediment accumulates in topographic depressions that are the result of meteoric water eroding the emerged carbonate reef platform during periods of lower sea level. The relief of some depressions may be modified by Holocene reef accretion. Depression morphology exerts a strong control on volume and internal distribution of sediment. In this study a total of 205 jet probe thickness measurements was collected from 54 major sand bodies on the fringing reef (0–20 m depth) adjacent to 22 km of Southeast O‘ahu coastline (Kailua, Lanikai, and Waima¯nalo). Volumes were determined and synthesized with previous volume estimates of coastal subaerial and deeper submarine sediment bodies (20–200 m depth), giving the total sediment storage within the coastal system. Sand bodies range from 50 to 2,800 m from shore. Measured thickness varied from 0 to greater than 3.0 m with a mean of 0.95 m. For this study sand bodies were classified into three dominate morphologies: channel, field, and karst depression. The volume of sediment stored in channels was 58;253G618 _ 103 m3, fields contained 171G6 _ 103 m3, and karst depressions contained 1;332G248 _ 103 m3. Correlation of sediment body distribution with reef and coastal plain morphology revealed potential geologic controls on sand body formation in this region. Meteoric runoff and reef slope are important controls on spatial distribution of sand bodies

The immunologic effect of early intravenous two and four gram bolus dosing of tranexamic acid compared to placebo in patients with severe traumatic bleeding (TAMPITI): A randomized, double-blind, placebo-controlled, single-center trial

Background: The hemostatic properties of tranexamic acid (TXA) are well described, but the immunological effects of TXA administration after traumatic injury have not been thoroughly examined. We hypothesized TXA would reduce monocyte activation in bleeding trauma patients with severe injury. Methods: This was a single center, double-blinded, randomized controlled trial (RCT) comparing placebo to a 2 g or 4 g intravenous TXA bolus dose in trauma patients with severe injury. Fifty patients were randomized into each study group. The primary outcome was a reduction in monocyte activation as measured by human leukocyte antigen-DR isotype (HLA-DR) expression on monocytes 72 h after TXA administration. Secondary outcomes included kinetic assessment of immune and hemostatic phenotypes within the 72 h window post-TXA administration. Results: The trial occurred between March 2016 and September 2017, when data collection ended. 149 patients were analyzed (placebo, Conclusion: In trauma patients with severe injury, 4 g intravenous bolus dosing of TXA has minimal immunomodulatory effects with respect to leukocyte phenotypes and circulating cytokine levels. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02535949

A pilot study of the King LT supralaryngeal airway use in a rural Iowa EMS system

Introduction In 2003, the King Laryngeal Tube (LT) received FDA approval for US sales. Prehospital systems in urban setting have begun evaluating and adopting the LT for clinical airway management. However, it is not routinely approved by State EMS Boards for use by all prehospita

Ebola virus epidemiology, transmission, and evolution during seven months in Sierra Leone

The 2013-2015 Ebola virus disease (EVD) epidemic is caused by the Makona variant of Ebola virus (EBOV). Early in the epidemic, genome sequencing provided insights into virus evolution and transmission and offered important information for outbreak response. Here, we analyze sequences from 232 patients sampled over 7 months in Sierra Leone, along with 86 previously released genomes from earlier in the epidemic. We confirm sustained human-to-human transmission within Sierra Leone and find no evidence for import or export of EBOV across national borders after its initial introduction. Using high-depth replicate sequencing, we observe both host-to-host transmission and recurrent emergence of intrahost genetic variants. We trace the increasing impact of purifying selection in suppressing the accumulation of nonsynonymous mutations over time. Finally, we note changes in the mucin-like domain of EBOV glycoprotein that merit further investigation. These findings clarify the movement of EBOV within the region and describe viral evolution during prolonged human-to-human transmission