3,215 research outputs found
Remote Sensing and Human Health: New Sensors and New Opportunities
Remote sensing data enable scientists to study the earth\u27s biotic and abiotic components. These components and their changes have been mapped from space at several temporal and spatial scales since 1972. A small number of investigators in the health community have explored remotely sensed environmental factors that might be associated with disease-vector habitats and human transmission risk. However, most human health studies using remote sensing data have focused on data from Landsat\u27s Multispectral Scanner (MSS) and Thematic Mapper (TM), the National Oceanic and Atmospheric Administration (NOAA)\u27s Advanced Very High Resolution Radiometer (AVHRR), and France\u27s SystĂšme Pour l\u27Observation de la Terre (SPOT). In many of these studies (Table 1), remotely sensed data were used to derive three variables: vegetation cover, landscape structure, and water bodies
Resolution of Clinical Signs of Ventilator-Associated Pneumonia in Trauma Patients
Objectives: The ATS/IDSA Ventilator-Associated Pneumonia (VAP) guidelines suggest that clinical improvement of VAP should be apparent within 3â6 days. This study evaluated resolution of clinical signs of VAP in trauma patients after diagnosis.
Methods: Critically injured adults admitted to the trauma intensive care unit (ICU) from June 1, 2006, to December 31, 2007, and subsequently given a diagnosis of VAP were retrospectively assessed. Clinical signs, including derangements of maximum temperature (Tmax), white blood cell (WBC) count, and PaO2/FiO2, were evaluated on days 1â16 after VAP diagnosis. Data are presented as mean ± SD unless otherwise stated. Clinical parameters after VAP were compared using repeated-measures ANOVA with the Tukey test for multiple comparisons.
Results: A total of 82 patients were identified. Data for the 34 patients without concurrent infections are presented. Demographic data include: Age 46 ± 17 years; 71% men; 94% blunt trauma; median (IQR) Injury Severity Score 29.5 (24â38); duration of mechanical ventilation 33 ± 27 days; ICU length of stay (LOS) 39 ± 25 days; hospital LOS 53 ± 33 days. Clinical signs following VAP diagnosis: Tmax (°F): Day 1=101.8 ± 1.3, Day 3=101.1 ± 1.1, Day 6=101.1 ± 1.4, Day 16=100.1 ± 3. Compared to Day 1, there was a significant reduction in Tmax at days 10, 11, 12, 13, 14, and 16 (p\u3c0.05 for all). WBC count (cells per microliter): day 1 = 12.9 ± 5, day 3 = 13.7 ± 5, day 6 = 14.4 ± 5, and day 16 = 13.8 ± 6. There was no significant difference in WBC on days 1â16 (p=0.42). PaO2/FiO2: day 1 = 232 ± 108, day 3 = 200 ± 87, day 6 = 218 ± 104, day 16 = 246 ± 126. Differences in PaO2/FiO2 on days 1â16 did not reach statistical significance (p=0.06).
Conclusion: Improvement of clinical parameters after a VAP diagnosis is delayed in trauma patients. Alternative methods for determining resolution should be investigated. Published in To be published in Critical Care Medicineâs December 2009 supplement
Development and Implementation of a HeparinâInduced Thrombocytopenia Pathway in a Trauma ICU
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Recalculated diet and daily ration of the shortfin mako (Isurus oxyrinchus), with a focus on quantifying predation on bluefish (Pomatomus saltatrix) in the northwest Atlantic Ocean
The diet and daily ration of the shortfin mako (Isurus oxyrinchus) in the northwest Atlantic were re-examined to determine whether fluctuations in prey abundance and
availability are reflected in these two biological variables. During the summers of 2001 and 2002, stomach
content data were collected from fishing tournaments along the northeast coast of the United States. These data were quantified by using four diet indices and were compared to
index calculations from historical diet data collected from 1972 through 1983. Bluefish (Pomatomus saltatrix) were the predominant prey in the 1972â83 and 2001â02 diets, accounting for 92.6% of the current diet by weight and 86.9% of the historical diet by volume. From the 2001â 02
diet data, daily ration was estimated and it indicated that shortfin makos must consume roughly 4.6% of their body weight per day to fulfill energetic demands. The daily energetic requirement was broken down by using a calculated energy content for the current diet of 4909 KJ/kg. Based on the proportional energy of bluefish in the diet by weight, an average shortfin mako consumes roughly 500 kg of bluefish per year off the northeast coast of the United States. The results are discussed in relation to the potential effect of intense shortfin mako predation on bluefish abundance in the region
Recalculated diet and daily ration of the shortfin mako (\u3cem\u3eIsurus oxyrinchus\u3c/em\u3e), with a focus on quantifying predation on bluefish (\u3cem\u3ePomatomus saltatrix\u3c/em\u3e) in the northwest Atlantic Ocean
The diet and daily ration of the shortfin mako (Isurus oxyrinchus) in the northwest Atlantic were re-examined to determine whether fluctuations in prey abundance and availability are ref lected in these two biological variables. During the summers of 2001 and 2002, stomach content data were collected from fishing tournaments along the northeast coast of the United States. These data were quantified by using four diet indices and were compared to index calculations from historical diet data collected from 1972 through 1983. Bluefish (Pomatomus saltatrix) were the predominant prey in the 1972â83 and 2001â02 diets, accounting for 92.6% of the current diet by weight and 86.9% of the historical diet by volume. From the 2001â 02 diet data, daily ration was estimated and it indicated that shortfin makos must consume roughly 4.6% of their body weight per day to fulfill energetic demands. The daily energetic requirement was broken down by using a calculated energy content for the current diet of 4909 KJ/kg. Based on the proportional energy of bluefish in the diet by weight, an average shortfin mako consumes roughly 500 kg of bluefish per year off the northeast coast of the United States. The results are discussed in relation to the potential effect of intense shortfin mako predation on bluefish abundance in the region
Vertical movements of shortfin mako sharks Isurus oxyrinchus in the western North Atlantic Ocean are strongly influenced by temperature
Although shortfin mako sharks Isurus oxyrinchus are regularly encountered in pelagic fisheries, limited information is available on their vertical distribution and is primarily restricted to cooler areas of their geographic range. We investigated the vertical movements of mako sharks across differing temperature regimes within the western North Atlantic by tagging 8 individuals with pop-up satellite archival tags off the northeastern United States and the Yucatan Peninsula, Mexico. Depth and temperature records across 587 d showed vertical movements strongly associated with ocean temperature. Temperatures150 m compared to only 1% in the coldest water columns. The sharks showed diel diving behavior, with deeper dives occurring primarily during the daytime (maximum depth: 866 m). Overall, sharks experienced temperatures between 5.2 and 31.1°C. When the opportunity was available, sharks spent considerable time in waters ranging from 22 to 27°C, indicating underestimation of the previously reported upper limit of the mako sharksâ preferred temperature. The preference for higher temperatures does not support endothermy as an adaption for niche expansion in mako sharks. The strong influence of thermal habitat on movement behavior suggests potentially strong impacts of rising ocean temperatures on the ecology of this highly migratory top predator
Resolution of Clinical Signs in Trauma Intensive Care Unit Patients Following Diagnosis of Ventilator-Associated Pneumonia
PURPOSE: The ATS/IDSA Ventilator-Associated Pneumonia (VAP) guidelines suggest that clinical improvement of VAP should be apparent within 3-6 days. Anecdotally, such improvement has not been noted in trauma patients at our institution. The current study was conducted to evaluate resolution of clinical signs of VAP following diagnosis.
METHODS: Critically injured adults admitted to the trauma intensive care unit (TICU) from 6/1/06-12/31/07 and subsequently diagnosed with VAP were retrospectively reviewed. Clinical signs, including derangements of maximum temperature (Tmax), white blood cell (WBC) count and Pa02/FiO2, were evaluated on days 1-16 following VAP diagnosis. Data are presented as mean ± SD unless otherwise stated. Clinical parameters following VAP were compared using repeated measures ANOVA with the Tukey test for multiple comparisons.
RESULTS: A total of 82 patients were identified. Data for the 34 patients without concurrent infections are presented. Demographic data include: Age 46 ± 17 years; 71% males; 94% blunt trauma; median (IQR) Injury Severity Score 29.5 (24 to 38); duration of mechanical ventilation 33 ± 27 days; ICU length of stay (LOS) 39 ± 25 days; hospital LOS 53 ± 33 days. Clinical signs following VAP diagnosis (Figure): Tmax (°F): Day 1=101.8 ± 1.3, Day 3=101.1 ± 1.1, Day 6=101.1 ± 1.4, Day 16=100.1 ± 3. Compared to Day 1, there was a significant reduction in Tmax at Days 10, 11, 12, 13, 14 and 16 (p \u3c 0.05 for all). WBC count (cells/ΌL): Day 1=12.9 ± 5, Day 3=13.7 ± 5, Day 6=14.4 ± 5, Day 16=13.8 ± 6. There was no significant difference in WBC count on Days 1-16 (p=0.42). PaO2/FiO2: Day 1=232 ± 108, Day 3=200 ± 87, Day 6=218 ± 104, Day 16=246 ± 126. Differences in PaO2/FiO2 on Days 1-16 did not reach statistical significance (p=0.06).
CONCLUSIONS: In trauma patients, improvement of clinical parameters following diagnosis of VAP is delayed beyond the 3-6 day timeframe suggested in the ATS/IDSA guidelines. Alternative methods for determining resolution of VAP in trauma patients should be investigated. METHODS INTRODUCTIO
Evolution of a 3 \msun star from the main sequence to the ZZ Ceti stage: the role played by element diffusion
The purpose of this paper is to present new full evolutionary calculations
for DA white dwarf stars with the major aim of providing a physically sound
reference frame for exploring the pulsation properties of the resulting models
in future communications. Here, white dwarf evolution is followed in a
self-consistent way with the predictions of time dependent element diffusion
and nuclear burning. In addition, full account is taken of the evolutionary
stages prior to the white dwarf formation. In particular, we follow the
evolution of a 3 \msun model from the zero-age main sequence (the adopted
metallicity is Z=0.02) all the way from the stages of hydrogen and helium
burning in the core up to the thermally pulsing phase. After experiencing 11
thermal pulses, the model is forced to evolve towards its white dwarf
configuration by invoking strong mass loss episodes. Further evolution is
followed down to the domain of the ZZ Ceti stars on the white dwarf cooling
branch. Emphasis is placed on the evolution of the chemical abundance
distribution due to diffusion processes and the role played by hydrogen burning
during the white dwarf evolution. Furthermore, the implications of our
evolutionary models for the main quantities relevant for adiabatic pulsation
analysis are discussed. Interestingly, the shape of the Ledoux term is markedly
smoother as compared with previous detailed studies of white dwarfs. This is
translated into a different behaviour of the Brunt-Vaisala frequency.Comment: 11 pages, 11 figures, accepted for publication in MNRA
Impact of the Lymphatic Filariasis Control Program towards elimination of filariasis in Vanuatu, 1997-2006
Background: Lymphatic filariasis (LF) occurs when filarial parasites are transmitted to humans through mosquitoes. The filarial worms affect the lymphatic system which leads to abnormal enlargement of body parts, chronic pain, disability, and social discrimination. In 1999, a commitment was made to eliminate LF from the Pacific Region by 2010. The Pacific Program to Eliminate LF began, with Vanuatu being one of the 16 endemic countries included in this program.
Methods: In 1997/1998 a LF prevalence baseline survey was conducted to determine the need for mass drug administration (MDA) in Vanuatu. In 1999, the Vanuatu Lymphatic Filariasis Control Program was established, and nationwide MDA was implemented from 2000 to 2004. LF prevalence was collected during the MDA through sentinel site and spot check surveys, and after 5 years of MDA. MDA implementation methods included health worker training, social mobilization, and culturally appropriate health promotion strategies.
Results: LF prevalence at baseline was 4.79%; after MDA this declined to 0.16% in 2005/2006. Average MDA coverage ranged from 75.5â81.5% across 5 years. All three evaluation units surveyed in 2005/2006 were below the 1% threshold required to stop MDA.
Conclusions: The LF Control Program between 1997 and 2006 was successful in reducing LF prevalence to <1%. High MDA coverage was a critical component of this success. This period of the Vanuatu LF Control Program played an important role in helping to eliminate LF in Vanuatu
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