Brian S. Carter Oral History

Brian S. Carter was interviewed by Brian Sisk on August 23, 2019 for approximately one hour and 2 minutes for the Pediatric Palliative Care Oral History Project.https://digitalcommons.wustl.edu/oralhistories/1017/thumbnail.jp

Do oil and gas platforms off California reduce recruitment of bocaccio (Sebastes paucispinis) to natural habitat? An analysis based on trajectories derived from high-frequency radar

To investigate the possibility that oil and gas platforms may reduce recruitment of rockfishes (Sebastes spp.) to natural habitat, we simulated drift pathways termed “trajectories” in our model) from an existing oil platform to nearshore habitat using current measurements from high-frequency (HF) radars. The trajectories originated at Platform Irene, located west of Point Conception, California, during two recruiting seasons for bocaccio (Sebastes paucispinis): May through August, 1999 and 2002. Given that pelagic juvenile bocaccio dwell near the surface, the trajectories estimate transport to habitat. We assumed that appropriate shallow water juvenile habitat exists inshore of the 50-m isobath. Results from 1999 indicated that 10% of the trajectories represent transport to habitat, whereas 76% represent transport across the offshore boundary. For 2002, 24% represent transport to habitat, and 69% represent transport across the offshore boundary. Remaining trajectories (14% and 7% for 1999 and 2002, respectively) exited the coverage area either northward or southward along isobaths. Deployments of actual drifters (with 1-m drogues) from a previous multiyear study provided measurements originating near Platform Irene from May through August. All but a few of the drifters moved offshore, as was also shown with the HF radar-derived trajectories. These results indicate that most juvenile bocaccio settling on the platform would otherwise have been transported offshore and perished in the absence of a platform. However, these results do not account for the swimming behavior of juvenile bocaccio, about which little is known

Field Experiments and Meta-analysis Reveal Wetland Vegetation as a Crucial Element in the Coastal Protection Paradigm

Increasing rates of sea-level rise and wave actionthreaten coastal populations. Defense of shorelinesby protection and restoration of wetlands has beeninvoked as a win-win strategy for humans and na-ture, yet evidence from field experiments supportingthe wetland protection function is uncommon, as isthe understanding of its context dependency. Herewe provide evidence from field manipulationsshowing that the loss of wetland vegetation, regard-less of disturbance size, increases the rate oferosion on wave-stressed shorelines. Vegetationremoval (simulated disturbance) along the edge ofsalt marshes reveals that loss of wetland plants ele-vates the rate of lateral erosion and that extensiveroot systems, rather than aboveground biomass,are primarily responsible for protection againstedge erosion in marshes. Meta-analysis furthershows that disturbances that generate plant die-off on salt marsh edges generally hasten edgeerosion in coastal marshes and that the erosion pro-tection function of wetlands relates more to lateralthan vertical edge-erosional processes and ispositively correlated with the amount of below-ground plant biomass lost. Collectively, our findingssubstantiate a coastal protection paradigm thatincorporates preservation of shoreline vegetation,illuminate key context dependencies in this theory,and highlight local disturbances (e.g., oil spills)that kill wetland plants as agents that can acceleratecoastal erosion

Identification of Differential Gene Expression in Brassica rapa Nectaries through Expressed Sequence Tag Analysis

BACKGROUND: Nectaries are the floral organs responsible for the synthesis and secretion of nectar. Despite their central roles in pollination biology, very little is understood about the molecular mechanisms underlying nectar production. This project was undertaken to identify genes potentially involved in mediating nectary form and function in Brassica rapa. METHODOLOGY AND PRINCIPAL FINDINGS: Four cDNA libraries were created using RNA isolated from the median and lateral nectaries of B. rapa flowers, with one normalized and one non-normalized library being generated from each tissue. Approximately 3,000 clones from each library were randomly sequenced from the 5' end to generate a total of 11,101 high quality expressed sequence tags (ESTs). Sequence assembly of all ESTs together allowed the identification of 1,453 contigs and 4,403 singleton sequences, with the Basic Localized Alignment Search Tool (BLAST) being used to identify 4,138 presumptive orthologs to Arabidopsis thaliana genes. Several genes differentially expressed between median and lateral nectaries were initially identified based upon the number of BLAST hits represented by independent ESTs, and later confirmed via reverse transcription polymerase chain reaction (RT PCR). RT PCR was also used to verify the expression patterns of eight putative orthologs to known Arabidopsis nectary-enriched genes. CONCLUSIONS/SIGNIFICANCE: This work provided a snapshot of gene expression in actively secreting B. rapa nectaries, and also allowed the identification of differential gene expression between median and lateral nectaries. Moreover, 207 orthologs to known nectary-enriched genes from Arabidopsis were identified through this analysis. The results suggest that genes involved in nectar production are conserved amongst the Brassicaceae, and also supply clones and sequence information that can be used to probe nectary function in B. rapa

Killing Tensors and Conformal Killing Tensors from Conformal Killing Vectors

Koutras has proposed some methods to construct reducible proper conformal Killing tensors and Killing tensors (which are, in general, irreducible) when a pair of orthogonal conformal Killing vectors exist in a given space. We give the completely general result demonstrating that this severe restriction of orthogonality is unnecessary. In addition we correct and extend some results concerning Killing tensors constructed from a single conformal Killing vector. A number of examples demonstrate how it is possible to construct a much larger class of reducible proper conformal Killing tensors and Killing tensors than permitted by the Koutras algorithms. In particular, by showing that all conformal Killing tensors are reducible in conformally flat spaces, we have a method of constructing all conformal Killing tensors (including all the Killing tensors which will in general be irreducible) of conformally flat spaces using their conformal Killing vectors.Comment: 18 pages References added. Comments and reference to 2-dim case. Typos correcte

Perinatal palliative care in sub-Saharan Africa: recommendations for practice, future research, and guideline development

Worldwide, sub-Saharan Africa has the highest burden of global neonatal mortality (43%) and neonatal mortality rate (NMR): 27 deaths per 1,000 live births. The WHO recognizes palliative care (PC) as an integral, yet underutilized, component of perinatal care for pregnancies at risk of stillbirth or early neonatal death, and for neonates with severe prematurity, birth trauma or congenital anomalies. Despite bearing a disproportionate burden of neonatal mortality, many strategies to care for dying newborns and support their families employed in high-income countries (HICs) are not available in low-and-middle-income countries (LMICs). Many institutions and professional societies in LMICs lack guidelines or recommendations to standardize care, and existing guidelines may have limited adherence due to lack of space, equipment, supplies, trained professionals, and high patient load. In this narrative review, we compare perinatal/neonatal PC in HICs and LMICs in sub-Saharan Africa to identify key areas for future, research-informed, interventions that might be tailored to the local sociocultural contexts and propose actionable recommendations for these resource-deprived environments that may support clinical care and inform future professional guideline development

Evaluation of an emergency department lean process improvement program to reduce length of stay

Study objective In recent years, lean principles have been applied to improve wait times in the emergency department (ED). In 2009, an ED process improvement program based on lean methods was introduced in Ontario as part of a broad strategy to reduce ED length of stay and improve patient flow. This study seeks to determine the effect of this program on ED wait times and quality of care. Methods We conducted a retrospective cohort study of all ED visits at program and control sites during 3 program waves from April 1, 2007, to June 30, 2011, in Ontario, Canada. Time series analyses of outcomes before and after the program and difference-in-differences analyses comparing changes in program sites with control sites were conducted. Results In before-after models among program sites alone, 90th percentile ED length of stay did not change in wave 1 (–14 minutes [95% confidence interval {CI} –47 to 20]) but decreased after wave 2 (–87 [95% CI –108 to –66]) and wave 3 (–33 [95% CI –50 to –17]); median ED length of stay decreased after wave 1 (–18 [95% CI –24 to –12]), wave 2 (–23 [95% CI –27 to –19]), and wave 3 (–15 [95% CI –18 to –12]). In all waves, decreases were observed in time to physician assessment, left-without-being-seen rates, and 72-hour ED revisit rates. In the difference-in-difference models, in which changes in program sites were compared with controls, the program was associated with no change in 90th percentile ED length of stay in wave 2 (17 [95% CI –0.2 to 33]) and increases in wave 1 (23 [95% CI 0.9 to 45]) and wave 3 (31 [95% CI 10 to 51]), modest reductions in median ED length of stay in waves 2 and 3 alone, and a decrease in time to physician assessment in wave 3 alone. Conclusion Although the program reduced ED waiting times, it appeared that its benefits were diminished or disappeared when compared with that of control sites, which were exposed to system-wide initiatives such as public reporting and pay for performance. This study suggests that further evaluation of the effectiveness of lean methods in the ED is warranted before widespread implementation

Medical interns' knowledge and training regarding urethral catheter insertion and insertion-related urethral injury in male patients

<p>Abstract</p> <p>Background</p> <p>Improper catheterization can lead to urethral injury. Yet research from four continents suggests training of junior doctors in catheterization is insufficient. European research suggests a majority of catheterization related morbidities occur when the procedure is performed by interns.</p> <p>Methods</p> <p>To assess the knowledge and practices of medical interns relating to urethral catheterization and iatrogenic urethral injury secondary to traumatic catheter insertion, a questionnaire survey was conducted of all first year medical interns at a tertiary national university hospital in the Philippines. The questionnaire contained 17 items covering 4 areas: methods of training in catheterization and level of experience; perceived adequacy of training; theoretical knowledge of catheterization; the mechanisms of catheter-related urethral injury.</p> <p>Results</p> <p>225/240 interns (94%) completed the survey (130 (57.8%) female). 125 (55.6%) responded that they had adequate theoretical training and 150 (66.7%) adequate practical training. All had performed more than 10 catheterizations and 204 (90%) were supervised when they first performed catheterization. Despite relatively high levels of experience and confidence, deficits were identified in detailed knowledge of correct catheterization procedures and of risks associated with urethral injury.</p> <p>Conclusions</p> <p>More thorough training of incoming medical interns in urinary catheterization may help to reduce the risk of complications and injury. Training should be universal and thought given to its timing within the curriculum. Training should include step by step instruction in the process, emphasis on history taking and awareness of factors associated with increased risk of urethral injury.</p