Simulation Modelling of Inequality in Cancer Service Access

This paper applies economic concepts from measuring income inequality to an exercise in assessing spatial inequality in cancer service access in regional areas. We propose a mathematical model for accessing chemotherapy among local government areas (LGAs). Our model incorporates a distance factor. With a simulation we report results for a single inequality measure: the Lorenz curve is depicted for our illustrative data. We develop this approach in order to move incrementally towards its application to actual data and real-world health service regions. We seek to develop the exercises that can lead policy makers to relevant policy information on the most useful data collections to be collected and modeling for cancer service access in regional areas.Comment: 6 pages, 3 figure

Professional medical writing support and the reporting quality of randomized controlled trial abstracts among high-impact general medical journals

Background : In articles reporting randomized controlled trials, professional medical writing support is associated with increased adherence to Consolidated Standards of Reporting Trials (CONSORT). We set out to determine whether professional medical writing support was also associated with improved adherence to CONSORT for Abstracts. Methods : Using data from a previously published cross-sectional study of 463 articles reporting randomized controlled trials published between 2011 and 2014 in five top medical journals, we determined the association between professional medical writing support and CONSORT for Abstracts items using a Wilcoxon rank-sum test. Results : The mean proportion of adherence to CONSORT for Abstracts items reported was similar with and without professional medical writing support (64.3% vs 66.5%, respectively; p=0.30). Professional medical writing support was associated with lower adherence to reporting study setting (relative risk [RR]; 0.40; 95% confidence interval [CI], 0.23–0.70), and higher adherence to disclosing harms/side effects (RR 2.04; 95% CI, 1.37–3.03) and funding source (RR 1.75; 95% CI, 1.18–2.60). Conclusions : Although professional medical writing support was not associated with increased overall adherence to CONSORT for Abstracts, important aspects were improved with professional medical writing support, including reporting of adverse events and funding source. This study identifies areas to consider for improvement.Publisher PDFPeer reviewe

The Relative Contribution of Methanotrophs to Microbial Communities and Carbon Cycling in Soil Overlying a Coal-Bed Methane Seep

Seepage of coal-bed methane (CBM) through soils is a potential source of atmospheric CH4 and also a likely source of ancient (i.e. 14C-dead) carbon to soil microbial communities. Natural abundance 13C and 14C compositions of bacterial membrane phospholipid fatty acids (PLFAs) and soil gas CO2 and CH4 were used to assess the incorporation of CBM-derived carbon into methanotrophs and other members of the soil microbial community. Concentrations of type I and type II methanotroph PLFA biomarkers (16:1ω8c and 18:1ω8c, respectively) were elevated in CBM-impacted soils compared with a control site. Comparison of PLFA and 16s rDNA data suggested type I and II methanotroph populations were well estimated and overestimated by their PLFA biomarkers, respectively. The δ13C values of PLFAs common in type I and II methanotrophs were as negative as -67‰ and consistent with the assimilation of CBM. PLFAs more indicative of nonmethanotrophic bacteria had δ13C values that were intermediate indicating assimilation of both plantand CBM-derived carbon. Δ14C values of select PLFAs (-351 to -936‰) indicated similar patterns of CBM assimilation by methanotrophs and nonmethanotrophs and were used to estimate that 35–91% of carbon assimilated by nonmethanotrophs was derived from CBM depending on time of sampling and soil depth

The Pothole Hydrology-Linked Systems Simulator (PHyLiSS)—Development and Application of a Systems Model for Prairie-Pothole Wetlands

The North American Prairie Pothole Region covers about 770,000 square kilometers of the United States and Canada (including parts of 5 States and 3 provinces: North Dakota, South Dakota, Montana, Minnesota, Iowa, Saskatchewan, Manitoba, and Alberta). The Laurentide Ice Sheet shaped the landscape of the region about 12,000 to 14,000 years ago. The retreat of the ice sheet left behind low-permeability glacial till and a landscape dotted with millions of depressions known today as prairie potholes. The wetlands that subsequently formed in these depressions, prairie-pothole wetlands, provide critical migratory-bird habitat and support dynamic aquatic communities. Extensive grasslands and productive agricultural systems surround these wetland ecosystems. In prairie-pothole wetlands, the compositions of plant, invertebrate, and vertebrate communities are highly dependent on hydrogeochemical conditions. Regional climate shifts between wet and dry periods affect the length of time that wetlands contain ponded surface water and the chemistry of that ponded water. Land-use change can exacerbate or reduce the effects of climate on wetland hydrology and water chemistry. A mechanistic understanding of the relation among climate, land use, hydrology, chemistry, and biota in prairie-pothole wetlands is needed to better understand the complex, and often interacting, effects of climate and land use on prairie-pothole wetland systems and to facilitate climate and land-use change adaptation efforts. The Pothole Hydrology-Linked Systems Simulator (PHyLiSS) model was developed to address this need. The model simulates water-surface elevation dynamics in prairie-pothole wetlands and quantifies changes in salinity. The PHyLiSS model is unique among other wetland models because it accommodates differing sizes and morphometries of wetland basins, is not dependent on a priori designations of wetland class, and allows for functional changes associated with dynamic shifts in ecohydrological states. The PHyLiSS model also has the capability to simulate wetland salinity, and potential future iterations will also simulate the effects of changing hydrology and geochemical conditions on biota. This report documents the development of the hydrological and geochemical components of the PHyLiSS model and provides example applications

The correlation of early flow disturbances with the development of infrainguinal graft stenosis: A 10-year study of 341 autogenous vein grafts

AbstractPurpose: Although duplex surveillance of infrainguinal bypass grafts is widely accepted, the optimal frequency and intensity of graft surveillance remains controversial. Earlier reports have suggested that grafts can be stratified into high-risk and low-risk groups based on the presence or absence of early graft flow disturbances. The purpose of this study was to provide long-term data in determining whether early graft flow disturbances detected by means of duplex scanning can predict the development of intrinsic vein graft stenosis. Methods: We reviewed a series of patients undergoing prospective duplex graft surveillance after autogenous infrainguinal bypass grafting procedures from 1987 to 1997. Patients included in the study underwent at least one duplex scan within 3 months of graft implantation and were observed for a minimum of 6 months. Grafts were categorized as abnormal when a focal flow disturbance with a peak systolic velocity greater than 150 cm/s was identified within 3 months of graft implantation. Results: Of 341 vein grafts in 296 patients who met inclusion criteria, 89 grafts (26%) required revision for intrinsic stenosis; the mean follow-up period was 35 months (range, 6 months to 10 years). Early flow disturbances were detected in 84 (25%) grafts. Grafts with early flow disturbances were more likely to ultimately require revision (43% vs 21%; P = .0001) and required initial revision earlier (8 months vs 16 months; P = .019). Eighty-two percent of initial graft revisions occurred in the first 2 postoperative years; 69% occurred in the first year. However, an annual 2% to 4% incidence of late-appearing graft stenosis persisted during long-term follow-up. An additional 24 patients (7% of grafts) required an inflow or outflow reconstruction. Conclusion: Grafts with early postoperative flow disturbances detected by means of duplex scanning have nearly three times the incidence of graft-threatening stenosis and an earlier requirement for revision, when compared with normal grafts. This suggests that the biology and etiology of these lesions may differ. These data support not only aggressive efforts to detect early graft lesions to stratify grafts at highest risk, but also continued lifelong graft surveillance to detect late-appearing lesions, inflow and outflow disease progression, and maximize graft patency. (J Vasc Surg 1999;30:8-15.

Forest elephant movement and habitat use in a tropical forest-grassland mosaic in Gabon

Poaching of forest elephants (Loxodonta cyclotis) for ivory has decimated their populations in Central Africa. Studying elephant movement can provide insight into habitat and resource use to reveal where, when, and why they move and guide conservation efforts. We fitted 17 forest elephants with global positioning system (GPS) collars in 2015 and 2016 in the tropical forest-grassland mosaic of the Wonga Wongué Presidential Reserve (WW), Gabon. Using the location data, we quantified movement distances, home ranges, and habitat use to examine the environmental drivers of elephant movements and predict where elephants occur spatially and temporally. Forest elephants, on average, traveled 2,840 km annually and had home ranges of 713 km2, with males covering significantly larger home ranges than females. Forest elephants demonstrated both daily and seasonal movement patterns. Daily, they moved between forest and grassland at dawn and dusk. Seasonally, they spent proportionally more time in grassland than forest during the short-wet season when grasses recruit. Forest elephants also traveled faster during the short-wet season when fruit availability was greatest, likely reflecting long, direct movements to preferred fruiting tree species. Forest elephants tended to select areas with high tree and shrub density that afford cover and browse. When villages occurred in their home ranges elephants spent a disproportionate amount of time near them, particularly in the dry season, probably for access to agricultural crops and preferred habitat. Given the importance of the grassland habitat for elephants, maintenance of the forest-grassland matrix is a conservation priority in WW. Law enforcement, outreach, and education should focus on areas of potential human-elephant conflict near villages along the borders of the reserve. GPS-tracking should be extended into multi-use areas in the peripheries of protected areas to evaluate the effects of human disturbance on elephant movements and to maintain connectivity among elephant populations in Gabon

The global decline of reptiles, deja’ vu amphibians

Reptile species are declining on a global scale. Six significant threats to reptile populations are habitat loss and degradation, introduced invasive species, environmental pollution, disease, unsustainable use, and global climate change