Translating Research Into Practice: Speeding the Adoption of Innovative Health Care Programs

Looks at case studies of four innovative clinical programs to determine key factors influencing the diffusion and adoption of innovations in health care

Paleoclimate of the subtropical Andes during the latest Miocene, Lauca T Basin, Chile

Uplift of the Andean Cordillera during the Miocene and Pliocene produced large-scale changes in regional atmospheric circulation that impacted local ecosystems. The Lauca Basin (northern Chilean Altiplano) contains variably fluvial and lacustrine sedimentary sequences spanning the interval from 8.7 to 2.3 Ma. Field samples were collected from paleo-lacustrine sediments in the basin. Sediments were dated using detrital zircon geochronology on volcanic tuffs, yielding an age range between ~5.57 and 5.44 Ma. These new age constraints provided an opportunity to evaluate changes in the Lauca Basin ecosystem across this dynamic Miocene-Pliocene transition. We employed multiple proxies (lithofacies analysis, diatoms, pollen, and oxygen stable isotopes of authigenic carbonates) to interpret ancient lacustrine and terrestrial paleoenvironments. Alternations among mudstone, carbonate, and evaporitic facies indicate lake-level variability through time. The diatom assemblage is characterized by meso- to hypersaline and alkaline-tolerant taxa typical of shallow lakes. The δ18O values ranged from −8.96 to −2.22‰ indicating fluctuations in water balance. Pollen taxa in the outcrop are typical of a transitional stage between seasonal cloud forest and open grassland. Together, these proxies indicate that the Lauca paleolake sediments were deposited under a wetter-than-modern climate with high temporal variability. Our results refine previous studies in the Lauca Basin and are consistent with other regional studies suggesting that the South American summer monsoon at the Miocene-Pliocene transition was more intense than it is at present

Who Listens to Our Advice? A Secondary Analysis of Data From a Clinical Trial Testing an Intervention Designed to Decrease Delay in Seeking Treatment for Acute Coronary Syndrome

Objective Prolonged prehospital delay in persons experiencing acute coronary syndrome (ACS) remains a problem. Understanding which patients respond best to particular interventions designed to decrease delay time would provide mechanistic insights into the process by which interventions work. Methods In the PROMOTION trial, 3522 at-risk patients were enrolled from 5 sites in the United States (56.4%), Australia and New Zealand; 490 (N = 272 intervention, N = 218 control) had an acute event within 2 years. Focusing on these 490, we (1) identified predictors of a rapid response to symptoms, (2) identified intervention group subjects with a change in these predictors over 3 months of follow-up, and (3) compared intervention group participants with and without the favorable response pattern. Hypothesized predictors of rapid response were increased perceived control and decreased anxiety. Knowledge, attitudes, and beliefs were hypothesized to differ between responders and non-responders. Results Contrary to hypothesis, responders had low anxiety and low perceived control. Only 73 (26.8%) subjects showed this pattern 3 months following the intervention. No differences in ACS knowledge, attitudes, or beliefs were found. Conclusion The results of this study challenge existing beliefs. Practice implications New intervention approaches that focus on a realistic decrease in anxiety and perceived control are needed

A 1.8 million year history of Amazon vegetation

During the Pleistocene, long-term trends in global climate were controlled by orbital cycles leading to high amplitude glacial-interglacial variability. The history of Amazonian vegetation during this period is largely unknown since no continuous record from the lowland basin extends significantly beyond the last glacial stage. Here we present a paleoenvironmental record spanning the last 1800 kyr based on palynological data, biome reconstructions, and biodiversity metrics from a marine sediment core that preserves a continuous archive of sediments from the Amazon River. Tropical rainforests dominated the Amazonian lowlands during the last 1800 ka interchanging with surrounding warm-temperate rainforests and tropical seasonal forests. Between 1800 and 1000 ka, rainforest biomes were present in the Amazon drainage basin, along with extensive riparian wetland vegetation. Tropical rainforest expansion occurred during the relatively warm Marine Isotope Stages 33 and 31 (ca. 1110 to 1060 ka), followed by a contraction of both forests and wetlands until ca. 800 ka. Between 800 and 400 ka, low pollen concentration and low diversity of palynological assemblages renders difficult the interpretation of Amazonian vegetation. A strong synchronicity between vegetation changes and glacial-interglacial global climate cycles was established around 400 ka. After 400 ka, interglacial vegetation was dominated by lowland tropical rainforest in association with warmer temperatures and higher CO2. During cooler temperatures and lower CO2 of glacial stages, tropical seasonal forests expanded, presumably towards eastern Amazonia. While this study provides no evidence supporting a significant expansion of savanna or steppe vegetation within the Amazonian lowlands during glacial periods, there were changes in the rainforest composition in some parts of the basin towards a higher proportion of deciduous elements, pointing to less humid conditions and/or greater seasonality of precipitation. Nevertheless, rainforest persisted during both glacial and interglacial periods. These findings confirm the sensitivity of tropical lowland vegetation to changes in CO2, temperature, and moisture availability and the most suitable conditions for tropical rainforests occurred during the warmest stages of the Mid Pleistocene Transition and during the interglacial stages of the past 400 kyr

Improved Constraints on Northern Extratropical CO2 Fluxes Obtained by Combining Surface-Based and Space-Based Atmospheric CO2 Measurements

Abstract Top-down estimates of CO2 fluxes are typically constrained by either surface-based or space-based CO2 observations. Both of these measurement types have spatial and temporal gaps in observational coverage that can lead to differences in inferred fluxes. Assimilating both surface-based and space-based measurements concurrently in a flux inversion framework improves observational coverage and reduces sampling related artifacts. This study examines the consistency of flux constraints provided by these different observations and the potential to combine them by performing a series of 6-year (2010?2015) CO2 flux inversions. Flux inversions are performed assimilating surface-based measurements from the in situ and flask network, measurements from the Total Carbon Column Observing Network (TCCON), and space-based measurements from the Greenhouse Gases Observing Satellite (GOSAT), or all three data sets combined. Combining the data sets results in more precise flux estimates for subcontinental regions relative to any of the data sets alone. Combining the data sets also improves the accuracy of the posterior fluxes, based on reduced root-mean-square differences between posterior flux-simulated CO2 and aircraft-based CO2 over midlatitude regions (0.33?0.56?ppm) in comparison to GOSAT (0.37?0.61?ppm), TCCON (0.50?0.68?ppm), or in situ and flask measurements (0.46?0.56?ppm) alone. These results suggest that surface-based and GOSAT measurements give complementary constraints on CO2 fluxes in the northern extratropics and can be combined in flux inversions to improve constraints on regional fluxes. This stands in contrast with many earlier attempts to combine these data sets and suggests that improvements in the NASA Atmospheric CO2 Observations from Space (ACOS) retrieval algorithm have significantly improved the consistency of space-based and surface-based flux constraints

Improved Constraints on Northern Extratropical CO2 Fluxes Obtained by Combining Surface-Based and Space-Based Atmospheric CO2 Measurements

© 2020. The Authors. Top-down estimates of CO2 fluxes are typically constrained by either surface-based or space-based CO2 observations. Both of these measurement types have spatial and temporal gaps in observational coverage that can lead to differences in inferred fluxes. Assimilating both surface-based and space-based measurements concurrently in a flux inversion framework improves observational coverage and reduces sampling related artifacts. This study examines the consistency of flux constraints provided by these different observations and the potential to combine them by performing a series of 6-year (2010–2015) CO2 flux inversions. Flux inversions are performed assimilating surface-based measurements from the in situ and flask network, measurements from the Total Carbon Column Observing Network (TCCON), and space-based measurements from the Greenhouse Gases Observing Satellite (GOSAT), or all three data sets combined. Combining the data sets results in more precise flux estimates for subcontinental regions relative to any of the data sets alone. Combining the data sets also improves the accuracy of the posterior fluxes, based on reduced root-mean-square differences between posterior flux-simulated CO2 and aircraft-based CO2 over midlatitude regions (0.33–0.56 ppm) in comparison to GOSAT (0.37–0.61 ppm), TCCON (0.50–0.68 ppm), or in situ and flask measurements (0.46–0.56 ppm) alone. These results suggest that surface-based and GOSAT measurements give complementary constraints on CO2 fluxes in the northern extratropics and can be combined in flux inversions to improve constraints on regional fluxes. This stands in contrast with many earlier attempts to combine these data sets and suggests that improvements in the NASA Atmospheric CO2 Observations from Space (ACOS) retrieval algorithm have significantly improved the consistency of space-based and surface-based flux constraints

First LIGO search for gravitational wave bursts from cosmic (super)strings

We report on a matched-filter search for gravitational wave bursts from cosmic string cusps using LIGO data from the fourth science run (S4) which took place in February and March 2005. No gravitational waves were detected in 14.9 days of data from times when all three LIGO detectors were operating. We interpret the result in terms of a frequentist upper limit on the rate of gravitational wave bursts and use the limits on the rate to constrain the parameter space (string tension, reconnection probability, and loop sizes) of cosmic string models.Comment: 11 pages, 3 figures. Replaced with version submitted to PR

All-sky LIGO Search for Periodic Gravitational Waves in the Early S5 Data

We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50--1100 Hz and with the frequency's time derivative in the range -5.0E-9 Hz/s to zero. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semi-coherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 1.E-24 are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 1.0E-6, the search is sensitive to distances as great as 500 pc--a range that could encompass many undiscovered neutron stars, albeit only a tiny fraction of which would likely be rotating fast enough to be accessible to LIGO. This ellipticity is at the upper range thought to be sustainable by conventional neutron stars and well below the maximum sustainable by a strange quark star.Comment: 6 pages, 1 figur

Stacked Search for Gravitational Waves from the 2006 SGR 1900+14 Storm

We present the results of a LIGO search for short-duration gravitational waves (GWs) associated with the 2006 March 29 SGR 1900+14 storm. A new search method is used, "stacking'' the GW data around the times of individual soft-gamma bursts in the storm to enhance sensitivity for models in which multiple bursts are accompanied by GW emission. We assume that variation in the time difference between burst electromagnetic emission and potential burst GW emission is small relative to the GW signal duration, and we time-align GW excess power time-frequency tilings containing individual burst triggers to their corresponding electromagnetic emissions. We use two GW emission models in our search: a fluence-weighted model and a flat (unweighted) model for the most electromagnetically energetic bursts. We find no evidence of GWs associated with either model. Model-dependent GW strain, isotropic GW emission energy E_GW, and \gamma = E_GW / E_EM upper limits are estimated using a variety of assumed waveforms. The stacking method allows us to set the most stringent model-dependent limits on transient GW strain published to date. We find E_GW upper limit estimates (at a nominal distance of 10 kpc) of between 2x10^45 erg and 6x10^50 erg depending on waveform type. These limits are an order of magnitude lower than upper limits published previously for this storm and overlap with the range of electromagnetic energies emitted in SGR giant flares.Comment: 7 pages, 3 figure

Implications For The Origin Of GRB 051103 From LIGO Observations

We present the results of a LIGO search for gravitational waves (GWs) associated with GRB 051103, a short-duration hard-spectrum gamma-ray burst (GRB) whose electromagnetically determined sky position is coincident with the spiral galaxy M81, which is 3.6 Mpc from Earth. Possible progenitors for short-hard GRBs include compact object mergers and soft gamma repeater (SGR) giant flares. A merger progenitor would produce a characteristic GW signal that should be detectable at the distance of M81, while GW emission from an SGR is not expected to be detectable at that distance. We found no evidence of a GW signal associated with GRB 051103. Assuming weakly beamed gamma-ray emission with a jet semi-angle of 30 deg we exclude a binary neutron star merger in M81 as the progenitor with a confidence of 98%. Neutron star-black hole mergers are excluded with > 99% confidence. If the event occurred in M81 our findings support the the hypothesis that GRB 051103 was due to an SGR giant flare, making it the most distant extragalactic magnetar observed to date.Comment: 8 pages, 3 figures. For a repository of data used in the publication, go to: https://dcc.ligo.org/cgi-bin/DocDB/ShowDocument?docid=15166 . Also see the announcement for this paper on ligo.org at: http://www.ligo.org/science/Publication-GRB051103/index.ph