460 research outputs found
Comparison of ground and satellite based measurements of the fraction of photosynthetically active radiation intercepted by tall-grass prairie
The fraction, of photosynthetically active radiation absorbed by vegetation, F sub ipar, is an important requirement for estimating vegetation biomass productivity and related quantities. This was an integral part of a large international effort; the First ISLSCP Field Experiment (FIFE). The main objective of FIFE was to study the effects of vegetation on the land atmosphere interactions and to determine if these interactions can be assessed from satellite spectral measurements. The specific purpose of this experiment was to find out how well measurements of F sub ipar relate to ground, helicopter, and satellite based spectral reflectance measurements. Concurrent measurements of F sub ipar and ground, helicopter, and satellite based measurements were taken at 13 tall grass prairie sites in Kansas. The sites were subjected to various combinations of burning and grazing managements
An assessment of patient-reported long-term outcomes following surgery for cauda equina syndrome
The GEMAS Project: Geochemistry of European agricultural and grazing land soils.
Viene illustrato il progetto GEMAS che ha interessato la campionatura e le analisi di suoli dell'ntero continente Europeo da parte dei Servizi Geologici d'Europa, nell'ìambito delle attività dell'EuroGeoSurvey
Scan-Negative Cauda Equina Syndrome A Prospective Cohort Study
Objective: To describe clinical features relevant to diagnosis, mechanism, and etiology in patients with “scan-negative” cauda equina syndrome (CES).
Methods: We carried out a prospective study of consecutive patients presenting with the clinical features of CES to a regional neurosurgery center comprising semi-structured interview and questionnaires investigating presenting symptoms, neurologic examination, psychiatric and functional disorder comorbidity, bladder/bowel/sexual function, distress, and disability.
Results: A total of 198 patients presented consecutively over 28 months. A total of 47 were diagnosed with scan-positive CES (mean age 48 years, 43% female). A total of 76 mixed category patients had nerve root compression/displacement without CES compression (mean age 46 years, 71% female) and 61 patients had scan-negative CES (mean age 40 years, 77% female). An alternative neurologic cause of CES emerged in 14/198 patients during admission and 4/151 patients with mean duration 25 months follow-up. Patients with scan-negative CES had more positive clinical signs of a functional neurologic disorder (11% scan-positive CES vs 34% mixed and 68% scan-negative, p < 0.0001), were more likely to describe their current back pain as worst ever (41% vs 46% and 70%, p = 0.005), and were more likely to have symptoms of a panic attack at onset (37% vs 57% and 70%, p = 0.001). Patients with scan-positive CES were more likely to have reduced/absent bilateral ankle jerks (78% vs 30% and 12%, p < 0.0001). There was no significant difference between groups in the frequency of reduced anal tone and urinary retention.
Conclusion: The first well-phenotyped, prospective study of scan-negative CES supports a model in which acute pain, medication, and mechanisms overlapping with functional neurologic disorders may be relevant
A comparison of two cases of low-latitude thundersnow
http://solberg.snr.missouri.edu/gcc/Two cases of low-latitude snow with lightning are studied to determine their characteristics. Both cases had synoptic-scale origins, but also featured smaller-scale influences (e. g. orographic lift and elevated instability).The first event occurred in the Southern Hemisphere and was a late winter case that developed under the influence of underlying orography. Lightning was plentiful in that event (94 cloud-to-ground flashes in the region), but snow accumulations were not significant. Lightning flashes of negative polarity dominated this case, with a mean peak amplitude of -43.2 kA. The second event was a Northern Hemisphere case of elevated convection, with frontogenesis beneath an extended layer of potential instability. Appreciable lightning occurred with this event as well (706 cloud-to-ground flashes in the region), and snow accumulations were significant over a broad area. Lightning flashes of negative polarity dominated this case also, with a mean peak amplitude of -23.7 kA. Each of these events is worthy of further scrutiny, as studies of such storms do not appear often in the literature. Indeed, such warm, subtropical regions are often unprepared for the effects of just a little snow or ice accumulation. Future forecasters can anticipate better such anomalous events by looking for these broad features: 1) significant and well-defined synoptic-scale weather systems at low latitudes, 2) a strong baroclinic zone with a well-defined (≥60 ms-1) jet structure aloft, 3) cold air of appreciable depth and areal extent drawn much closer to the equator than is typical, and 4) a moist neutral to conditionally unstable layer above the frontal zone
Avoidable mortality from giving tranexamic acid to bleeding trauma patients: an estimation based on WHO mortality data, a systematic literature review and data from the CRASH-2 trial
BACKGROUND: The CRASH-2 trial showed that early administration of tranexamic acid (TXA) safely reduces mortality in bleeding in trauma patients. Based on data from the CRASH-2 trial, global mortality data and a systematic literature review, we estimated the number of premature deaths that might be averted every year worldwide through the use of TXA. METHODS: We used CRASH-2 trial data to examine the effect of TXA on death due to bleeding by geographical region. We used WHO mortality data (2008) and data from a systematic review of the literature to estimate the annual number of in-hospital trauma deaths due to bleeding. We then used the relative risk estimates from the CRASH-2 trial to estimate the number of premature deaths that could be averted if all hospitalised bleeding trauma patients received TXA within one hour of injury, and within three hours of injury. Sensitivity analyses were used to explore the effect of uncertainty in the parameter estimates and the assumptions made in the model. RESULTS: There is no evidence that the effect of TXA on death due to bleeding varies by geographical region (heterogeneity p = 0.70). Based on WHO data and our systematic literature review, we estimate that each year worldwide there are approximately 400,000 in-hospital trauma deaths due to bleeding. If patients received TXA within one hour of injury then approximately 128,000 (uncertainty range [UR] ≈ 72,000 to 172,000) deaths might be averted. If patients received TXA within three hours of injury then approximately 112,000 (UR ≈ 68,000 to 148,000) deaths might be averted. Country specific estimates show that the largest numbers of deaths averted would be in India and China. CONCLUSIONS: The use of TXA in the treatment of traumatic bleeding has the potential to prevent many premature deaths every year. A large proportion of the potential health gains are in low and middle income countries
Presentation, management, and outcomes of cauda equina syndrome up to one year after surgery, using clinician and participant reporting: A multi-centre prospective cohort study.
BACKGROUND: Cauda equina syndrome (CES) results from nerve root compression in the lumbosacral spine, usually due to a prolapsed intervertebral disc. Evidence for management of CES is limited by its infrequent occurrence and lack of standardised clinical definitions and outcome measures. METHODS: This is a prospective multi-centre observational cohort study of adults with CES in the UK. We assessed presentation, investigation, management, and all Core Outcome Set domains up to one year post-operatively using clinician and participant reporting. Univariable and multivariable associations with the Oswestry Disability Index (ODI) and urinary outcomes were investigated. FINDINGS: In 621 participants with CES, catheterisation for urinary retention was required pre-operatively in 31% (191/615). At discharge, only 13% (78/616) required a catheter. Median time to surgery from symptom onset was 3 days (IQR:1-8) with 32% (175/545) undergoing surgery within 48 h. Earlier surgery was associated with catheterisation (OR:2.2, 95%CI:1.5-3.3) but not with admission ODI or radiological compression. In multivariable analyses catheter requirement at discharge was associated with pre-operative catheterisation (OR:10.6, 95%CI:5.8-20.4) and one-year ODI was associated with presentation ODI (r = 0.3, 95%CI:0.2-0.4), but neither outcome was associated with time to surgery or radiological compression. Additional healthcare services were required by 65% (320/490) during one year follow up. INTERPRETATION: Post-operative functional improvement occurred even in those presenting with urinary retention. There was no association between outcomes and time to surgery in this observational study. Significant healthcare needs remained post-operatively. FUNDING: DCN Endowment Fund funded study administration. Castor EDC provided database use. No other study funding was received
HIV-1 Infection in Cyprus, the Eastern Mediterranean European Frontier: A Densely Sampled Transmission Dynamics Analysis from 1986 to 2012
Since HIV-1 treatment is increasingly considered an effective preventionstrategy, it is important to study local HIV-1 epidemics to formulate tailored preventionpolicies. The prevalence of HIV-1 in Cyprus was historically low until 2005. To investigatethe shift in epidemiological trends, we studied the transmission dynamics of HIV-1 in Cyprususing a densely sampled Cypriot HIV-1 transmission cohort that included 85 percent ofHIV-1-infected individuals linked to clinical care between 1986 and 2012 based on detailedclinical, epidemiological, behavioral and HIV-1 genetic information. Subtyping andtransmission cluster reconstruction were performed using maximum likelihood and Bayesianmethods, and the transmission chain network was linked to the clinical, epidemiological andbehavioral data. The results reveal that for the main HIV-1 subtype A1 and B sub-epidemics,young and drug-naïve HIV-1-infected individuals in Cyprus are driving the dynamics of thelocal HIV-1 epidemic. The results of this study provide a better understanding of thedynamics of the HIV-1 infection in Cyprus, which may impact the development of preventionstrategies. Furthermore, this methodology for analyzing densely sampled transmissiondynamics is applicable to other geographic regions to implement effective HIV-1 preventionstrategies in local settings
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