An integrated approach for evaluating coastal vulnerability in a changing climate

Coastal hazards such as flooding and erosion threaten many coastal communities and ecosystems. With documented increases in both storm frequency and intensity and projected acceleration of sea level rise, incorporating the impacts of climate change and variability into coastal vulnerability assessments is becoming a necessary, yet challenging task. We are developing an integrated approach to probabilistically incorporate the impacts of climate change into coastal vulnerability assessments via a multi-scale, multi-hazard methodology. By examining the combined hazards of episodic flooding/inundation and storm induced coastal change with chronic trends under a range of future climate change scenarios, a quantitative framework can be established to promote more sciencebased decision making in the coastal zone. Our focus here is on an initial application of our method in southern Oregon, United States. (PDF contains 5 pages

Medication induced transient myopic shift

A 30-year-old female presented two days post myomectomy with blurred vision due to myopic shift. She was found to have a shallow anterior chamber with normal intra-ocular pressures and no uveal effusion. This was thought to be medication induced and after suspending celecoxib her vision improved back to baseline

Novel application of X-ray fluorescence microscopy (XFM) for the non-destructive micro-elemental analysis of natural mineral pigments on Aboriginal Australian objects

Open Access Article. This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.This manuscript presents the first non-destructive synchrotron micro-X-ray fluorescence study of natural mineral pigments on Aboriginal Australian objects. Our results demonstrate the advantage of XFM (X-ray fluorescence microscopy) of Aboriginal Australian objects for optimum sensitivity, elemental analysis, micron-resolution mapping of pigment areas and the method also has the advantage of being non-destructive to the cultural heritage objects. Estimates of pigment thickness can be calculated. In addition, based on the elemental maps of the pigments, further conclusions can be drawn on the composition and mixtures and uses of natural mineral pigments and whether the objects were made using traditional or modern methods and materials. This manuscript highlights the results of this first application of XFM to investigate complex mineral pigments used on Aboriginal Australian objects

SIDMED: Sistema de Dispensa??o de Medicamentos Excepcionais

Este trabalho prop?e o desenvolvimento de um sistema de gest?o e controle de entrega de medicamentos excepcionais, destinado ao Centro de Refer?ncia em Esclerose M?ltipla da Para?ba (CREM-PB), que atende pacientes com doen?as desmielinizantes em todo o estado da Para?ba. Nesse contexto, o principal desafio na dispensa??o de medicamentos ? a comunica??o com os pacientes. Atualmente, a comunica??o ? feita atrav?s de calend?rios impressos e postagens nas redes sociais da Associa??o Paraibana de Esclerose M?ltipla (APBEM), que fornecem informa??es sobre a dispensa??o dos medicamentos. No entanto, esses m?todos t?m se mostrado ineficientes, pois podem n?o atingir a todos os pacientes . O sistema tem como objetivo melhorar a ger?ncia e controle de dispensa??o de medicamentos, bem como a comunica??o com pacientes. Al?m disso, o SIDMED permite armazenar informa??es de pacientes, registrar medicamentos e agenda de consultas e retiradas. Com essa solu??o, busca-se proporcionar praticidade aos profissionais e melhorar a qualidade do servi?o oferecid

Cost analysis of large-scale implementation of the ‘Helping Babies Breathe’ newborn resuscitation-training program in Tanzania

Background: Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. Methods: We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Results: Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2$4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between$2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost$2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. Conclusion: HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention

Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania

Background: Newborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania. Methods: An initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site to others who were not trained. After a noted drop in skills, the program developed structured on-the-job training guidance and included this in the training. The approaches were implemented sequentially in 8 regions each with nurses/ midwives, other clinicians and medical attendants who had not received HBB training before. Newborn resuscitation skills were assessed immediately after training and 4–6 weeks after training using a validated objective structured clinical examination, and retention, measured through degree of skills drop, was compared between the two training approaches. Results: Eight thousand, three hundred and ninety-one providers were trained and assessed: 3592 underwent the initial training approach and 4799 underwent the modified approach. Immediately post-training, average skills scores were similar between initial and modified training groups: 80.5 and 81.3%, respectively (p-value 0.07). Both groups experienced statistically significant drops in newborn resuscitation skills over time. However, the modified training approach was associated with significantly higher skills scores 4–6 weeks post training: 77.6% among the modified training approach versus 70.7% among the initial training approach (p-value \u3c 0.0001). Medical attendant cadre showed the greatest skills retention. Conclusions: A modified training approach consisting of structured OJT, guidance and tools improved newborn resuscitation skills retention among health care providers. The study results give evidence for including on-site training as part of efforts to improve provider performance and strengthen quality of care

Conformational altered p53 as an early marker of oxidative stress in Alzheimer\u27s disease

In order to study oxidative stress in peripheral cells of Alzheimer\u27s disease (AD) patients, immortalized lymphocytes derived from two peculiar cohorts of patients, referring to early onset AD (EOSAD) and subjects harboured AD related mutation (ADmut), were used. Oxidative stress was evaluated measuring i) the typical oxidative markers, such as HNE Michel adducts, 3 Nitro-Tyrosine residues and protein carbonyl on protein extracts, ii) and the antioxidant capacity, following the enzymatic kinetic of superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GRD). We found that the signs of oxidative stress, measured as oxidative marker levels, were evident only in ADmut but not in EOSAD patients. However, oxidative imbalance in EOSAD as well as ADmut lymphocytes was underlined by a reduced SOD activity and GRD activity in both pathological groups in comparison with cells derived from healthy subjects. Furthermore, a redox modulated p53 protein was found conformational altered in both EOSAD and ADmut B lymphocytes in comparison with control cells. This conformational altered p53 isoform, named unfolded p53 , was recognized by the use of two specific conformational anti-p53 antibodies. Immunoprecipitation experiments, performed with the monoclonal antibodies PAb1620 (that recognizes p53wt) and PAb240 (that is direct towards unfolded p53), and followed by the immunoblotting with anti-4-hydroxynonenal (HNE) and anti- 3-nitrotyrosine (3NT) antibodies, showed a preferential increase of nitrated tyrosine residues in unfolded p53 isoform comparing to p53 wt protein, in both ADmut and EOSAD. In addition, a correlation between unfolded p53 and SOD activity was further found. Thus this study suggests that ROS/RNS contributed to change of p53 tertiary structure and that unfolded p53 can be considered as an early marker of oxidative imbalance in these patients

Effects of Salicornia-Based Skin Cream Application on Healthy Humans’ Experimental Model of Pain and Itching

Halophyte plants are salt-tolerant and are acclimated for growth in saline soils such as along coastal areas. Among the halophytes, the Salicornia species have been used as both folk medicine and functional food for many years due to their high levels of bioactive compounds with supposed anti-inflammatory and antioxidative effects. However, the properties of Salicornia bioactive extracts on pain and itching still remain unclear. In this study, 30 healthy volunteers were randomized to treatments with 10% Salicornia-based cream or placebo cream for 24 or 48 h. On day 0, and 24 or 48 h post cream application, cold/heat detection and pain thresholds, mechanical pain thresholds and sensitivity, trans-epidermal water loss, histamine- and cowhage-evoked itch, and micro-vascular reactivity (neurogenic inflammation) were assessed to evaluate the analgesic, anti-pruritogenic and vasomotor effects. Skin permeability was reduced in the Salicornia-treated area for 48 h compared with 24 h application (p-value < 0.05). After 48 h of application, a decrease in mechanical-evoked itching (hyperkinesis) compared with 24 h treatment (p-value < 0.05) and increased warm detection and heat pain thresholds (p-value < 0.05) was found. Histamine-induced neurogenic inflammation showed a significant reduction in the cream-treated areas after 48 h compared with 24 h (p-value < 0.05). The results of this study indicate the overall inhibitory effect of Salicornia on hyperkinesis (mechanically evoked itch), the analgesic effect on thermal sensation, and modulation of the skin barrier architecture. Further studies are needed for the assessment of the long-term effects

Hatfield Marine Science Center Dynamic Revetment Report DSL permit #45455-FP Monitoring Report February, 2012

The Hatfield Marine Science Center (HMSC) is an interagency campus in Newport, Oregon with a mission of research, education and outreach in marine sciences through collaborative partnerships. Located on a 49 acre site on Yaquina Bay, Oregon, it is adjacent to diverse habitats, many of which are subject to action of waves and tides. A Dynamic Revetment (gravel beach) was installed in November, 2011 on the shoreline along the northeastern edge of the HMSC to mitigate erosion that threatened HMSC critical infrastructure. Shoreline topographic and biological monitoring was initiated before and continued after the project completion. Monitoring of beach profiles along the project area showed that a Dynamic Revetment installed in 2007 had been successful in stabilizing further retreat of the beach. As of January 2012, the 2011 project also appears to have stabilized the shoreline, while rapid erosion has continued in the adjacent Reference beach area. For invertebrates, fish, and vegetation, only pre-installation comparisons of the project (DRP) and Reference beach have been conducted. For both invertebrates (infauna, beach wrack associates) and fish, there were statistically significant differences over the combined DRP and Reference beaches reflecting small scale ecological variability. Shoreline vegetation also displayed some differences in species composition in preinstallation sampling, but total shore vegetation cover did not differ significantly between the two beach areas. Visual counts of marine mammals and birds were conducted both pre- and post-installation. There were no marine mammals observed, and no birds were observed prior to the project. Variability among observation periods was extremely high, with many zero observations. There were no statistically significant differences in the number of birds observed based either on tide (high vs. low) or sample area (DRP vs. (Reference). Post-installation sampling for all the above parameters will continue.The information in this document contained in sections 3.1 and 3.3 has been subjected to review by the National Health and Environmental Effects Research Laboratory of US EPA and approved for publication. Approval does not signify that the contents reflect the views of the Agency, nor does mention of trade names or commercial products constitute endorsement or recommendation for use

Toward integrated historical climate research: the example of Atmospheric Circulation Reconstructions over the Earth

Climate change has become a key environmental narrative of the 21st century. However, emphasis on the science of climate change has overshadowed studies focusing on human interpretations of climate history, of adaptation and resilience, and of explorations of the institutions and cultural coping strategies that may have helped people adapt to climate changes in the past. Moreover, although the idea of climate change has been subject to considerable scrutiny by the physical sciences, recent climate scholarship has highlighted the need for a re examination of the cultural and spatial dimensions of climate, with contributions from the humanities and social sciences. Establishing a multidisciplinary dialogue and approach to climate research past, present, and future has arguably never been more important. This article outlines developments in historical climatology research and considers examples of integrated multidisciplinary approaches to climate, climatic variability, and climate change research, conducted across the physical sciences, social sciences, humanities, and the arts. We highlight the international Atmospheric Circulation Reconstructions over the Earth (ACRE) initiative as one example of such an integrated approach. Initially, ACRE began as a response from climate science to the needs of the agricultural sector in Queensland, Australia for a longer, more spatially, and temporally-complete database of the weather. ACRE has now evolved to embrace an international group of researchers working together across disciplines to integrate their efforts into a four-dimensional (4D) dynamical global historical climate-quality reanalysis (reconstruction). WIREs Clim Change 2016, 7:164–174. doi:10.1002/wcc.37