Analysis of Weather Data Collected From Two Locations in a Small Urban Community

The heat island effect is a well known feature in the microclimate of urban areas, and is considered to be the difference between the urban area and its surroundings. While this study only employs two instruments, the authors are not aware of any studies which examine the differences in temperature between an instrument inside a town the size of Sedalia and its surroundings by collecting hourly information. We attempt to infer here the impact of Sedalia, Missouri, the State Fair Community College campus, and the state fairgrounds on the temperature patterns for a small region of west-central Missouri. The two stations, one on the grounds of State Fair Community College and the other at the Sedalia Airport were used. Temperature, precipitation, cloudiness, and wind information were gathered hourly between 1 February and 31 March, 2005. The weather station at the regional airport was located 11 km (7 miles) northeast of the campus instrument. Our results indicate that the city has no discernable impact on the distribution of monthly precipitation totals. We found a distinct difference between the local surface temperatures as recorded by each instrument. For the Sedalia area, the temperature differences between the town center and the outside location were approximately 2 - 6oF (1.0 - 3.3o C) warmer, typically, than the surrounding environment, as inferred by these instruments. This difference was as much as 11o F (6oC) when comparing hourly temperature information. Additionally, the difference was larger for clear days and days during which there was little wind

Total Intravenous Anesthesia Including Ketamine versus Volatile Gas Anesthesia for Combat-related Operative Traumatic Brain Injury

Background: Traumatic brain injury is a leading cause of death and severe neurologic disability. The effect of anesthesia techniques on neurologic outcomes in traumatic brain injury and potential benefits of total intravenous anesthesia (TIVA) compared with volatile gas anesthesia (VGA), although proposed, has not been well evaluated. The purpose of this study was to compare TIVA versus VGA in patients with combatrelated traumatic brain injury. Methods: The authors retrospectively reviewed 252 patients who had traumatic brain injury and underwent operative neurosurgical intervention. Statistical analyses, including propensity score and matched analyses, were performed to assess differences between treatment groups (TIVA vs. VGA) and good neurologic outcome. Results: Two hundred fourteen patients met inclusion criteria and were analyzed; 120 received VGA and 94 received TIVA. Good neurologic outcome (Glasgow Outcome Score 4 -5) and decreased mortality were associated with TIVA compared with VGA (75% vs. 54%; P ‫؍‬ 0.002 and 5% vs. 16%; P ‫؍‬ 0.02, respectively). Multivariate logistic regression found admission Glasgow Coma Scale score of 8 or greater (odds ratio, 13.3; P < 0.001) and TIVA use (odds ratio, 2.3; P ‫؍‬ 0.05) to be associated with good neurologic outcomes. After controlling for confounding factors using propensity analysis and repeated one-to-one matching of patients receiving TIVA with those receiving VGA with regard to Injury Severity Score, Glasgow Coma Scale score, base deficit, Head Abbreviated Injury Score, and craniectomy or craniotomy, the authors could not find an association between treatment and neurologic outcome. Conclusion: Total intravenous anesthesia often including ketamine was not associated with improved neurologic outcom

A Possible Heat Island Effect from a Small Rural Community

Abstract: The purpose of this paper is to understand whether or not heat that is radiated from the business district of a very small community impacts the local temperature Þ eld in the outer and inner portions of the community as a function of one or more variables (wind speed, wind direction, and degree of cloud cover). Previous studies of larger communities in the region showed that wind speed, direction, or cloud cover could lead to differences in the strength of the heat island effect even for a community of about 20,000 to 25,000 residents. Here we study the impact of a community which has fewer than 10,000 residents, and demonstrate that there was circumstantial evidence for a heat island effect

Computerized Diagnostic Assistant for the Automatic Detection of Pneumothorax on Ultrasound: A Pilot Study

Introduction: Bedside thoracic ultrasound (US) can rapidly diagnose pneumothorax (PTX) with improved accuracy over the physical examination and without the need for chest radiography (CXR); however, US is highly operator dependent. A computerized diagnostic assistant was developed by the United States Army Institute of Surgical Research to detect PTX on standard thoracic US images. This computer algorithm is designed to automatically detect sonographic signs of PTX by systematically analyzing B-mode US video clips for pleural sliding and M-mode still images for the seashore sign. This was a pilot study to estimate the diagnostic accuracy of the PTX detection computer algorithm when compared to an expert panel of US trained physicians.Methods: This was a retrospective study using archived thoracic US obtained on adult patients presenting to the emergency department (ED) between 5/23/2011 and 8/6/2014. Emergency medicine residents, fellows, attending physicians, physician assistants, and medical students performed the US examinations and stored the images in the picture archive and communications system (PACS). The PACS was queried for all ED bedside US examinations with reported positive PTX during the study period along with a random sample of negatives. The computer algorithm then interpreted the images, and we compared the results to an independent, blinded expert panel of three physicians, each with experience reviewing over 10,000 US examinations.Results: Query of the PACS system revealed 146 bedside thoracic US examinations for analysis. Thirteen examinations were indeterminate and were excluded. There were 79 true negatives, 33 true positives, 9 false negatives, and 12 false positives. The test characteristics of the algorithm when compared to the expert panel were sensitivity 79% (95 % CI [63-89]) and specificity 87% (95% CI [77-93]). For the 20 images scored as highest quality by the expert panel, the algorithm demonstrated 100% sensitivity (95% CI [56-100]) and 92% specificity (95% CI [62-100]).Conclusion: This novel computer algorithm has potential to aid clinicians with the identification of the sonographic signs of PTX in the absence of expert physician sonographers. Further refinement and training of the algorithm is still needed, along with prospective validation, before it can be utilized in clinical practice