399 research outputs found

    Changes in vegetation over nine years after rehabilitating a linear feature in Australia's arid zone

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    A 36-km road built in 1961 between Ayers Rock (Uluru) and the Olgas (Kata Tjuta), Northern Territory, Australia had seriously deteriorated by the 1980s. A newly aligned road, which was ecologically located and avoid sensitive Aboriginal sites, was completed early in 1991. The old road was rehabilitated by deep ripping, filling with imported sand and topsoil and by grading logs and windrows1 over the new surface. This paper reports on the effectiveness of the rehabilitation technique used in reinstating vegetation over 8 years and considers whether this rehabilitation aim was met. Plant colonisation and succession were monitored on 15 paired plots, one in the rehabilitated road and the other in the adjacent undisturbed habitat (with four exceptions) and also on the windrows. Sites at eight creek crossings and those subject to fire and rabbit activity were also monitored. Different landscape units responded in different ways to the rehabilitation. Herbaceous species from imported sand plain fill and top soil eventually dominated the road where they were introduced and were likely to persist in most areas because of local recruitment. The revegetation of the road has stabilised the old road surface as observed by the reduced erosion although succession did not always approach the reference site communities because of a greater resemblance to the Simpson Land System. Over the 8 years of monitoring considerable changes in vegetation occurred and are probably continuing. Only the road sites in the Simpson Land System approached the condition of the adjacent undisturbed vegetation because the vegetation of the other two land systems became closer to that of the Simpson Land System rather than to that of the surrounding vegetation. It is recommended that the introduced Buffel grass, known to alter landscape-level processes by reducing native herbaceous species and increasing risk of high intensity wildfire, which is most evident at creek crossings, should be controlled. Recommendations are made for improved management. © 2012 Australian Rangeland Society

    Heart Fatty Acid Binding Protein and cardiac troponin: development of an optimal rule-out strategy for acute myocardial infarction

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    Background: Improved ability to rapidly rule-out Acute Myocardial Infarction (AMI) in patients presenting with chest pain will promote decongestion of the Emergency Department (ED) and reduce unnecessary hospital admissions. We assessed a new commercial Heart Fatty Acid Binding Protein (H-FABP) assay for additional diagnostic value when combined with cardiac troponin (using a high sensitivity assay). Methods: H-FABP and high-sensitivity troponins I (hs-cTnI) and T (hs-cTnT) were measured in samples taken on-presentation from patients, attending the ED, with symptoms triggering investigation for possible acute coronary syndrome. The optimal combination of H-FABP with each hs-cTn was defined as that which maximized the proportion of patients with a negative test (low-risk) whilst maintaining at least 99 % sensitivity for AMI. A negative test comprised both H-FABP and hs-cTn below the chosen threshold in the absence of ischemic changes on the ECG. Results: One thousand seventy-nine patients were recruited including 248 with AMI. H-FABP 99 % sensitivity for AMI whilst classifying 40.9 % of patients as low-risk. The combination of H-FABP < 3.9 ng/mL and hs-cTnT < 7.6 ng/L with a negative ECG maintained the same sensitivity whilst classifying 32.1 % of patients as low risk. Conclusions: In patients requiring rule-out of AMI, the addition of H-FABP to hs-cTn at presentation (in the absence of new ischaemic ECG findings) may accelerate clinical diagnostic decision making by identifying up to 40 % of such patients as low-risk for AMI on the basis of blood tests performed on presentation. If implemented this has the potential to significantly accelerate triaging of patients for early discharge from the ED

    The utility of presentation and 4-hour high sensitivity troponin I to rule-out acute myocardial infarction in the emergency department

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    Objectives: International guidance recommends that early serial sampling of high sensitivity troponin be used to accurately identify acute myocardial infarction (AMI) in chest pain patients. The background evidence for this approach is limited. We evaluated whether on presentation and 4-hour high-sensitivity troponin I (hs-cTnI) could be used to accurately rule-out AMI. Design and methods: hs-cTnI was measured on presentation and at 4-hours in adult patients attending an emergency department with possible acute coronary syndrome. We determined the sensitivity for AMI for at least one hs-cTnI above the 99th percentile for a healthy population or alone or in combination with new ischemic ECG changes. Both overall and sex-specific 99th percentiles were assessed. Patients with negative tests were designated low-risk. Results: 63 (17.1%) of 368 patients had AMI. The median (interquartile range) time from symptom onset to first blood sampling was 4.8. h (2.8-8.6). The sensitivity of the presentation and 4. h hs-cTnI using the overall 99th percentile was 92.1% (95% CI 82.4% to 97.4%) and negative predictive value 95.4% (92.3% to 97.4%) with 78.3% low-risk. Applying the sex-specific 99th percentile did not change the sensitivity. The addition of ECG did not change the sensitivity. Conclusion: Hs-cTnI >. 99th percentile thresholds measured on presentation and at 4-hours was not a safe strategy to rule-out AMI in this clinical setting irrespective of whether sex-specific 99th percentiles were used, or whether hs-cTnI was combined with ECG results

    Perinatal outcomes after in-utero exposure to beta-blockers in women with heart disease:Data from the ESC EORP registry of pregnancy and cardiac disease (ROPAC)

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    Background: Beta-blockers are commonly used drugs during pregnancy, especially in women with heart disease, and are regarded as relatively safe although evidence is sparse. Differences between beta-blockers are not well-studied. Methods: In the Registry of Pregnancy And Cardiac disease (ROPAC, n = 5739), a prospective global registry of pregnancies in women with structural heart disease, perinatal outcomes (small for gestational age (SGA), birth weight, neonatal congenital heart disease (nCHD) and perinatal mortality) were compared between women with and without beta-blocker exposure, and between different beta-blockers. Multivariable regression analysis was used for the effect of beta-blockers on birth weight, SGA and nCHD (after adjustment for maternal and perinatal confounders). Results: Beta-blockers were used in 875 (15.2%) ROPAC pregnancies, with metoprolol (n = 323, 37%) and bisoprolol (n = 261, 30%) being the most frequent. Women with beta-blocker exposure had more SGA infants (15.3% vs 9.3%, p &lt; 0.001) and nCHD (4.7% vs 2.7%, p = 0.001). Perinatal mortality rates were not different (1.4% vs 1.9%, p = 0.272). The adjusted mean difference in birth weight was −177 g (−5.8%), the adjusted OR for SGA was 1.7 (95% CI 1.3–2.1) and for nCHD 2.3 (1.6–3.5). With metoprolol as reference, labetalol (0.2, 0.1–0.4) was the least likely to cause SGA, and atenolol (2.3, 1.1–4.9) the most. Conclusions: In women with heart disease an association was found between maternal beta-blocker use and perinatal outcomes. Labetalol seems to be associated with the lowest risk of developing SGA, while atenolol should be avoided.</p

    2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker

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    Objectives The purpose of this study was to determine whether a new accelerated diagnostic protocol (ADP) for possible cardiac chest pain could identify low-risk patients suitable for early discharge (with follow-up shortly after discharge). Background Patients presenting with possible acute coronary syndrome (ACS), who have a low short-term risk of adverse cardiac events may be suitable for early discharge and shorter hospital stays. Methods This prospective observational study tested an ADP that included pre-test probability scoring by the Thrombolysis In Myocardial Infarction (TIMI) score, electrocardiography, and 0 + 2 h values of laboratory troponin I as the sole biomarker. Patients presenting with chest pain due to suspected ACS were included. The primary endpoint was major adverse cardiac event (MACE) within 30 days. Results Of 1,975 patients, 302 (15.3%) had a MACE. The ADP classified 392 patients (20%) as low risk. One (0.25%) of these patients had a MACE, giving the ADP a sensitivity of 99.7% (95% confidence interval [CI]: 98.1% to 99.9%), negative predictive value of 99.7% (95% CI: 98.6% to 100.0%), specificity of 23.4% (95% CI: 21.4% to 25.4%), and positive predictive value of 19.0% (95% CI: 17.2% to 21.0%). Many ADP negative patients had further investigations (74.1%), and therapeutic (18.3%) or procedural (2.0%) interventions during the initial hospital attendance and/or 30-day follow-up. Conclusions Using the ADP, a large group of patients was successfully identified as at low short-term risk of a MACE and therefore suitable for rapid discharge from the emergency department with early follow-up. This approach could decrease the observation period required for some patients with chest pain. (An observational study of the diagnostic utility of an accelerated diagnostic protocol using contemporary central laboratory cardiac troponin in the assessment of patients presenting to two Australasian hospitals with chest pain of possible cardiac origin; ACTRN12611001069943

    Mooring design using wave-state estimate from the Southern Ocean

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    Author Posting. © American Meteorological Society, 2011. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Atmospheric and Oceanic Technology 28 (2011): 1351–1360, doi:10.1175/JTECH-D-10-05033.1.The Southern Ocean Flux Station was deployed near 47°S, 140°E. The extreme wind and wave conditions at this location require appropriate mooring design, which includes dynamic fatigue analysis and static analysis. An accurate estimate of the wave conditions was essential. A motion reference unit was deployed in a nearby test mooring for 6 months. The motion data provided estimates of significant wave height that agreed well with the Australian Bureau of Meteorology wave model, increasing confidence in the model performance in the Southern Ocean. The results of the dynamic fatigue analysis using three input wave datasets and implications for the mooring design are described. The design analysis predicts the fatigue life for critical mooring components and guided the final selection of links and chain shackles. The three input wave climatologies do not differ greatly, and this is reflected in minimal changes to mooring components for each of the fatigue analyses.Many years of logistic support for these deployments have been provided by the Australian Marine National Facility and the Australian Antarctic Sciences program (Award 1156). IMOS is funded through the Federal Government’s National Collaborative Research Infrastructure Strategy and the Super Science Initiative

    Rapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection: A Collaborative Meta-analysis.

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    Background: High-sensitivity assays for cardiac troponin T (hs-cTnT) are sometimes used to rapidly rule out acute myocardial infarction (AMI). Purpose: To estimate the ability of a single hs-cTnT concentration below the limit of detection (<0.005 µg/L) and a nonischemic electrocardiogram (ECG) to rule out AMI in adults presenting to the emergency department (ED) with chest pain. Data Sources: EMBASE and MEDLINE without language restrictions (1 January 2008 to 14 December 2016). Study Selection: Cohort studies involving adults presenting to the ED with possible acute coronary syndrome in whom an ECG and hs-cTnT measurements were obtained and AMI outcomes adjudicated during initial hospitalization. Data Extraction: Investigators of studies provided data on the number of low-risk patients (no new ischemia on ECG and hs-cTnT measurements <0.005 µg/L) and the number who had AMI during hospitalization (primary outcome) or a major adverse cardiac event (MACE) or death within 30 days (secondary outcomes), by risk classification (low or not low risk). Two independent epidemiologists rated risk of bias of studies. Data Synthesis: Of 9241 patients in 11 cohort studies, 2825 (30.6%) were classified as low risk. Fourteen (0.5%) low-risk patients had AMI. Sensitivity of the risk classification for AMI ranged from 87.5% to 100% in individual studies. Pooled estimated sensitivity was 98.7% (95% CI, 96.6% to 99.5%). Sensitivity for 30-day MACEs ranged from 87.9% to 100%; pooled sensitivity was 98.0% (CI, 94.7% to 99.3%). No low-risk patients died. Limitation: Few studies, variation in timing and methods of reference standard troponin tests, and heterogeneity of risk and prevalence of AMI across studies. Conclusion: A single hs-cTnT concentration below the limit of detection in combination with a nonischemic ECG may successfully rule out AMI in patients presenting to EDs with possible emergency acute coronary syndrome. Primary Funding Source: Emergency Care Foundation

    JINGLE, a JCMT legacy survey of dust and gas for galaxy evolution studies - I. Survey overview and first results

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    JINGLE is a new JCMT legacy survey designed to systematically study the cold interstellar medium of galaxies in the local Universe. As part of the survey we perform 850 μm continuum measurements with SCUBA-2 for a representative sample of 193 Herschel-selected galaxies with M* \u3e 109 M⊙, as well as integrated CO(2-1) line fluxes with RxA3m for a subset of 90 of these galaxies. The sample is selected from fields covered by the Herschel-ATLAS survey that are also targeted by the MaNGA optical integral-field spectroscopic survey. The new JCMT observations combined with the multiwavelength ancillary data will allow for the robust characterization of the properties of dust in the nearby Universe, and the benchmarking of scaling relations between dust, gas, and global galaxy properties. In this paper we give an overview of the survey objectives and details about the sample selection and JCMT observations, present a consistent 30-band UV-to-FIR photometric catalogue with derived properties, and introduce the JINGLE Main Data Release. Science highlights include the non-linearity of the relation between 850 μm luminosity and CO line luminosity (log LCO(2-1) = 1.372 logL850-1.376), and the serendipitous discovery of candidate z \u3e 6 galaxies
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