Crop Water Stress Index of an Irrigated Vineyard in the Central Valley of California

Water-limiting conditions in many California vineyards necessitate assessment of vine water stress to aid irrigation management strategies and decisions. This study was designed to evaluate the utility of a Crop Water Stress Index (CWSI) using multiple canopy temperature sensors and to study the diurnal signature in the stress index of an irrigated vineyard. A detailed instrumentation package comprised of eddy covariance instrumentation, ancillary surface energy balance components, soil water content sensors and a unique multi-canopy temperature sensor array were deployed in a production vineyard near Lodi, CA. The instrument package was designed to measure and monitor hourly growing season turbulent fluxes of heat and water vapor, radiation, air temperature, soil water content directly beneath a vine canopy, and vine canopy temperatures. April 30–May 02, June 10–12 and July 27–28, 2016 were selected for analysis as these periods represented key vine growth and production phases. Considerable variation in computed CWSI was observed between each of the hourly average individual canopy temperature sensors throughout the study; however, the diurnal trends remained similar: highest CWSI values in morning and lowest in the late afternoon. While meteorological conditions were favorable for plant stress to develop, soil water content near field capacity due to frequent irrigation allowed high evapotranspiration rates resulting in downward trending CWSI values during peak evaporative demand. While the CWSI is typically used to evaluate plant stress under the conditions of our study, the trend of the CWSI suggested a lowering of plant water stress as long as there was adequate soil water available to meet atmospheric demand

Assessment of websites with information on medicines

Objetivo: Identificar sitios web con información sobre medicamentos a través de expertos y evaluar su adecuación a códigos de conducta y las recomendaciones de la Organización Mundial de la Salud. Diseño: Estudio transversal de la adecuación a los criterios, a partir de un cuestionario diseñado ad hoc (efectuado independientemente por dos evaluadores). Los sitios web fueron identificados a partir de la técnica Delphi (35 expertos). Emplazamiento: Sitios web con información sobre medicamentos. Unidad de análisis: 35 sitios web seleccionados por la técnica Delphi. En la tercera ronda se alcanzó un nivel de estabilidad (variabilidad intercuartílica) aceptable (< 0,05). Mediciones principales: Responsabilidad, transparencia y honestidad, autoría de la información, política editorial, protección de datos personales, actualización de la información y accesibilidad. Se realizó un análisis descriptivo del cumplimiento y se estimó el coeficiente kappa para valorar la concordancia entre evaluadores (criterios de Fleiss). Resultados: Destacan con cumplimiento general alto el National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra y National Institute for Health and Clinical Excellence. La dimensión de actualización de la información es la que presentó una menor valoración para los diferentes sitios web. Conclusiones: La calidad de los sitios web sobre medicamentos recomendada por expertos es variable. Sin embargo, hay diversos sitios web de cumplimiento alto, que se detallan en el informe.Aims: To identify websites with information on medicines and assess, using experts, their adherence to codes of conduct and recommendations by the WHO. Design: Cross-sectional study based on an ad hoc designed questionnaire (performed independently by 2 reviewers). The websites were identified by the Delphi technique (35 experts). Setting: Websites with information on medicines. Participants: A total of 35 websites selected by the Delphi technique. An acceptable level of stability was achieved in the third round (interquartile variability; <0.05). Main measurements: Responsibility, transparency and honesty, authorship of the information, content review policy, privacy and data protection policies, updated information and accessibility. A descriptive analysis of compliance was carried out and the kappa coefficient was estimated to evaluate the agreement between assessors (Fleiss's Criteria). Results: The National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra and National Institute for Health and Clinical Excellence stood out with an overall high fulfilment of the questionnaire. The updated information dimension was the lowest evaluation for the different websites. Conclusions: The quality of the web sites evaluated varied widely. Although there are several websites, which are detailed in the article, with high overall scores

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

The Somatic Genomic Landscape of Glioblastoma

We describe the landscape of somatic genomic alterations based on multi-dimensional and comprehensive characterization of more than 500 glioblastoma tumors (GBMs). We identify several novel mutated genes as well as complex rearrangements of signature receptors including EGFR and PDGFRA. TERT promoter mutations are shown to correlate with elevated mRNA expression, supporting a role in telomerase reactivation. Correlative analyses confirm that the survival advantage of the proneural subtype is conferred by the G-CIMP phenotype, and MGMT DNA methylation may be a predictive biomarker for treatment response only in classical subtype GBM. Integrative analysis of genomic and proteomic profiles challenges the notion of therapeutic inhibition of a pathway as an alternative to inhibition of the target itself. These data will facilitate the discovery of therapeutic and diagnostic target candidates, the validation of research and clinical observations and the generation of unanticipated hypotheses that can advance our molecular understanding of this lethal cancer

MANAGING HEALTHCARE FOR EXPATRIATES: QUALITY ASSURANCE USING A TECHNOLOGY-BASED APPROACH

As organizations expand internationally to compete in the global economy, the healthcare needs of their “expats” increase proportionately. Concerns about access to and the quality of healthcare services are commonly shared by expats. Expats expect quality healthcare coverage and the lack of appropriate international healthcare may result in their decreased productivity. The provision of comprehensive healthcare services for expats similar to those available in their home countries poses a significant challenge for global organizations. Technology innovations, especially those known as telemedicine offer the greatest potential to deliver quality healthcare in the global environment. This paper discusses the role that technology innovation will play in addressing the challenge of providing healthcare services for expats