A new approach for characterizing atmospheric aerosols from spectral values of their optical depth. A simulated case study.

We are developing a new method to determine the spectral contribution to the aerosol optical depth due to each aerosol type. An aerosol type depends directly on the procedence of the particles (marine, continental, artic, etc) and it is formed by some different pure components (mineral, soot, soluble and insoluble particles, sulphate, etc). In order to separate these contributions it is necessary to have the spectral aerosol optical thickness and aerosol size distribution. We use this distribution function to identify the different components of aerosols allowing us to reconstruct the aerosol optical depth taking into account the contribution of each type of aerosol. The validation of the method will be carried out by verifying that the spectral aerosol optical depth corresponds to the sum of the optical depths obtained for each identified aerosol type

Perceptions about the Self-Learning Methodology in Simulated Environments in Nursing Students: A Mixed Study

The self-learning methodology in simulated environments (MAES©) is an active method of education. The aim of this study was to analyze the perceptions and opinions of undergraduate and graduate nursing students about the self-learning methodology in simulated environments. A mixed, cross-sectional, descriptive study based on a survey tool made ad hoc (quantitative approach) and an open questionnaire (qualitative approach) was carried out. A sample of 149 undergraduate and 25 postgraduate nursing students were tested. The score was high for all the variables of the questionnaire analyzed: for perception of simulation performance, M = 73.5 (SD = 14.5), for motivation, M = 23.9 (SD = 5.9), for the opinion about facilitators, M = 25.9 (SD = 4.5), and for the promotion of team work, M = 16.9 (SD = 3.4). Five dimensions were identified and evaluated in the qualitative research. The students were pleased with MAES© and had a positive perception, since they considered that MAES© increased their learning

A comparison of Microtops II and satellite ozone measurements in the period 2001-2011

Daily average total ozone Microtops measurements obtained during several campaigns conducted from 2001 to 2011 at latitudes from 31 to 68°N and in different seasons are compared with satellite observations. The Microtops ozone is derived using different wavelength combinations (Channel I, 305.5/312.5 nm; Channel II, 312.5/320 nm; and Channel III, 305.5/312.5/320 nm). Satellite data from TOMS, OMI, GOME, and GOME-2 are used in the comparison. The three Microtops channels show a high correlation with the satellite retrievals. Channel I shows the best results and produces a mean bias deviation (MBD) less than 2.14% with respect to TOMS, OMI and GOME. The MBD increases to 3% in the comparison against GOME-2, due to the small number of available data. In addition, the total ozone content provided by Channel I displays the more stable behavior during the ten-year period. The Channel III total ozone shows MBD values smaller than those observed for Channel I. However the Channels II and III present a larger variability and show a larger spread of the data. Consequently, Channel I appears as the best option for long term measurements with Microtops

Comparison of injury severity scores (ISS) obtained by manual coding versus ?Two-step conversion? from ICD-9-CM

Background: The International Classification of Diseases (ICD) is the standard diagnostic tool for classifying and coding diseases and injuries. The Abbreviated Injury Scale (AIS) is the most widely used injury severity scoring system. Although manual coding is considered the gold standard, it is sometimes unavailable or impractical. There have been many prior attempts to develop programs for the automated conversion of ICD rubrics into AIS codes. Objective: To convert ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes into AIS 2005 (update 2008) codes via a derived map using a two-step process and, subsequently, to compare Injury Severity Score (ISS) resulting from said conversion with manually coded ISS values. Methods: A cross-sectional retrospective study was designed in which medical records at the Hospital Universitario Marqués de Valdecilla of Cantabria (HUMV) and the Complejo Hospitalario of Navarra (CHN), both in Spain, were reviewed. Coding of injuries using AIS 2005 (update 2008) version was done manually by a certified AIS specialist and ISS values were calculated. ICD-9-CM codes were automatically converted into ISS values by another certified AIS specialist in a two-step process. ISS scores obtained from manual coding were compared to those obtained through this conversion process. Results: The comparison of obtained through conversion versus manual ISS resulted in 396 concordant pairs (70.2%); the analysis of values according to ISS categories (ISS24) showed 493 concordant pairs (87.4%). Regarding the criterion of ?major trauma? patient (i.e., ISS> 15), 538 matching pairs (95.2%) were obtained. The conversion process resulted in underestimation of ISS in 112 cases (19.9%) and conversion was not possible in 136 cases (19%) for different reasons. Conclusions: The process used in this study has proven to be a useful tool for selecting patients who meet the ISS>15 criterion for ?major trauma?. Further research is needed to improve the conversion process

Using High-Fidelity Simulation to Introduce Communication Skills about End-of-Life to Novice Nursing Students

Background: High-fidelity simulation is being considered as a suitable environment for imparting the skills needed to deal with end-of-life (EOL) situations. The objective was to evaluate an EOL simulation project that introduced communication skills to nursing students who had not yet begun their training in real healthcare environments. Methods: A sequential approach was used. The ?questionnaire for the evaluation of the end-of-life project? was employed. Results: A total of130 students participated. Increasing the time spent in high-fidelity simulation significantly favored the exploration of feelings and fears regarding EOL (t = ?2.37, p = 0.019), encouraged dialogue (t = ?2.23, p = 0.028) and increased the acquisition of communication skills (t = ?2.32, p = 0.022).Conclusions: High-fidelity simulation promotes communication skills related to EOL in novice nursing studentsThis research was funded by the University of Cantabria (Spain). Grant number 28.0000.229

Operational considerations to improve total ozone measurements with a Microtops II ozone monitor

A Microtops II 'ozone monitor' with UV channels centered at 305.5, 312.5, and 320 nm has been used routinely in six experimental campaigns carried out in several geographic locations and seasons, covering latitudes from 35 to 68° N during the last ten years (2001-2011). The total ozone content is retrieved by Microtops II by using different combinations (Channel I, 305.5/312.5 nm; Channel II, 312.5/320 nm; and Channel III, 305.5/312.5/320 nm) of the signals at the three ultraviolet wavelengths. The long-term performance of the total ozone content determination has been studied taking into account the sensitivities to the calibration, airmass, temperature and aerosols. When a calibration was used and the airmass limit was fixed to 3, the root mean square deviations of the relative differences produced by Microtops II with respect to several Brewers are 0.9, 2, and 2% respectively for the Channel I, Channel II, and Channel III retrieval. The performance of the Microtops retrieval has been stable during the last ten years. Channel I represents the best option to determine the instantaneous total ozone content. Channels II and III values appear weakly sensitive to temperature, ozone content, and aerosols. Channel II is more stable than Channel I for airmasses larger than 2.6. The conclusions do not show any dependence on latitude and season

Impact of CD4 and CD8 dynamics and viral rebounds on loss of virological control in HIV controllers

Objective: HIV controllers (HICs) spontaneously maintain HIV viral replication at low level without antiretroviral therapy (ART), a small number of whom will eventually lose this ability to control HIV viremia. The objective was to identify factors associated with loss of virological control. Methods: HICs were identified in COHERE on the basis of \ue2\u89\ua55 consecutive viral loads (VL) \ue2\u89\ua4500 copies/mL over \ue2\u89\ua51 year whilst ART-naive, with the last VL \ue2\u89\ua4500 copies/mL measured \ue2\u89\ua55 years after HIV diagnosis. Loss of virological control was defined as 2 consecutive VL >2000 copies/mL. Duration of HIV control was described using cumulative incidence method, considering loss of virological control, ART initiation and death during virological control as competing outcomes. Factors associated with loss of virological control were identified using Cox models. CD4 and CD8 dynamics were described using mixed-effect linear models. Results: We identified 1067 HICs; 86 lost virological control, 293 initiated ART, and 13 died during virological control. Six years after confirmation of HIC status, the probability of losing virological control, initiating ART and dying were 13%, 37%, and 2%. Current lower CD4/CD8 ratio and a history of transient viral rebounds were associated with an increased risk of losing virological control. CD4 declined and CD8 increased before loss of virological control, and before viral rebounds. Discussion: Expansion of CD8 and decline of CD4 during HIV control may result from repeated low-level viremia. Our findings suggest that in addition to superinfection, other mechanisms, such as low grade viral replication, can lead to loss of virological control in HICs