Renal Replacement Therapy in Austere Environments

Myoglobinuric renal failure is the classically described acute renal event occurring in disaster environments—commonly after an earthquake—which most tests the ingenuity and flexibility of local and regional nephrology resources. In recent decades, several nephrology organizations have developed response teams and planning protocols to address disaster events, largely focusing on patients at risk for, or with, acute kidney injury (AKI). In this paper we briefly review the epidemiology and outcomes of patients with dialysis-requiring AKI after such events, while providing greater focus on the management of the end-stage renal disease population after a disaster which incapacitates a pre-existing nephrologic infrastructure (if it existed at all). “Austere” dialysis, as such, is defined as the provision of renal replacement therapy in any setting in which traditional, first-world therapies and resources are limited, incapacitated, or nonexistent

I Walk My Dog Because It Makes Me Happy: A Qualitative Study to Understand Why Dogs Motivate Walking and Improved Health

Dog walking is a popular everyday physical activity. Dog owners are generally more active than non-owners, but some rarely walk with their dog. The strength of the dog–owner relationship is known to be correlated with dog walking, and this qualitative study investigates why. Twenty-six interviews were combined with autoethnography of dog walking experiences. Dog walking was constructed as “for the dog”, however, owners represented their dog’s needs in a way which aligned with their own. Central to the construction of need was perceptions of dog personality and behaviour. Owners reported deriving positive outcomes from dog walking, most notably, feelings of “happiness”, but these were “contingent” on the perception that their dogs were enjoying the experience. Owner physical activity and social interaction were secondary bonuses but rarely motivating. Perceptions and beliefs of owners about dog walking were continually negotiated, depending on how the needs of the owner and dog were constructed at that time. Complex social interactions with the “significant other” of a pet can strongly motivate human health behaviour. Potential interventions to promote dog walking need to account for this complexity and the effect of the dog-owner relationship on owner mental wellbeing

Brief Note Surface Charge Determination of Proteus Mirabilis Exposed to Carbenicillin

Author Institution: Division of Infectious Diseases, Department of Medicine, The Ohio State University College of Medicin

Threat Avoidance Behavior and Land Use of the Northern Bobwhite in the Rolling Plains of Texas

Northern bobwhites (Colinus virginianus) are an economically important species for several regions within the state of Texas. Bobwhites, along with their fiscal importance, fill a key role within the ecosystem as an r-selected common prey species. However, throughout the past few decades, bobwhite populations have plummeted to record lows. Currently many studies are investigating possible causes behind this precipitous decline, but efforts to discover better land management practices that provide preferred habitat for bobwhites should not be abandoned. Current landscape recommendations related to bobwhite escape cover stem from data collected on anthropogenic threats to bobwhites (i.e., coveys flushed by human disturbance). Bobwhites have a multitude of non-anthropogenic threats in the wild, and the existing data may lack important information regarding threat-specific avoidance behavior. Predation is a primary cause of bobwhite mortality, and we focused on bobwhite anti-predatory behavior and resulting land-use strategies with an ultimate goal of providing management recommendations to increase bobwhite survival. We designed and conducted an experiment to investigate not only bobwhite responses to anthropogenic threats, but also their responses to common natural predators. We investigated bobwhite behavioral and use of cover actions in response to 4 threat types: researchers, hunters, raptors, and nocturnal mammals. We collected data from January through March in 2010 and from November 2010 through March 2011. We measured characteristics of bobwhite flushing behavior, flight speed, and land and vegetative use when presented with specific threats. We located radio-marked coveys and conducted a walk-through for the researcher threat, if necessary, to cause the birds to flush. The hunter and raptor threats were conducted similarly with introduction of pointing dogs and shotgun blasts for the hunting scenario, and introduction of a trained northern goshawk (Accipiter gentilis) to give chase to bobwhites in the raptor scenario. We followed the same methods as the researcher treatment when creating the nocturnal mammal treatment, but conducted the test at night and followed the birds’ flight with a thermal imaging scope. There was a significant difference in landing cover among threat types with bobwhites selecting shrubs for landing cover when pursued by a raptor (P , 0.0001), whereas they showed no selection for shrubs when flushed by the other threat types. Bobwhites landed in live oak (Quercus virginianus) mottes and hackberry (Celtis reticulata) shrubs with the highest frequency, followed closely by wolfberry (Lycium barbarum), lote bush (Ziziphyus obtusifolia), and Englemann’s pricklypear (Opuntia engelmannii) when escaping the raptorial threat, These 5 species accounted for 49% of all shrubs used (19 total species) as escape cover in the raptor treatment. Obstructive vegetative height was higher at landing sites when bobwhites were presented with a raptor (P , 0.0001) or hunter (P 1⁄4 0.033) threat; however, bobwhites displayed no selection for obstructive vegetative height when presented with a researcher or nocturnal mammal threat. Further analyses will include modeling environmental and experimental parameters to find likely predictors of bobwhite threat avoidance behaviors, such as flushing speed, flight speed, and flight distance; behaviors that arguably affect energy expenditure and may interact with bobwhite health and predator avoidance capabilities. Our results suggest that land management recommendations based solely on anthropogenic threats may be insufficient to enable successful bobwhite escape strategies from raptors. Considering the availability and ‘integrity’ of shrubs as escape cover from raptors when contemplating brush management plans may enhance bobwhite management. We expect to provide threat-specific land management recommendations for bobwhites related to shrub species and density as well as grass density with continued analysis of these data

Effect of mattress deflection on CPR quality assessment for older children and adolescents

Appropriate chest compression (CC) depth is associated with improved CPR outcome. CCs provided in hospital are often conducted on a compliant mattress. The objective was to quantify the effect of mattress compression on the assessment of CPR quality in children. Methods: A force and deflection sensor (FDS) was used during CPR in the Pediatric Intensive Care Unit and Emergency Department of a children's hospital. The sensor was interposed between the chest of the patient and hands of the rescuer and measured CC depth. Following CPR event, each event was reconstructed with a manikin and an identical mattress/backboard/patient configuration. CCs were performed using FDS on the sternum and a reference accelerometer attached to the spine of the manikin, providing a means to Calculate the mattress deflection. Results: Twelve CPR events with 14,487 CC (11 patients, median age 14.9 years) were recorded and reconstructed: 9 on ICU beds (9296 CC), 3 on stretchers (5191 CC). Measured mean CC depth during CPR was 47 +/- 8 mm on ICU beds, and 45 +/- 7 mm on stretcher beds with overestimation of 13 +/- 4 mm and 4 +/- 1 mm, respectively, due to mattress compression. After adjusting for this, the proportion of CC that met the CPR guidelines decreased from 88.4 to 31.8% on ICU beds (p < 0.001), and 86.3 to 64.7% on stretcher (p < 0.001 The proportion of appropriate depth CC was significantly smaller on ICU beds (p < 0.001). Conclusion: CC conducted on a non-rigid surface may not be deep enough. FDS may overestimate CC depth by 28% on ICU beds, and 10% on stretcher beds

Improved Efficacy of a Gene Optimised Adenovirus-based Vaccine for Venezuelan Equine Encephalitis Virus

<p>Abstract</p> <p>Background</p> <p>Optimisation of genes has been shown to be beneficial for expression of proteins in a range of applications. Optimisation has increased protein expression levels through improved codon usage of the genes and an increase in levels of messenger RNA. We have applied this to an adenovirus (ad)-based vaccine encoding structural proteins (E3-E2-6K) of Venezuelan equine encephalitis virus (VEEV).</p> <p>Results</p> <p>Following administration of this vaccine to Balb/c mice, an approximately ten-fold increase in antibody response was elicited and increased protective efficacy compared to an ad-based vaccine containing non-optimised genes was observed after challenge.</p> <p>Conclusion</p> <p>This study, in which the utility of optimising genes encoding the structural proteins of VEEV is demonstrated for the first time, informs us that including optimised genes in gene-based vaccines for VEEV is essential to obtain maximum immunogenicity and protective efficacy.</p

Quick Start Guide to Soil Methods for Ecologists

Increasingly biologists and ecologists are becoming aware of the vital importance of soil to processes observed above ground and are incorporating soil analyses into their research. Because of the dynamic and heterogeneous nature of soil, proper incorporation of soil analysis into ecological studies requires knowledge and planning. Unfortunately, many ecologists may not be current (or trained at all) in soil science.We provide this review, based on our cumulative \u3e60 years of work in soil science,to help familiarize researchers with essential information to appropriately incorporate soil analyses into ecological studies. Specifically, we provide a brief introduction into soils and then discuss issues related to soil sterilization, choosing a soil for a greenhouse project, sampling soils, and soil analyses

Estimating the impact of city-wide Aedes aegypti population control: An observational study in Iquitos, Peru.

During the last 50 years, the geographic range of the mosquito Aedes aegypti has increased dramatically, in parallel with a sharp increase in the disease burden from the viruses it transmits, including Zika, chikungunya, and dengue. There is a growing consensus that vector control is essential to prevent Aedes-borne diseases, even as effective vaccines become available. What remains unclear is how effective vector control is across broad operational scales because the data and the analytical tools necessary to isolate the effect of vector-oriented interventions have not been available. We developed a statistical framework to model Ae. aegypti abundance over space and time and applied it to explore the impact of citywide vector control conducted by the Ministry of Health (MoH) in Iquitos, Peru, over a 12-year period. Citywide interventions involved multiple rounds of intradomicile insecticide space spray over large portions of urban Iquitos (up to 40% of all residences) in response to dengue outbreaks. Our model captured significant levels of spatial, temporal, and spatio-temporal variation in Ae. aegypti abundance within and between years and across the city. We estimated the shape of the relationship between the coverage of neighborhood-level vector control and reductions in female Ae. aegypti abundance; i.e., the dose-response curve. The dose-response curve, with its associated uncertainties, can be used to gauge the necessary spraying effort required to achieve a desired effect and is a critical tool currently absent from vector control programs. We found that with complete neighborhood coverage MoH intra-domicile space spray would decrease Ae. aegypti abundance on average by 67% in the treated neighborhood. Our framework can be directly translated to other interventions in other locations with geolocated mosquito abundance data. Results from our analysis can be used to inform future vector-control applications in Ae. aegypti endemic areas globally

A survey of educational articles appearing in sixteen popular magazines for an eleven year period from January, 1943 through December, 1953.

Thesis (Ed.M.)--Boston Universit

Prognostic Biomarkers for Acute Graft-versus-Host Disease Risk after Cyclophosphamide–Fludarabine Nonmyeloablative Allotransplantation

AbstractFive candidate plasma biomarkers (suppression of tumorogenesis 2 [ST2], regenerating islet-derived-3α [REG3α], elafin, tumor necrosis factor receptor 1 [TNFR1], and soluble IL-2 receptor-alpha [sIL2Rα]) were measured at specific time points after cyclophosphamide/fludarabine-based nonmyeloablative allotransplantation (NMAT) in patients who did or did not develop acute graft-versus-host disease (aGVHD). Plasma samples from 34 patients were analyzed at days +7, +14, +21, and +30. At a median follow-up of 358 days, 17 patients had experienced aGVHD with a median time to onset at day +36. Risk of aGVHD was associated with elevated plasma ST2 concentrations at day +7 (c-statistic = .72, P = .03), day +14 (c-statistic = .74, P = .02), and day +21 (c-statistic = .75, P = .02); elevated plasma REG3α concentrations at day +14 (c-statistic = .73, P = .03), day +21 (c-statistic = .76, P = .01), and day +30 (c-statistic = .73, P = .03); and elevated elafin at day +14 (c-statistic = .71, P = .04). Plasma concentrations of TNFR1 and sIL2Rα were not associated with aGVHD risk at any of the time points studied. This study identified ST2, REG3α, and elafin as prognostic biomarkers to evaluate risk of aGVHD after cyclophosphamide/fludarabine-based NMAT. These results need to be confirmed in an independent validation cohort