Tropospheric Carbon Monoxide Measurements from the Scanning High-Resolution Interferometer Sounder on 7 September 2000 in Southern Africa During SAFARI 2000

[1] Retrieved tropospheric carbon monoxide (CO) column densities are presented for more than 9000 spectra obtained by the University of Wisconsin-Madison (UWis) Scanning High-Resolution Interferometer Sounder (SHIS) during a flight on the NASA ER-2 on 7 September 2000 as part of the Southern African Regional Science Initiative (SAFARI 2000) dry season field campaign. Enhancements in tropospheric column CO were detected in the vicinity of a controlled biomass burn in the Timbavati Game Reserve in northeastern South Africa and over the edge of the river of smoke in south central Mozambique. Relatively clean air was observed over the far southern coast of Mozambique. Quantitative comparisons are presented with in situ measurements from five different instruments flying on two other aircraft: the University of Washington Convair-580 (CV) and the South African Aerocommander JRB in the vicinity of the Timbavati fire. Measured tropospheric CO columns (extrapolated from 337 to 100 mb) of 2.1 × 1018 cm−2 in background air and up to 1.5 × 1019 cm−2 in the smoke plume agree well with SHIS retrieved tropospheric CO columns of (2.3 ± 0.25) × 1018 cm−2 over background air near the fire and (1.5 ± 0.35) × 1019 cm−2 over the smoke plume. Qualitative comparisons are presented with three other in situ CO profiles obtained by the South African JRA aircraft over Mozambique and northern South Africa showing the influence of the river of smoke

The Southern African Regional Science Initiative (SAFARI 2000): Overview of the Dry Season Field Campaign

The Southern African Regional Science Initiative (SAFARI 2000) is an international science project investigating the earth-atmosphere-human system in southern Africa. The programme was conducted over a two-year period from March 1999 to March 2001. The dry season field campaign (August-September 2000) was the most intensive activity and involved over 200 scientists from eighteen countries. The main objectives were to characterize and quantify biogenic, pyrogenic and anthropogenic aerosol and trace gas emissions and their transport and transformations in the atmosphere, and to validate NASA\u27s Earth Observing System\u27s satellite Terra within a scientific context. Five aircraft - two South African Weather Service Aerocommanders, the University of Washington\u27s CV-580, the U.K. Meteorological Office\u27s C-130, and NASA\u27s ER-2-with different altitude capabilities, participated in the campaign. Additional airborne sampling of southern African air masses, that had moved downwind of the subcontinent, was conducted by the CSIRO over Australia. Multiple observations were made in various geographical sectors under different synoptic conditions. Airborne missions were designed to optimize the value of synchronous over-flights of the Terra satellite platform, above regional ground validation and science targets. Numerous smaller-scale ground validation activities took place throughout the subcontinent during the campaign period

Gender differences in presentation and diagnosis of chest pain in primary care

<p>Abstract</p> <p>Background</p> <p>Chest pain is a common complaint and reason for consultation in primary care. Research related to gender differences in regard to Coronary Heart Disease (CHD) has been mainly conducted in hospital but not in primary care settings. We aimed to analyse gender differences in aetiology and clinical characteristics of chest pain and to provide gender related symptoms and signs associated with CHD.</p> <p>Methods</p> <p>We included 1212 consecutive patients with chest pain aged 35 years and older attending 74 general practitioners (GPs). GPs recorded symptoms and findings of each patient and provided follow up information. An independent interdisciplinary reference panel reviewed clinical data of every patient and decided about the aetiology of chest pain at the time of patient recruitment. Multivariable regression analysis was performed to identify clinical predictors that help to rule in or out CHD in women and men.</p> <p>Results</p> <p>Women showed more psychogenic disorders (women 11,2%, men 7.3%, p = 0.02), men suffered more from CHD (women 13.0%, men 17.2%, p = 0.04), trauma (women 1.8%, men 5.1%, p < 0.001) and pneumonia/pleurisy (women 1.3%, men 3.0%, p = 0.04) Men showed significantly more often chest pain localised on the right side of the chest (women 9.1%, men 25.0%, p = 0.01). For both genders known clinical vascular disease, pain worse with exercise and age were associated positively with CHD. In women pain duration above one hour was associated positively with CHD, while shorter pain durations showed an association with CHD in men. In women negative associations were found for stinging pain and in men for pain depending on inspiration and localised muscle tension.</p> <p>Conclusions</p> <p>We found gender differences in regard to aetiology, selected clinical characteristics and association of symptoms and signs with CHD in patients presenting with chest pain in a primary care setting. Further research is necessary to elucidate whether these differences would support recommendations for different diagnostic approaches for CHD according to a patient's gender.</p

Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1±16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1±6 HU comparing right and left coronary artery and 56±9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291±65 HU in the ascending aorta, 334±93 HU in the pulmonary trunk, and 285±66 HU and 268±67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain

Ruling out coronary heart disease in primary care patients with chest pain: a clinical prediction score

Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify coronary heart disease in emergency settings, but not in primary care. Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one of 59 family practitioners' offices. Using delayed diagnosis we derived a prediction rule to rule out coronary heart disease by means of a logistic regression model. Known cardiovascular risk factors, pain characteristics, and physical signs associated with coronary heart disease were explored to develop a clinical score. Patients diagnosed with angina or acute myocardial infarction within the year following their initial visit comprised the coronary heart disease group. The coronary heart disease score was derived from eight variables: age, gender, duration of chest pain from 1 to 60 minutes, substernal chest pain location, pain increasing with exertion, absence of tenderness point at palpation, cardiovascular risks factors, and personal history of cardiovascular disease. Area under the receiver operating characteristics curve was of 0.95 with a 95% confidence interval of 0.92; 0.97. From this score, 413 patients were considered as low risk for values of percentile 5 of the coronary heart disease patients. Internal validity was confirmed by bootstrapping. External validation using data from a German cohort (Marburg, n = 774) revealed a receiver operating characteristics curve of 0.75 (95% confidence interval, 0.72; 0.81) with a sensitivity of 85.6% and a specificity of 47.2%. This score, based only on history and physical examination, is a complementary tool for ruling out coronary heart disease in primary care patients complaining of chest pain

Scenario-Based Design Theorizing:The Case of a Digital Idea Screening Cockpit

As ever more companies encourage employees to innovate, a surplus of ideas has become reality in many organizations – often exceeding the available resources to execute them. Building on insights from a literature review and a 3-year collaboration with a banking software provider, the paper suggests a Digital Idea Screening Cockpit (DISC) to address this challenge. Following a design science research approach, it suggests a prescriptive design theory that provides practitioner-oriented guidance for implementing a DISC. The study shows that, in order to facilitate the assessment, selection, and tracking of ideas for different stakeholders, such a system needs to play a dual role: It needs to structure decision criteria and at the same be flexible to allow for creative expression. Moreover, the paper makes a case for scenario-based design theorizing by developing design knowledge via scenarios

A study to derive a clinical decision rule for triage of emergency department patients with chest pain: design and methodology

<p>Abstract</p> <p>Background</p> <p>Chest pain is the second most common chief complaint in North American emergency departments. Data from the U.S. suggest that 2.1% of patients with acute myocardial infarction and 2.3% of patients with unstable angina are misdiagnosed, with slightly higher rates reported in a recent Canadian study (4.6% and 6.4%, respectively). Information obtained from the history, 12-lead ECG, and a single set of cardiac enzymes is unable to identify patients who are safe for early discharge with sufficient sensitivity. The 2007 ACC/AHA guidelines for UA/NSTEMI do not identify patients at low risk for adverse cardiac events who can be safely discharged without provocative testing. As a result large numbers of low risk patients are triaged to chest pain observation units and undergo provocative testing, at significant cost to the healthcare system. Clinical decision rules use clinical findings (history, physical exam, test results) to suggest a diagnostic or therapeutic course of action. Currently no methodologically robust clinical decision rule identifies patients safe for early discharge.</p> <p>Methods/design</p> <p>The goal of this study is to derive a clinical decision rule which will allow emergency physicians to accurately identify patients with chest pain who are safe for early discharge. The study will utilize a prospective cohort design. Standardized clinical variables will be collected on all patients at least 25 years of age complaining of chest pain prior to provocative testing. Variables strongly associated with the composite outcome acute myocardial infarction, revascularization, or death will be further analyzed with multivariable analysis to derive the clinical rule. Specific aims are to: i) apply standardized clinical assessments to patients with chest pain, incorporating results of early cardiac testing; ii) determine the inter-observer reliability of the clinical information; iii) determine the statistical association between the clinical findings and the composite outcome; and iv) use multivariable analysis to derive a highly sensitive clinical decision rule to guide triage decisions.</p> <p>Discussion</p> <p>The study will derive a highly sensitive clinical decision rule to identify low risk patients safe for early discharge. This will improve patient care, lower healthcare costs, and enhance flow in our busy and overcrowded emergency departments.</p

Climate change and Saharan dust drive recent cladoceran and primary production changes in remote alpine lakes of Sierra Nevada, Spain

Recent anthropogenic climate change and the exponential increase over the past few decades of Saharan dust deposition, containing ecologically important inputs of phosphorus (P) and calcium (Ca), are potentially affecting remote aquatic ecosystems. In this study, we examine changes in cladoceran assemblage composition and chlorophyll-a concentrations over the past ~150 years from high-resolution, welldated sediment cores retrieved from six remote high mountain lakes in the Sierra Nevada Mountains of Southern Spain, a region affected by Saharan dust deposition. In each lake, marked shifts in cladoceran assemblages and chlorophyll-a concentrations in recent decades indicate a regional-scale response to climate and Saharan dust deposition. Chlorophyll-a concentrations have increased since the 1970s, consistent with a response to rising air temperatures and the intensification of atmospheric deposition of Saharan P. Similar shifts in cladoceran taxa across lakes began over a century ago, but have intensified over the past ~50 years, concurrent with trends in regional air temperature, precipitation, and increased Saharan dust deposition. An abrupt increase in the relative abundance of the benthic cladoceran Alona quadrangularis at the expense of Chydorus sphaericus, and a significant increase in Daphnia pulex gr. was a common trend in these softwater lakes. Differences in the magnitude and timing of these changes are likely due to catchment and lake-specific differences. In contrast with other alpine lakes that are often affected by acid deposition, atmospheric Ca deposition appears to be a significant explanatory factor, among others, for the changes in the lake biota of Sierra Nevada that has not been previously considered. The effects observed in Sierra Nevada are likely occurring in other Mediterranean lake districts, especially in softwater, oligotrophic lakes. The predicted increases in global temperature and Saharan dust deposition in the future will further impact the ecological condition of these ecosystemsMinisterio de Educación y Ciencia (MEC), Grant/Award Number: AP2007-00352; Programa Nacional de Movilidad de Recursos Humanos de Investigaci on (MICINN); Ministerio de Medio Ambiente (MMA), Grant/Award Number: 87/2007; Ministerio de Econom ıa, Industria y Competitividad (MINECO), Grant/Award Number: CGL2011-23483; Natural Sciences and Engineering Research Council of Canad