Taking stock of nature: Essential biodiversity variables explained

In 2013, the Group on Earth Observations Biodiversity Observation Network (GEO BON) developed the framework of Essential Biodiversity Variables (EBVs), inspired by the Essential Climate Variables (ECVs). The EBV framework was developed to distill the complexity of biodiversity into a manageable list of priorities and to bring a more coordinated approach to observing biodiversity on a global scale. However, efforts to address the scientific challenges associated with this task have been hindered by diverse interpretations of the definition of an EBV. Here, the authors define an EBV as a critical biological variable that characterizes an aspect of biodiversity, functioning as the interface between raw data and indicators. This relationship is clarified through a multi-faceted stock market analogy, drawing from relevant examples of biodiversity indicators that use EBVs, such as the Living Planet Index and the UK Spring Index. Through this analogy, the authors seek to make the EBV concept accessible to a wider audience, especially to non-specialists and those in the policy sector, and to more clearly define the roles of EBVs and their relationship with biodiversity indicators. From this we expect to support advancement towards globally coordinated measurements of biodiversity

Global Emergency Medicine: A Review of the Literature From 2014

ObjectivesThe Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer‐reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners.MethodsThis year 6,376 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 477 articles were deemed appropriate by at least one reviewer and approved by the editor for formal scoring of overall quality and importance.ResultsOf the 477 articles that met our predetermined inclusion criteria, 63% were categorized as emergency care in resource‐limited settings, 13% as EM development, and 23% as disaster and humanitarian response. Twenty‐five articles received scores of 17.5 or higher and were selected for formal summary and critique. Inter‐rater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.657 (95% confidence interval = 0.589 to 0.713). Studies and reviews focusing on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource‐limited settings represented the majority of articles selected for final review.ConclusionsIn 2014, there were fewer total articles, but a slightly higher absolute number of articles screening in for formal scoring, when compared to the 2013 review. The number of EM development articles decreased, while the number of disaster and humanitarian response articles increased. As in prior years, the majority of articles focused on infectious diseases and trauma.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113141/1/acem12733.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/113141/2/acem12733_am.pd

Emergency department quality and safety indicators in resource-limited settings: an environmental survey

Background: As global emergency care grows, practical and effective performance measures are needed to ensure high quality care. Our objective was to systematically catalog and classify metrics that have been used to measure the quality of emergency care in resource-limited settings. Methods: We searched MEDLINE, Embase, CINAHL, and the gray literature using standardized terms. The references of included articles were also reviewed. Two researchers screened titles and abstracts for relevance; full text was then reviewed by three researchers. A structured data extraction tool was used to identify and classify metrics into one of six Institute of Medicine (IOM) quality domains (safe, timely, efficient, effective, equitable, patient-centered) and one of three of Donabedian’s structure/process/outcome categories. A fourth expert reviewer blinded to the initial classifications re-classified all indicators, with a weighted kappa of 0.89. Results: A total of 1705 articles were screened, 95 received full text review, and 34 met inclusion criteria. One hundred eighty unique metrics were identified, predominantly process (57 %) and structure measures (27 %); 16 % of metrics were related to outcomes. Most metrics evaluated the effectiveness (52 %) and timeliness (28 %) of care, with few addressing the patient centeredness (11 %), safety (4 %), resource-efficiency (3 %), or equitability (1 %) of care. Conclusions: The published quality metrics in emergency care in resource-limited settings primarily focus on the effectiveness and timeliness of care. As global emergency care is built and strengthened, outcome-based measures and those focused on the safety, efficiency, and equitability of care need to be developed and studied to improve quality of care and resource utilization. Electronic supplementary material The online version of this article (doi:10.1186/s12245-015-0088-x) contains supplementary material, which is available to authorized users

Detectors for the James Webb Space Telescope Near-Infrared Spectrograph I: Readout Mode, Noise Model, and Calibration Considerations

We describe how the James Webb Space Telescope (JWST) Near-Infrared Spectrograph's (NIRSpec's) detectors will be read out, and present a model of how noise scales with the number of multiple non-destructive reads sampling-up-the-ramp. We believe that this noise model, which is validated using real and simulated test data, is applicable to most astronomical near-infrared instruments. We describe some non-ideal behaviors that have been observed in engineering grade NIRSpec detectors, and demonstrate that they are unlikely to affect NIRSpec sensitivity, operations, or calibration. These include a HAWAII-2RG reset anomaly and random telegraph noise (RTN). Using real test data, we show that the reset anomaly is: (1) very nearly noiseless and (2) can be easily calibrated out. Likewise, we show that large-amplitude RTN affects only a small and fixed population of pixels. It can therefore be tracked using standard pixel operability maps.Comment: 55 pages, 10 figure

Outcomes of Invasive and Noninvasive Ventilation in a Haitian Emergency Department

Background: Limited data exist on the outcomes of patients requiring invasive ventilation or noninvasive positive pressure ventilation (NIPPV) in low-income countries. To our knowledge, no study has investigated this topic in Haiti. Objectives: We describe the clinical epidemiology, treatment, and outcomes of patients requiring NIPPV or intubation in an emergency department (ED) in rural Haiti. Methods: This is an observational study utilizing a convenience sample of adult and pediatric patients requiring NIPPV or intubation in the ED at an academic hospital in central Haiti from January 2019–February 2021. Patients were prospectively identified at the time of clinical care. Data on demographics, clinical presentation, management, and ED disposition were extracted from patient charts using a standardized form and analyzed in SAS v9.4. The primary outcome was survival to discharge. Findings: Of 46 patients, 27 (58.7%) were female, mean age was 31 years, and 14 (30.4%) were pediatric (age <18 years). Common diagnoses were cardiogenic pulmonary edema, pneumonia/pulmonary sepsis, and severe asthma. Twenty-three (50.0%) patients were initially treated with NIPPV, with 4 requiring intubation; a total of 27 (58.7%) patients were intubated. Among those for whom intubation success was documented, first-pass success was 57.7% and overall success was 100% (one record missing data); intubation was associated with few immediate complications. Twenty-two (47.8%) patients died in the ED. Of the 24 patients who survived, 4 were discharged, 19 (intubation: 12; NIPPV: 9) were admitted to the intensive care unit or general ward, and 1 was transferred. Survival to discharge was 34.8% (intubation: 22.2%; NIPPV: 52.2%); 1 patient left against medical advice following admission. Conclusions: Patients with acute respiratory failure in this Haitian ED were successfully treated with both NIPPV and intubation. While overall survival to discharge remains relatively low, this study supports developing capacity for advanced respiratory interventions in low-resource settings

Thermal and non-thermal components of the interstellar medium at sub-kiloparsec scales in galaxies

Aims: We present new radio continuum observations of ten BIMA SONG galaxies, taken at 1.4 GHz with the Very Large Array. These observations allow us to extend the study of the relationships between the radio continuum (RC) and CO emission to 22 CO luminous galaxies for which single dish CO images have been added to interferometric data. New Spitzer infrared (IR) images of six of these galaxies have been released. The analysis of these high resolution images allowed us to probe the RC-IR-CO correlations down to linear scales of a few hundred pc. Results: for the 22 galaxies analysed, the RC-CO correlation on scales from $\sim10$ kpc down to $\sim100$ pc is nearly linear and has a scatter of a factor of two, i.e. comparable to that of the global correlations. There is no evidence for any severe degradation of the scatter below the kpc scale. This also applies to the six galaxies for which high-resolution mid-IR data are available. In the case of NGC 5194, we find that the non-thermal radio spectral index is correlated with the RC/FIR ratio. Conclusions: The scatter of the point-by-point correlations does not increase significantly with spatial resolution. We thus conclude that we have not yet probed the physical scales at which the correlations break down. However, we observe local deviations from the correlations in regions with a high star formation rate, such as the spiral arms, where we observe a flat radio spectrum and a low RC/FIR ratio. In the intra-arm regions and in the peripheral regions of the disk, the RC/FIR is generally higher and it is characterized by a steepening of the radio spectrum.Comment: 27 pages, 9 figures (low resolution), accepted for publication in A&A. High resolution version of the paper is available at: http://lucipher.ca.astro.it/~rpaladin/PAPER/RC-C

Critical Care Units in Malawi: A Cross-Sectional Study

Background: The global burden of critical illness falls disproportionately outside high-income countries. Despite younger patient populations with similar or lower disease severity, critical illness outcomes are poor outside high-income countries. A lack of data limits attempts to understand and address the drivers of critical care outcomes outside high-income countries. Objectives: We aim to characterize the organization, available resources, and service capacity of public sector critical care units in Malawi and identify barriers to improving care. Methods: We conducted a secondary analysis of the Malawi Emergency and Critical Care Survey, a cross-sectional study performed from January to February 2020 at all four central hospitals and a simple random sample of nine out of 24 public sector district hospitals in Malawi, a predominantly rural, low-income country of 19.6 million in southern Africa. Data from critical care units were used to characterize resources, processes, and barriers to care. Findings: There were four HDUs and four ICUs across the 13 hospitals in the Malawi Emergency and Critical Care Survey sample. The median critical care beds per 1,000,000 catchment was 1.4 (IQR: 0.9 to 6.7). Absent equipment was the most common barrier in HDUs (46% [95% CI: 32% to 60%]). Stockouts was the most common barriers in ICUs (48% [CI: 38% to 58%]). ICUs had a median 3.0 (range: 2 to 8) functional ventilators per unit and reported an ability to perform several quality mechanical ventilation interventions. Conclusions: Although significant gaps exist, Malawian critical care units report the ability to perform several complex clinical processes. Our results highlight regional inequalities in access to care and support the use of process-oriented questions to assess critical care capacity. Future efforts should focus on basic critical care capacity outside of urban areas and quantify the impact of context-specific variables on critical care mortality

Functional anonymisation: Personal data and the data environment

Anonymisation of personal data has a long history stemming from the expansion of the types of data products routinely provided by National Statistical Institutes. Variants on anonymisation have received serious criticism reinforced by much-publicised apparent failures. We argue that both the operators of such schemes and their critics have become confused by being overly focused on the properties of the data themselves. We claim that, far from being able to determine whether data are anonymous (and therefore non-personal) by looking at the data alone, any anonymisation technique worthy of the name must take account of not only the data but also their environment. This paper proposes an alternative formulation called functional anonymisation that focuses on the relationship between the data and the environment within which the data exist (their data environment). We provide a formulation for describing the relationship between the data and their environment that links the legal notion of personal data with the statistical notion of disclosure control. Anonymisation, properly conceived and effectively conducted, can be a critical part of the toolkit of the privacy-respecting data controller and the wider remit of providing accurate and usable data