Assess for Less: A Solution-Oriented, Ground-Based Geomorphic Analysis of an Urban Watershed in the Piedmont of North Carolina

2008 S.C. Water Resources Conference - Addressing Water Challenges Facing the State and Regio

The Perceived Impact of the New Rules Regarding Name, Image, and Likeness (NIL) in Intercollegiate Sports

New rules allow college athletes to earn significant income from a multitude of activities common among professional athletes. These activities include allowing athletes to profit from the sale of intellectual properties that bear their name, image, or likeness (NIL); additional opportunities include blogs, social media posts, camps, and autograph sessions. Early perceptions of the impact of these new NIL rules have been far from unanimous. A sample of 404 students from five American universities provided feedback regarding their perceptions of nine NIL-related considerations: the impact that the new NIL rules have had on college sports, if the athletes benefit, whether the rules impact recruiting, if they give Power 5 schools an advantage, if boosters and wealthy alumni are given too much power, the extent to which they hope athletes at their school can benefit from the new rules, if the new rules are detrimental to amateur athletics in general, whether they approve of the new rules, and if the new rules run counter to Title IX. The results indicate that students possess a generally favorable perception of the new rules

Effect of Calving Time and Weaning Time on Cow and Calf Performace - A Preliminary Report

Cows grazing native range pasture year round in western South Dakota were allotted to 3 management systems: 1) A calving season starting in mid March with calves weaned in late October; 2) A calving season starting in mid March with calves weaned in mid September; and 3) A calving season starting in early May with calves weaned in late October. The effect of management system on pregnancy rate was year dependent. After 4 years of the study, there was no consistent advantage for any particular group. Average weaning weight was consistently higher for the March calving/October weaned group that was older at weaning than the other two groups. In the first year of the study, severe winter weather caused a higher calf death loss that resulted in a lower weaning percentage for the March calving groups compared to the May calving group. The weaning percentage favored the March calving groups in year 4. With the exception of the first year, the pounds of calf weaned per cow exposed were greater for the March calving/October weaned group compared to the other two systems. An estimate of overall calf income was $30 higher per cow exposed for the March calving/October weaned group compared to the May calving group. In deciding the optimum time to calve, the potential to reduce cost of winter feed, equipment, facilities and labor for a specific situation would need to be considered

Medication use during end-of-life care in a palliative care centre

Background In end-of-life care, symptoms of discomfort are mainly managed by drug therapy, the guidelines for which are mainly based on expert opinions. A few papers have inventoried drug prescriptions in palliative care settings, but none has reported the frequency of use in combination with doses and route of administration. Objective To describe doses and routes of administration of the most frequently used drugs at admission and at day of death. Setting Palliative care centre in the Netherlands. Method In this retrospective cohort study, prescription data of deceased patients were extracted from the electronic medical records. Main outcome measure Doses, frequency and route of administration of prescribed drugs Results All regular medication prescriptions of 208 patients, 89 % of whom had advanced cancer, were reviewed. The three most prescribed drugs were morphine, midazolam and haloperidol, to 21, 11 and 23 % of patients at admission, respectively. At the day of death these percentages had increased to 87, 58 and 50 %, respectively. Doses of these three drugs at the day of death were statistically significantly higher than at admission. The oral route of administration was used in 89 % of patients at admission versus subcutaneous in 94 % at the day of death. Conclusions Nearing the end of life, patients in this palliative care centre receive discomfort-relieving drugs mainly via the subcutaneous route. However, most of these drugs are unlicensed for this specific application and guidelines are based on low level of evidence. Thus, there is every reason for more clinical research on drug use in palliative care

Improving coherence of ecosystem service provision between scales

© 2014 Elsevier B.V. High-level consensus about safeguarding ecosystem services for optimal benefits to society is not yet matched by transposition to field scale. Various 'societal levers' - markets, statutory legislation, common/civil law, market-based instruments and protocols - have evolved as a fragmented policy environment of incentives and constraints, influencing the freedoms of resource owners. This has produced mosaic landscapes reflecting both natural conditions and landowner aspirations. The Principles of the Ecosystem Approach serve as a framework to consider three case study sites: an English lowland estuary and two in Scotland. Societal levers today safeguard some socially valuable services, but the present policy environment is neither sufficient nor sufficiently integrated to achieve coherence between the choices of resource owners and wider societal aspirations for ecosystem service provision. The heterogeneity of societal levers protects freedom of choice, enables adaptive decision-making related to the properties of the natural resource, and makes allowance for changes in societal preferences. Resultant mosaic landscapes provide flexibility and resilience in ecosystem service production. However, further evolution of societal levers is required to bring about greater coherence of ecosystem service production from local to national/international scales. This paper explores how issues of scale, regulation and variability manifest in the ecosystem service framework

Sex differences in treatment and outcomes of patients with in-hospital ST-elevation myocardial infarction.

BACKGROUND AND HYPOTHESIS Two cohorts face high mortality after ST-elevation myocardial infarction (STEMI): females and patients with in-hospital STEMI. The aim of this study was to evaluate sex differences in ischemic times and outcomes of in-hospital STEMI patients. METHODS Consecutive STEMI patients treated with percutaneous coronary intervention (PCI) were prospectively recruited from 30 hospitals into the Victorian Cardiac Outcomes Registry (2013-2018). Sex discrepancies within in-hospital STEMIs were compared with out-of-hospital STEMIs. The primary endpoint was 12-month all-cause mortality. Secondary endpoints included symptom-to-device (STD) time and 30-day major adverse cardiovascular events (MACE). To investigate the relationship between sex and 12-month mortality for in-hospital versus out-of-hospital STEMIs, an interaction analysis was included in the multivariable models. RESULTS A total of 7493 STEMI patients underwent PCI of which 494 (6.6%) occurred in-hospital. In-hospital versus out-of-hospital STEMIs comprised 31.9% and 19.9% females, respectively. Female in-hospital STEMIs were older (69.5 vs. 65.9 years, p = .003) with longer adjusted geometric mean STD times (104.6 vs. 94.3 min, p < .001) than men. Female versus male in-hospital STEMIs had no difference in 12-month mortality (27.1% vs. 20.3%, p = .92) and MACE (22.8% vs. 19.3%, p = .87). Female sex was not independently associated with 12-month mortality for in-hospital STEMIs which was consistent across the STEMI cohort (OR: 1.26, 95% CI: 0.94-1.70, p = .13). CONCLUSIONS In-hospital STEMIs are more frequent in females relative to out-of-hospital STEMIs. Despite already being under medical care, females with in-hospital STEMIs experienced a 10-min mean excess in STD time compared with males, after adjustment for confounders. Adjusted 12-month mortality and MACE were similar to males

Differences in outcomes of patients with in-hospital versus out-of-hospital ST-elevation myocardial infarction: a registry analysis

OBJECTIVES Patients with ST-elevation myocardial infarction (STEMI) that occur while already in hospital ('in-hospital STEMI') face high mortality. However, data about this patient population are scarce. We sought to investigate differences in reperfusion and outcomes of in-hospital versus out-of-hospital STEMI. DESIGN, SETTING AND PARTICIPANTS Consecutive patients with STEMI all treated with percutaneous coronary intervention (PCI) across 30 centres were prospectively recruited into the Victorian Cardiac Outcomes Registry (2013-2018). PRIMARY AND SECONDARY OUTCOMES Patients with in-hospital STEMI were compared with patients with out-of-hospital STEMI with a primary endpoint of 30-day major adverse cardiovascular events (MACE). Secondary endpoints included ischaemic times, all-cause mortality and major bleeding. RESULTS Of 7493 patients with PCI-treated STEMI, 494 (6.6%) occurred in-hospital. Patients with in-hospital STEMI were older (67.1 vs 62.4 years, p<0.001), more often women (32% vs 19.9%, p<0.001), with more comorbidities. Patients with in-hospital STEMI had higher 30-day MACE (20.4% vs 9.8%, p<0.001), mortality (12.1% vs 6.9%, p<0.001) and major bleeding (4.9% vs 2.3%, p<0.001), than patients with out-of-hospital STEMI. According to guideline criteria, patients with in-hospital STEMI achieved symptom-to-device times of ≤70 min and ≤90 min in 29% and 47%, respectively. Patients with out-of-hospital STEMI achieved door-to-device times of ≤90 min in 71%. Occurrence of STEMI while in hospital independently predicted higher MACE (adjusted OR 1.77, 95% CI 1.33 to 2.36, p<0.001) and 12-month mortality (adjusted OR 1.49, 95% CI 1.08 to 2.07, p<0.001). CONCLUSIONS Patients with in-hospital STEMI experience delays to reperfusion with significantly higher MACE and mortality, compared with patients with out-of-hospital STEMI, after adjustment for confounders. Focused strategies are needed to improve recognition and outcomes in this high-risk and understudied population

MSL Entry, Descent and Landing Performance and Environments

A viewgraph presentation on the MARS Science Laboratory (MSL) Entry, Descent and Landing (EDL) performance and environments is shown. The topics include: 1) High Altitude and Precision Landing; 2) Guided, Lifting, Ballistic Trade; 3) Supersonic Chute Deploy Altitude; 4) Guided, Lifting, Ballistic Landing Footprint Video; 5) Transition Indicator at Peak Heating Point on Trajectory; 6) Aeroheating at Peak Heating Point on Trajectory Nominal, No Uncertainty Included; 7) Comparison to Previous Missions; 8) Pork Chop Plots - EDL Performance for Mission Design; 9) Max Heat Rate Est (CBE+Uncert) W/cm2; 10) Nominal Super Chute Deploy Alt Above MOLA (km); 11) Monte Carlo; 12) MSL Option M2 Entry, Descent and Landing; 13) Entry Performance; 14) Entry Aeroheating and Entry g's; 15) Terminal Descent; and 16) How An Ideal Chute Deployment Altitude Varies with Time of Year and Latitude (JSC Chart)

Pharmacokinetics of Morphine, Morphine-3-Glucuronide and Morphine-6-Glucuronide in Terminally Ill Adult Patients

Background and Objective: Morphine dosing can be challenging in terminally ill adult patients due to the heterogeneous nature of the population and the difficulty of accurately assessing pain during sedation. To determine the pharmacokinetics of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) in this population, and to find clinically relevant parameters for dose individualisation, we performed a population pharmacokinetic analysis. Methods: Blood samples were randomly collected from 47 terminally ill patients in both the pre-terminal and terminal phases. Nonlinear mixed-effects modelling (NONMEM) was used to develop a population pharmacokinetic model and perform covariate analysis. Results: The data were accurately described by a two-compartment model for morphine with two one-compartment models for both its metabolites. Typical morphine clearance was 48 L/h and fell exponentially by more than 10 L/h in the last week before death. Decreased albumin levels and a decreased estimated glomerular filtration rate (eGFR) resulted in lower metabolite clearance. Between-subject variability in clearance was 52 % (morphine), 75 % (M3G) and 79 % (M6G), and changed to 53, 29 and 34 %, respectively, after inclusion of the covariates. Conclusions: Our results show that morphine clearance decreased up to the time of death, falling by more than 10 L/h (26 %) in the last week before death, and that M3G and M6G accumulated due to decreased renal function. Further studies are warranted to determine whether dose adjustment of morphine is required in terminally ill patients