Connecting Contemporary Trauma Care to Florence Nightingale\u27s Visionary Work

The impact of Florence Nightingale\u27s visionary work continues to influence the delivery of nursing care in the contemporary emergency department (ED). Her foundational work in the Crimean War resulted in data-based recommendations for using the environment to promote healing and wellness among sick and wounded British soldiers. She advocated for attention to environmental details, including ventilation, air, warmth, drainage, cleanliness, natural light, and low noise levels. These important environmental concepts play a significant role in the nursing management of trauma patients in today\u27s ED. This article features an application of Nightingale\u27s environmental concepts to a trauma patient case exemplar and demonstrates the enduring impact of her work for trauma patients who receive care in the ED

Asteroseismological Observations of the Central Star of the Planetary Nebula NGC 1501

We report on a global CCD time-series photometric campaign to decode the pulsations of the nucleus of the planetary nebula NGC1501. The star is hot and hydrogen-deficient, similar to the pre-white-dwarf PG 1159 stars. NGC1501 shows pulsational brightness variations of a few percent with periods ranging from 19 to 87 minutes. The variations are very complex, suggesting a pulsation spectrum that requires a long unbroken time series to resolve. Our CCD photometry of the star covers a two-week period in 1991 November, and used a global network of observatories. We obtained nearly continuous coverage over an interval of one week in the middle of the run. We have identified 10 pulsation periods, ranging from 5235 s down to 1154 s. We find strong evidence that the modes are indeed nonradial g-modes. The ratios of the frequencies of the largest-amplitude modes agree with those expected for modes that are trapped by a density discontinuity in the outer layers. We offer a model for the pulsation spectrum that includes a common period spacing of 22.3 s and a rotation period of 1.17 days; the period spacing allows us to assign a seismological mass of 0.55+/-0.03 Msun.Comment: 12 pages, AASTEX, 7 tables, 6 EPS figures, to appear in AJ, 12/96 Corrected version repairs table formatting and adds missing Table

The Spectrum projection package: improvements in estimating incidence by age and sex, mother-to-child transmission, HIV progression in children and double orphans

BACKGROUND: The Spectrum program is used to estimate key HIV indicators from the trends in incidence and prevalence estimated by the Estimation and Projection Package or the Workbook. These indicators include the number of people living with HIV, new infections, AIDS deaths, AIDS orphans, the number of adults and children needing treatment, the need for prevention of mother-to-child transmission and the impact of antiretroviral treatment on survival. The UNAIDS Reference Group on Estimates, Models and Projections regularly reviews new data and information needs, and recommends updates to the methodology and assumptions used in Spectrum. METHODS: The latest update to Spectrum was used in the 2009 round of global estimates. This update contains new procedures for estimating: the age and sex distribution of adult incidence, new child infections occurring around delivery or through breastfeeding, the survival of children by timing of infection and the number of double orphans

Estimating HIV Incidence among Adults in Kenya and Uganda: A Systematic Comparison of Multiple Methods

CITATION: Kim, A. A. et al. 2011. Estimating HIV incidence among adults in Kenya and Uganda : a systematic comparison of multiple methods. PLos ONE, 6(3): e17535, doi:10.1371/journal.pone.0017535.The original publication is available at http://journals.plos.org/plosoneBackground: Several approaches have been used for measuring HIV incidence in large areas, yet each presents specific challenges in incidence estimation. Methodology/Principal Findings: We present a comparison of incidence estimates for Kenya and Uganda using multiple methods: 1) Epidemic Projections Package (EPP) and Spectrum models fitted to HIV prevalence from antenatal clinics (ANC) and national population-based surveys (NPS) in Kenya (2003, 2007) and Uganda (2004/2005); 2) a survey-derived model to infer age-specific incidence between two sequential NPS; 3) an assay-derived measurement in NPS using the BED IgG capture enzyme immunoassay, adjusted for misclassification using a locally derived false-recent rate (FRR) for the assay; (4) community cohorts in Uganda; (5) prevalence trends in young ANC attendees. EPP/Spectrum-derived and survey-derived modeled estimates were similar: 0.67 [uncertainty range: 0.60, 0.74] and 0.6 [confidence interval: (CI) 0.4, 0.9], respectively, for Uganda (2005) and 0.72 [uncertainty range: 0.70, 0.74] and 0.7 [CI 0.3, 1.1], respectively, for Kenya (2007). Using a local FRR, assay-derived incidence estimates were 0.3 [CI 0.0, 0.9] for Uganda (2004/2005) and 0.6 [CI 0, 1.3] for Kenya (2007). Incidence trends were similar for all methods for both Uganda and Kenya. Conclusions/Significance: Triangulation of methods is recommended to determine best-supported estimates of incidence to guide programs. Assay-derived incidence estimates are sensitive to the level of the assay's FRR, and uncertainty around high FRRs can significantly impact the validity of the estimate. Systematic evaluations of new and existing incidence assays are needed to the study the level, distribution, and determinants of the FRR to guide whether incidence assays can produce reliable estimates of national HIV incidence.http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0017535Publisher's versio

Embracing different approaches to estimating HIV incidence, prevalence and mortality

Background: Joint United Nations Programme on HIV/AIDS (UNAIDS) and Murray et al. have both produced sets of estimates for worldwide HIV incidence, prevalence and mortality. Understanding differences in these estimates can strengthen the interpretation of each

Protective Role for Properdin in Progression of Experimental Murine Atherosclerosis

Genetic, dietary and immune factors contribute to the pathogenesis of atherosclerosis in humans and mice. Complement activation is an integral part of the innate immune defence but also shapes cellular responses and influences directly triglyceride synthesis. Deficiency of Factor B of the alternative pathway (AP) of complement is beneficial in LDLR−/− mice fed a high fat diet. The serum glycoprotein properdin is a key positive regulator of the AP but has not been studied in experimental atherosclerosis. Atherosclerosis was assessed after feeding low fat (LFD) or high fat (HFD) Western type diets to newly generated LDLR−/− ProperdinKO (LDLR−/−PKO) and LDLR−/−PWT mice. Lipids, lymphocytes and monocytes were similar among genotypes, genders and diets. Complement C3, but not C3adesarg, levels were enhanced in LDLR−/−PKO mice regardless of diet type or gender. Non-esterified fatty acids (NEFA) were decreased in male LDLR−/−PKO fed a HFD compared with controls. All mice showed significant atherosclerotic burden in aortae and at aortic roots but male LDLR−/− mice fed a LFD were affected to the greatest extent by the absence of properdin. The protective effect of properdin expression was overwhelmed in both genders of LDLR−/−mice when fed a HFD. We conclude that properdin plays an unexpectedly beneficial role in the development and progression of early atherosclerotic lesions

New results on GP Com

We present high resolution optical and UV spectra of the 46 min orbital period, helium binary, GP Com. Our data contains simultaneous photometric correction which confirms the flaring behaviour observed in previous optical and UV data. In this system all lines show a triple peaked structure where the outer two peaks are associated with the accretion disc around the compact object. The main aim of this paper is to constrain the origin of the central peak, also called ``central spike''. We find that the central spike contributes to the flare spectra indicating that its origin is probably the compact object. We also detect that the central spike moves with orbital phase following an S-wave pattern. The radial velocity semiamplitude of the S-wave is ~10 km/s indicating that its origin is near the centre of mass of the system, which in this case lies very close to the white dwarf. Our resolution is higher than that of previous data which allows us to resolve structure in the central peak of the line. The central spike in three of the HeI lines shows another peak blueshifted with respect to the main peak. We propose that one of the peaks is a neutral helium forbidden transition excited in a high electron density region. This forbidden transition is associated with the permitted one (the stronger peak in two of the lines). The presence of a high electron density region again favours the white dwarf as their origin.Comment: 14 pages, 16 figures. Accepted for publication in A&

Detection of the white dwarf and the secondary star in the new SU UMa dwarf nova HS 2219+1824

We report the discovery of a new, non-eclipsing SU UMa-type dwarf nova, HS 2219+1824. Photometry obtained in quiescence (V ≈ 17.5) reveals a double-humped light curve from which we derive an orbital period of 86.2 min. Additional photometry obtained during a superoutburst reaching V 12.0 clearly shows superhumps with a period of 89.05 min. The optical spectrum contains double-peaked Balmer and He I emission lines from the accretion disc as well as broad absorption troughs of Hβ, Hγ, and Hδ from the white dwarf primary star. Modelling of the optical spectrum implies a white dwarf temperature of 13 000 K < ∼ T eff < ∼ 17 000 K, a distance of 180 pc < ∼ d < ∼ 230 pc, and suggests that the spectral type of the donor star is later than M 5. Phase-resolved spectroscopy obtained during quiescence reveals a narrow Hα emission line component which has a radial velocity amplitude and phase consistent with an origin on the secondary star, possibly on the irradiated hemisphere facing the white dwarf. This constitutes the first detection of line emission from the secondary star in a quiescent SU UMa star