The Role of Photography in Increasing Efficiency of Dermatologic Inpatient Consulting Service

Abstract Introduction: Inpatient dermatology consultations can bring a mixed bag of pathologies. Due to the highly specialized nature of dermatology and the lack of dermatologic training in medical school, the dermatologic team is consulted for matters that range from non-urgent to pressing. Pictures are a critical component of dermatology and greatly aid in the diagnosis of cutaneous diseases. In the inpatient setting, pictures can help streamline diagnosis and prevent unnecessary tests or procedures. The purpose of this study was to evaluate for the presence of pictures in patients’ chart after a dermatology consult had been placed through EPIC at the University of Nebraska Medical Center (UNMC). Methods: Baseline data was gathered for two months in regards to the presence or absence of pictures in patients’ charts upon consultation of the UNMC academic dermatology service. At the two month mark, a prompt was added to the EPIC order for dermatology consultation stating, “Are there pictures in the chart?” This prompt required the consulting team to check ‘yes’ or ‘no’ before proceeding with signing the electronic order. Data was then gathered after two months following initiation of the prompt. Results: In the baseline two months, 15/33 (45.4%) consults contained photographs. In the two months following the prompt, “Are there pictures in the chart?”, 57/71 (80.3%) of consult orders placed contained a photograph. A Chi-squared analysis was preformed and revealed a significant difference (Chi-squared statistic 12.823, p-value \u3c 0.001) between the number of pictures placed in the chart with consult order before and after prompt. Conclusion: By adding a prompt in the EPIC order questioning picture availability, a significant increase was seen in pictures taken by consulting teams. This can help improve patient care by decreasing time to diagnosis, preventing unnecessary testing or procedures, and practicing cost-efficient medicine

Perioperative outcomes of a hydrocortisone protocol after endonasal surgery for pituitary adenoma resection

Adrenal insufficiency after transsphenoidal resection of pituitary adenoma (PA) can be seen in 1-12% of cases. In PA, the use of postoperative cortisol measurement and supplementation remains controversial. It is unclear whether postoperative cortisol supplementation has a measurable effect on improving outcomes in patients with pituitary adenoma undergoing endoscopic transsphenoidal surgery (ETS). The objective of the study was to evaluate a postoperative steroid treatment protocol in patients with PA undergoing ETS

SCUBA Mapping of Spitzer c2d Small Clouds and Cores

We present submillimeter observations of dark clouds that are part of the Spitzer Legacy Program, From Molecular Cores to Planet-Forming Disks (c2d). We used the Submillimetre Common User's Bolometer Array to map the regions observed by Spitzer by the c2d program to create a census of dense molecular cores including data from the infrared to the submillimeter. In this paper, we present the basic data from these observations: maps, fluxes, and source attributes. We also show data for an object just outside the Perseus cloud that was serendipitously observed in our program. We propose that this object is a newly discovered, evolved protostar.Comment: 37 pages, accepted to The Astronomical Journa

Discovery of a Low Mass Bipolar Molecular Outflow from L1014-IRS with the Submillimeter Array

Using the Submillimeter Array we report the discovery of a compact low mass bipolar molecular outflow from L1014-IRS and confirm its association with the L1014 dense core at 200 pc. Consequently, L1014-IRS is the lowest luminosity (L \~0.09 Lsun) and perhaps the lowest mass source known to be driving a bipolar molecular outflow, which is one of the smallest known in size (~500 AU), mass (< 10^{-4} Msun), and energetics (e.g., force < 10^{-7} Msun km/s/yr).Comment: 11 pages, 3 figures, to appear in ApJ Letter

Accurate early positions for Swift GRBS: enhancing X-ray positions with UVOT astrometry

Here we describe an autonomous way of producing more accurate prompt XRT positions for Swift-detected GRBs and their afterglows, based on UVOT astrometry and a detailed mapping between the XRT and UVOT detectors. The latter significantly reduces the dominant systematic error -- the star-tracker solution to the World Coordinate System. This technique, which is limited to times when there is significant overlap between UVOT and XRT PC-mode data, provides a factor of 2 improvement in the localisation of XRT refined positions on timescales of less than a few hours. Furthermore, the accuracy achieved is superior to astrometrically corrected XRT PC mode images at early times (for up to 24 hours), for the majority of bursts, and is comparable to the accuracy achieved by astrometrically corrected X-ray positions based on deep XRT PC-mode imaging at later times (abridged).Comment: 12 pages, 8 figures, 1 table, submitted to Astronomy and Astrophysics, August 7th 200

Mapping Marine Benthic Biodiversity in Wales.

The UK is committed through international agreements and European obligations to the establishment of an ecologically coherent network of Marine Protected Areas (MPAs) to conserve marine ecosystems and biodiversity. The Welsh Assembly Government has committed to using the new Marine Conservation Zone (MCZ) designation provided in the Marine and Coastal Access Act to create sites afforded a high level of protection. In addition the Marine and Coastal Access Act allows for the establishment of a system of Marine Spatial Planning in Welsh waters. The identification of areas of high biodiversity could be helpful for planning both Marine Protected Areas and for Marine Spatial Planning. Diverse communities can provide resilience to environmental perturbations (Petchey & Gaston 2009); the identification and protection of areas of high marine biodiversity can contribute to an ecosystem-based approach to the management of our seas. Furthermore, identifying which areas are most important for biodiversity not only yields benefits for the maintenance of ecosystem structure and functioning but can also enable cost effective prioritisation of areas for marine protection. The current study builds on work from previous studies at a UK-wide and regional level (Hiscock & Breckels 2007, Langmead et al. 2008) to develop an approach for mapping marine benthic biodiversity and apply it to Wales’ sea are

Revealing The Millimeter Environment of the New FU Orionis Candidate HBC722 with the Submillimeter Array

We present 230 GHz Submillimeter Array continuum and molecular line observations of the newly discovered FUor candidate HBC722. We report the detection of seven 1.3 mm continuum sources in the vicinity of HBC722, none of which correspond to HBC722 itself. We compile infrared and submillimeter continuum photometry of each source from previous studies and conclude that three are Class 0 embedded protostars, one is a Class I embedded protostar, one is a Class I/II transition object, and two are either starless cores or very young, very low luminosity protostars or first hydrostatic cores. We detect a northwest-southeast outflow, consistent with the previous detection of such an outflow in low-resolution, single-dish observations, and note that its axis may be precessing. We show that this outflow is centered on and driven by one of the nearby Class 0 sources rather than HBC722, and find no conclusive evidence that HBC722 itself is driving an outflow. The non-detection of HBC722 in the 1.3 mm continuum observations suggests an upper limit of 0.02 solar masses for the mass of the circumstellar disk. This limit is consistent with typical T Tauri disks and with a disk that provides sufficient mass to power the burst.Comment: 12 pages, 7 figures, accepted by Ap

Simple Process-Led Algorithms for Simulating Habitats (SPLASH v.1.0): Robust Indices of Radiation, Evapotranspiration and Plant-Available Moisture

Bioclimatic indices for use in studies of ecosystem function, species distribution, and vegetation dynamics under changing climate scenarios depend on estimates of surface fluxes and other quantities, such as radiation, evapotranspi- ration and soil moisture, for which direct observations are sparse. These quantities can be derived indirectly from me- teorological variables, such as near-surface air temperature, precipitation and cloudiness. Here we present a consolidated set of simple process-led algorithms for simulating habitats (SPLASH) allowing robust approximations of key quantities at ecologically relevant timescales. We specify equations, derivations, simplifications, and assumptions for the estima- tion of daily and monthly quantities of top-of-the-atmosphere solar radiation, net surface radiation, photosynthetic photon flux density, evapotranspiration (potential, equilibrium, and actual), condensation, soil moisture, and runoff, based on analysis of their relationship to fundamental climatic drivers. The climatic drivers include a minimum of three meteoro- logical inputs: precipitation, air temperature, and fraction of bright sunshine hours. Indices, such as the moisture index, the climatic water deficit, and the Priestley–Taylor coeffi- cient, are also defined. The SPLASH code is transcribed in C++, FORTRAN, Python, and R. A total of 1 year of results are presented at the local and global scales to exemplify the spatiotemporal patterns of daily and monthly model outputs along with comparisons to other model results

The Swift X-Ray Telescope: Status and Performance

We present science highlights and performance from the Swift X-ray Telescope (XRT), which was launched on November 20, 2004. The XRT covers the 0.2-10 keV band, and spends most of its time observing gamma-ray burst (GRB)afterglows, though it has also performed observations of many other objects. By mid-August 2007, the XRT had observed over 220 GRB afterglows, detecting about 96% of them. The XRT positions enable followup ground-based optical observations, with roughly 60% of the afterglows detected at optical or near IR wavelengths. Redshifts are measured for 33% of X-ray afterglows. Science highlights include the discovery of flaring behavior at quite late times, with implications for GRB central engines; localization of short GRBs, leading to observational support for compact merger progenitors for this class of bursts; a mysterious plateau phase to GRB afterglows; as well as many other interesting observations such as X-ray emission from comets, novae, galactic transients, and other objects.Comment: 9 pages, 14 figure