Using a Computer Module to Teach Use of the EpiPen®

Background: The medical literature suggests that patients and physicians are deficient in their ability to use a self-injectable epinephrine device (EpiPen®) for management of anaphylaxis. This study aims to determine whether a computer module is an effective tool for the instruction of a technical skill to medical trainees.Methods: We conducted a two group comparison study of 35 Post-Graduate Year 1 and 2 Family Medicine residents. Participants were instructed on use of the EpiPen® using either a written module or a computer module. Participants were evaluated on use of the EpiPen® using standardized objective outcome measures by a blinded assessor. Assessments took place prior to and following instruction, using the assigned learning modality.Results: There were 34 participants who completed the study. Both groups demonstrated significant improvement in demonstrating use of the EpiPen® following training (p <0.001 for both). A significant post-training difference favouring the computer module learners over the written module learners was observed (p = 0.035). However, only 53% and 18% of candidates (computer module and written module, respectively) were able to correctly perform all of the checklist steps.Conclusion: While our findings suggest computer modules represent an effective modality for teaching use of the EpiPen® to medical trainees, the low number of candidates who were able to perform all the checklist items regardless of modality needs to be addressed

A Loosely-Coupled Collaborative Integrated Environmental Modelling Framework

Integration of environmental models requires full support of the modelling community. When a large number of models are integrated, it requires consistency within scale, datasets, and model to model interactions to minimize the uncertainty among the models. The integrated environmental modelling (IEM) framework is a necessary approach to integrate multiple environmental models for a particular study. When modellers cannot afford considerable amount of time to get involved with full and tightly-integrated IEM or an IEM has very short time frame to complete, then a loosely-coupled collaborative IEM environment can provide the benefits of the integrated approach while minimizing the effort of each individual modeller. However, such a framework will require setting rules that all participants must adhere to. These rules address the issues of model inputs and model to model interaction. The framework should also provide value-added functionality to make the IEM framework more transparent and applicable

The Land and Water Integration Decision Support System

Integration of data and component models describing habitat-based land use, non-point source pollutants transport, and water and soil quality forms the decision support development processes to assist policy makers in examining management options for dealing with the impacts of land use on water for agricultural issues in Canada. The land and water integration decision support system emphasizes on scale consistency, scenario gaming and testing, pollutant source tracing and optimal solutions. Examples of a watershed-based decision support system on water quality impact were presented as part of an assessment for the evaluation of best management practice options for future agricultural intensification scenario

Paradoxical Association of C-Reactive Protein with Endothelial Function in Rheumatoid Arthritis

Background: Within the general population, levels of C-reactive protein (CRP) are positively associated with atherosclerotic cardiovascular disease (CVD). Whether CRP is causally implicated in atherogenesis or is the results of atherosclerosis is disputed. A role of CRP to protect endothelium-derived nitric oxide (EDNO) has been suggested. We examined the association of CRP with EDNO-dependent vasomotor function and subclinical measures of atherosclerosis and arteriosclerosis in patients with raised CRP resulting from rheumatoid arthritis (RA).Methodology/Principal Findings: Patients with RA (n = 59) and healthy control subjects (n = 123), underwent measures of high sensitivity CRP, flow-mediated dilation (FMD, dependent on EDNO), intima-media thickness (IMT, a measure of subclinical atherosclerosis) and aortic pulse wave velocity (PWV, a measure of arteriosclerosis). IMT and PWV were elevated in patients with RA compared to controls but FMD was similar in the two groups. In patients with RA, IMT and PWV were not correlated with CRP but FMD was positively independently correlated with CRP (P<0.01).Conclusions/Significance: These findings argue against a causal role of CRP in atherogenesis and are consistent with a protective effect of CRP on EDNO bioavailability

The Full Kepler Phase Curve of the Eclipsing Hot White Dwarf Binary System KOI-964

We analyze the full Kepler phase curve of KOI-964, a binary system consisting of a hot white dwarf on an eclipsing orbit around an A-type host star. Using all 18 quarters of long-cadence photometry, we carry out a joint light-curve fit and obtain improved phase-curve amplitudes, occultation depths, orbital parameters, and transit ephemeris over the previous results of Carter et al. A periodogram of the residuals from the phase-curve fit reveals an additional stellar variability signal from the host star with a characteristic period of 0.620276 ± 0.000011 days and a full amplitude of 24 ± 2 ppm. We also present new Keck/HIRES radial velocity observations, which we use to measure the orbit and obtain a mass ratio of q = 0.106 ± 0.012. Combining this measurement with the results of a stellar isochrone analysis, we find that the masses of the host star and white dwarf companion are 2.23 ± 0.12 M⊙ and 0.236^(+0.028)_(−0.027) M⊙, respectively. The effective temperatures of the two components are 9940^(+260)_(−230) K and 15,080 ± 400 K, respectively, and we determine the age of the system to be 0.21^(+0.11)_(−0.08) Gyr. We use the measured system properties to compute predicted phase-curve amplitudes and find that while the measured Doppler-boosting and mutual illumination components agree well with theory, the ellipsoidal distortion amplitude is significantly underestimated. We detail possible explanations for this discrepancy, including interactions between the dynamical tide of the host star and the tidal bulge and possible nonsynchronous rotation of the host star

NASA's Land, Atmosphere Near Real-Time Capability for EOS (LANCE): Delivering Data and Imagery to Meet the Needs of Near Real-Time Applications

NASA's Land, Atmosphere Near real-time Capability for EOS (LANCE) is a virtual system that provides near real-time EOS data and imagery from the AIRS, AMSR2, LIS (ISS), MISR, MLS, MODIS, MOPITT, OMI, OMPS, and VIIRS instruments, to meet the needs of scientists and application users interested in monitoring a wide variety of natural and man-made phenomena. NRT imagery from LANCE are available through NASA's Global Imagery Browse Services (GIBS), Worldview, FIRMS and most recently through Worldview Snapshots a low band width application that has replaced the Rapid Response Subsets. Over the past year: data and imagery from the Lightning Imaging Sensor (LIS) on board the International Space Station (ISS), OMPS and VIIRS-Land have been added to LANCE. In the coming year LANCE will integrate the MODIS NRT Global Flood product, VIIRS Black Marble nighttime lights and Cloud Mask and Aerosol Dark Target from VIIRS Atmosphere. Here we provide a brief overview of LANCE, focusing on what's new and describing how these new data sets have been used to monitor lightning flashes, hurricanes and fires. For more information on LANCE visit: https://earthdata.nasa.gov/lance

Proceedings from the 2018 Canadian Association for the Study of the Liver Single Topic Conference—Decompensated Cirrhosis : from clinic to transplant

Actes publiés dans le Canadian Liver Journal; vol. 2, no. 4, Fall 2019, p. 137-170