Waveform capnography in the South African prehospital setting: knowledge assessment of qualified advanced life support (ALS) paramedics

Although there is extensive literature regarding out-of-hospital use of capnography, the willingness and knowledge of South African paramedics where capnography is available for routine use is poorly understood. From informal reviews, it would appear that even when capnography is available the practitioners decided to not use the tool. Aim: To determine the knowledge of prehospital providers with respect to the use of capnography to guide decision making in the treatment of patients. Methods: A cross-sectional research-generated survey of 80 out-of-hospital advanced life support paramedic providers in South Africa working in the private industry where capnography is available. Participants will be recruited with the assistance of the company's research committee using an email platform, and consent process. The questionnaire will establish the knowledge, ability and willingness of advanced life support paramedics to identify and use capnography as part of their clinical decision making process. Descriptive statistics will be used to interpret and report the data. The study should be concluded within 6 months of receiving ethical approval from Human Research Ethics Committee of the University of Cape Town. Discussion: The findings of the study will describe a cohort of out-of-hospital practitioners' knowledge and willingness to use capnography in an environment where it is routinely available. Recommendations will be made regarding the need for further policy development and change management for the implementation of best practice

Optimal Placement of Off-Stream Water Sources for Ephemeral Stream Recovery

Uneven and/or inefficient livestock distribution is often a product of an inadequate number and distribution of watering points.Placement of off-stream water practices (OSWP) in pastures is a key consideration in rangeland management plans and is criticalto achieving riparian recovery by improving grazing evenness, while improving livestock performance. Effective OSWPplacement also minimizes the impacts of livestock use radiating from OSWP, known as the ‘‘piosphere.’’ The objective of thisstudy was to provide land managers with recommendations for the optimum placement of OSWP. Specifically, we aimed toprovide minimum offset distances of OSWP to streams and assess the effective range of OSWP using Normalized DifferenceVegetation Index (NDVI) values, an indicator of live standing crop. NDVI values were determined from a time-series of SatellitePour l’Observation de la Terre (SPOT) 20-m images of western South Dakota mixed-grass prairie. The NDVI values inephemeral stream channels (in-channel) and uplands were extracted from pre- and post-OSWP images taken in 1989 and 2010,respectively. NDVI values were normalized to a reference imagine and subsequently by ecological site to produce nNDVI. Ourresults demonstrate a significant (P,0.05) increase in the nNDVI values of in-channel vegetation within 1 250 m of OSWPfollowing their implementation. The area of piospheres (n¼9) increased with pasture size (R2¼0.49,P¼0.05) and increasedwith average distance to OSWP in a pasture (R2¼0.43,P¼0.07). Piospheric reduction in nNDVI was observed within 200 m ofOSWP, occasionally overlapping in-channel areas. The findings of this study suggest placement of OSWP 200 to 1 250 m fromstreams to achieve optimal results. These results can be used to increase grazing efficiency by effectively placing OSWP andinsure that piospheres do not overlap ecologically important in-channel areas

Detecting the Influence of Best Management Practices on Vegetation Near Ephemeral Streams With Landsat Data

Various best management practices (BMPs) have been implemented on rangelands with the goals of controlling nonpoint sourcepollution, reducing the impact of livestock in ecologically important riparian areas, and improving grazing distribution.Providing off-stream water sources to livestock in pastures, cross-fencing, and rotational grazing are common rangeland BMPsthat have demonstrated success in drawing livestock grazing pressure away from streams. We evaluated the effects of rangelandBMP implementation with six commercial-scale pastures in the northern mixed-grass prairie. Four pastures received a BMPsuite consisting of off-stream water, cross-fencing, and deferred-rotation grazing, and two pastures did not receive BMPs. Wehypothesized that the BMPs increased the quantity of riparian vegetation cover relative to the conditions in these pasturesduring the pre-BMP period and to the two pastures that did not receive BMPs. We used a series of 30-m Landsat normalizeddifference vegetation index (NDVI) images to track the spatial and temporal changes (1984–2010,n¼24) in vegetation cover, towhich NDVI has been well correlated. Validation indicated that the remotely sensed signal from in-channel vegetation wasrepresentative of ground conditions. The BMP suite was associated with a 15% increase in the in-channel NDVI (0–30 m fromstream centerline) and 18% increase in the riparian NDVI (30–180 m from stream center line). Conversely, the in-channel andriparian NDVI of non-BMP pastures declined 30% and 18% over the study period. The majority of change occurred within 2 yrof BMP implementation. The patterns of in-channel NDVI among pastures suggested that BMP implementation likely alteredgrazing distribution by decreasing the preferential use of riparian and in-channel areas. We demonstrated that satellite imagerytime series are useful in retrospectively evaluating the efficacy of conservation practices, providing critical information to guideadaptive management and decision makers

Linking Phenology and Biomass Productivity in South Dakota Mixed-Grass Prairie

Assessing the health of rangeland ecosystems based solely on annual biomass production does not fully describe the condition of the plant community; the phenology of production can provide inferences about species composition, successional stage, and grazing impacts. We evaluated the productivity and phenology of western South Dakota mixed-grass prairie in the period from 2000 to 2008 using the normalized difference vegetation index (NDVI). The NDVI is based on 250-m spatial resolution Moderate Resolution Imaging Spectroradiometer (MODIS) satellite imagery. Growing-season NDVI images were integrated weekly to produce time-integrated NDVI (TIN), a proxy of total annual biomass production, and integrated seasonally to represent annual production by cool- and warm-season species (C3 and C4, respectively). Additionally, a variety of phenological indicators including cool-season percentage of TIN were derived from the seasonal profiles of NDVI. Cool-season percentage and TIN were combined to generate vegetation classes, which served as proxies of the conditions of plant communities. TIN decreased with precipitation from east to west across the study area. However, the cool-season percentage increased from east to west, following patterns related to the reliability (interannual coefficient of variation [CV]) and quantity of midsummer precipitation. Cool-season TIN averaged 76.8% of the total TIN. Seasonal accumulation of TIN corresponded closely (R2 . 0.90) to that of gross photosynthesis data from a carbon flux tower. Field-collected biomass and community composition data were strongly related to TIN and cool-season percentage. The patterns of vegetation classes were responsive to topographic, edaphic, and land management influences on plant communities. Accurate maps of biomass production, cool- and warm-season composition, and vegetation classes can improve the efficiency of land management by facilitating the adjustment of stocking rates and season of use to maximize rangeland productivity and achieve conservation objectives. Further, our results clarify the spatial and temporal dynamics of phenology and TIN in mixed-grass prairie

Nineteen Years Of Consistently Positive And Strong Female Mate Preferences Despite Individual Variation

Sexual selection driven by mate choice has generated some of the most astounding diversity in nature, suggesting population-level preferences should be strong and consistent over many generations. On the other hand, mating preferences are among the least repeatable components of an individual animal’s phenotype, suggesting low consistency across an animal’s lifetime. Despite decades of intensive study of sexual selection there is almost no information about the strength and consistency of preferences across many years. In this study we present the results of over 5000 mate choice tests with a species of wild frog conducted over 19 consecutive years. Results show that preferences are positive and strong and vary little across years. This consistency is despite the fact that there are substantial differences among females in their strength of preference. We also suggest mate preferences in populations that are primarily the result of sensory exploitation might be more stable over time compared to preferences that are primarily involved in assessing male quality

Spectroscopic properties of a two-level atom interacting with a complex spherical nanoshell

Frequency shifts, radiative decay rates, the Ohmic loss contribution to the nonradiative decay rates, fluorescence yields, and photobleaching of a two-level atom radiating anywhere inside or outside a complex spherical nanoshell, i.e. a stratified sphere consisting of alternating silica and gold concentric spherical shells, are studied. The changes in the spectroscopic properties of an atom interacting with complex nanoshells are significantly enhanced, often more than two orders of magnitude, compared to the same atom interacting with a homogeneous dielectric sphere. The detected fluorescence intensity can be enhanced by 5 or more orders of magnitude. The changes strongly depend on the nanoshell parameters and the atom position. When an atom approaches a metal shell, decay rates are strongly enhanced yet fluorescence exhibits a well-known quenching. Rather contra-intuitively, the Ohmic loss contribution to the nonradiative decay rates for an atomic dipole within the silica core of larger nanoshells may be decreasing when the silica core - inner gold shell interface is approached. The quasistatic result that the radial frequency shift in a close proximity of a spherical shell interface is approximately twice as large as the tangential frequency shift appears to apply also for complex nanoshells. Significantly modified spectroscopic properties (see computer program (pending publication of this manuscript) freely available at http://www.wave-scattering.com) can be observed in a broad band comprising all (nonresonant) optical and near-infrared wavelengths.Comment: 20 pages plus 63 references and 11 figures, plain LaTex, for more information see http://www.wave-scattering.com (color of D sphere in figures 2-6 altered, minor typos corrected.

Documentation of body mass index and control of associated risk factors in a large primary care network

<p>Abstract</p> <p>Background</p> <p>Body mass index (BMI) will be a reportable health measure in the United States (US) through implementation of Healthcare Effectiveness Data and Information Set (HEDIS) guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network.</p> <p>Methods</p> <p>We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m²), overweight (OW, 25-29.9), and obese (OB, ≥ 30). We measured documentation (yes/no) and control (above/below) of the following three risk factors: blood pressure (BP) ≤130/≤85 mmHg, low-density lipoprotein (LDL) ≤130 mg/dL (3.367 mmol/L), and fasting glucose <100 mg/dL (5.55 mmol/L) or casual glucose <200 mg/dL (11.1 mmol/L).</p> <p>Results</p> <p>BMI was documented in 48,376 patients (61%, range 34-94%), distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend <0.0001), but control of all three was lower (OB = 44%, OW = 49%, NW = 62%, p = 0.0001). The presence of cardiovascular disease (CVD) or diabetes modified some associations with obesity, and OB patients with CVD or diabetes had low rates of control of all three risk factors (CVD: OB = 49%, OW = 50%, NW = 56%; diabetes: OB = 42%, OW = 47%, NW = 48%, p < 0.0001 for adiposity-CVD or diabetes interaction).</p> <p>Conclusions</p> <p>In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.</p

Land Law, Property Ideologies and the British-Irish relationship

English and Irish land law are deeply influenced by the historical context of the British-Irish relationship, yet property scholarship comparing the two jurisdictions is surprisingly rare. The current Brexit negotiations provide a timely reminder of the strategic importance of property and trade relations between the two countries; and of their related-but-different legal cultures. In this article we examine how the property cultures of England and Ireland were shaped by the politics and practices of land tenure, by competing economic and property ideologies, and by the influence of both on national identity and statehood in both jurisdictions. The article reveals the role of local contexts and events in shaping land reform, and demonstrates the fertile potential of the comparative frame to contextualise each jurisdiction’s doctrines and practices. As domestic land law systems are drawn together in the context of emerging EU jurisdiction over areas like mortgage credit, each jurisdiction’s underpinning ideological commitments have important implications for the ease – or not – of attempts to harmonize member state practices. We explain the alignments and divergences between domestic underpinnings of Irish and English law, and reflect on the implications of our findings for contemporary property problems in the context of evolving economic and political relationships between the UK and Ireland

The Impact of Hydrogen Bonding on Amide 1H Chemical Shift Anisotropy Studied by Cross-Correlated Relaxation and Liquid Crystal NMR Spectroscopy

Site-specific (1)H chemical shift anisotropy (CSA) tensors have been derived for the well-ordered backbone amide moieties in the B3 domain of protein G (GB3). Experimental input data include residual chemical shift anisotropy (RCSA), measured in six mutants that align differently relative to the static magnetic field when dissolved in a liquid crystalline Pf1 suspension, and cross-correlated relaxation rates between the (1)H(N) CSA tensor and either the (1)H-(15)N, the (1)H-(13)C&#39;, or the (1)H-(13)C(alpha) dipolar interactions. Analyses with the assumption that the (1)H(N) CSA tensor is symmetric with respect to the peptide plane (three-parameter fit) or without this premise (five-parameter fit) yield very similar results, confirming the robustness of the experimental input data, and that, to a good approximation, one of the principal components orients orthogonal to the peptide plane. (1)H(N) CSA tensors are found to deviate strongly from axial symmetry, with the most shielded tensor component roughly parallel to the N-H vector, and the least shielded component orthogonal to the peptide plane. DFT calculations on pairs of N-methyl acetamide and acetamide in H-bonded geometries taken from the GB3 X-ray structure correlate with experimental data and indicate that H-bonding effects dominate variations in the (1)H(N) CSA. Using experimentally derived (1)H(N) CSA tensors, the optimal relaxation interference effect needed for narrowest (1)H(N) TROSY line widths is found at similar to 1200 MHz

Rab6 and Rab11 Regulate Chlamydia trachomatis Development and Golgin-84-Dependent Golgi Fragmentation

Many intracellular pathogens that replicate in special membrane bound compartments exploit cellular trafficking pathways by targeting small GTPases, including Rab proteins. Members of the Chlamydiaceae recruit a subset of Rab proteins to their inclusions, but the significance of these interactions is uncertain. Using RNA interference, we identified Rab6 and Rab11 as important regulators of Chlamydia infections. Depletion of either Rab6 or Rab11, but not the other Rab proteins tested, decreased the formation of infectious particles. We further examined the interplay between these Rab proteins and the Golgi matrix components golgin-84 and p115 with regard to Chlamydia-induced Golgi fragmentation. Silencing of the Rab proteins blocked Chlamydia-induced and golgin-84 knockdown-stimulated Golgi disruption, whereas Golgi fragmentation was unaffected in p115 depleted cells. Interestingly, p115-induced Golgi fragmentation could rescue Chlamydia propagation in Rab6 and Rab11 knockdown cells. Furthermore, transport of nutrients to Chlamydia, as monitored by BODIPY-Ceramide, was inhibited by Rab6 and Rab11 knockdown. Taken together, our results demonstrate that Rab6 and Rab11 are key regulators of Golgi stability and further support the notion that Chlamydia subverts Golgi structure to enhance its intracellular development