Optimizing the Electrocardiogram and Pressure Monitoring

journal articleBiomedical Informatic

Physician Decision-Making: Evaluaton of Data Used in a Computerized ICU

journal articleBiomedical Informatic

Development of a Computerized Laboratory Alerting System

journal articleBiomedical Informatic

Development of an Effective User Interface for a Computerized Laboratory Alerting System

Conference PaperBiomedical Informatic

Mothers and Infants in the Prehistoric Santa Clara Valley: What Stable Isotopes Tell Us about Ancestral Ohlone Weaning Practices

Breast-feeding and weaning are a part of childhood in all human populations, but the exact timing of these milestones varies between groups. As infants incorporate the nutrients from breast milk into their growing bones, chemical evidence is captured in the form of higher stable nitrogen (δ15N) isotope values. This study interprets δ15N values in the bone collagen of children (n = 24) buried at the Yukisma Mound (CA-SCL-38), in Santa Clara County, California. Radiocarbon dates for this site span 2200-250 B.P., but primarily fall during the Late period (740-230 B.P.). In the one probable mother-infant pair available for study, a 2.9 per mil enrichment of δ15N values was observed, consistent with the expected trophic level enrichment of breast-feeding infants. δ15N values of children under seven years old suggest the introduction of weaning foods between 1.5 and 2 years of age, and cessation of breast-feeding by 3 to 3.5 years of age. These results differ from the practices reported in the ethnohistoric literature. This paper includes photos of human remains, taken during excavation at CA-SCL-38 by Ohlone Family Consulting Services, the CRM arm of the Muwekma Ohlone Tribe (which also served as the Most Likely Descendant tribal group for this project). The images were provided to the authors by the tribe, and specific permission was granted to include them in this publication

Data Recovery at Justiceburg Reservoir (Lake Alan Henry), Garza and Kent Counties, Texas: Phase III, Season 1

Phase III data recovery investigations at one historic and three prehistoric sites, augmented by additional survey and off-site geological investigations, were conducted at Lake Alan Henry (formerly Justiceburg Reservoir) on the Double Mountain Fork of the Brazos River in Garza and Kent counties, Texas, during the fall and winter of 1990-1991. Descriptive data from this first of three field seasons of data recovery are presented here in anticipation of a final synthetic report that will relate all the investigations to a series of research design hypotheses. Analysis of surface distributions at 41KT42, a late nineteenth- to early twentieth-century ranch line camp known locally as the Ed Scott Cabin, groups the artifacts into material and functional categories that demonstrate primary and secondary refuse accumulations adjacent to the cabin. The distribution of primary refuse shows kitchen artifacts are spatially distinct from other types that include architectural, firearm, ranching, clothing, and personal items. The primary discard pattern is obfuscated by redistribution attributed to secondary refuse discard. The uppermost of two superimposed hearths at 41GR484, the Grape Creek Bench Site, is radiocarbon dated to 260 B.P. and yielded charcoal identified as Carya sp. Excavations were halt~d at this Late Prehistoric II site because of extremely low artifact recovery. Geoarcheological investigations demonstrate that most of the site has been destroyed by cutbank erosion associated with the meanderings of Grape Creek. At 41KT33, the Late Prehistoric I South Sage Creek Site, stone-lined hearth features dated to 1005 B.P. are surrounded by clusters of artifacts. Petrographic analysis of brownware ceramics suggests affiliations with the local Palo Duro Complex and nonlocally with the Pecos River valley. The Gobbler Creek Bridge Site, 4IGR383, spans the late Archaic and Late Prehistoric I periods. Intact· and dispersed stone-lined hearths radiocarbon dated to 1865-1215 B.P. are surrounded by artifact clusters. Both of the sites appear to have been multifunctional campsites, and repeated occupations are likely. Dense concentrations of fire-cracked rocks at these sites may represent secondary refuse disposal. Lithic analysis indicates extensive use of nonlocal materials derived from Cretaceous formations that occur in the Callahan Divide and Edwards Plateau to the south. Freshwater mussels are the only faunal remains recovered from either of these sites. The meat is presumed to have been consumed as food, while the shells sometimes were made into ornaments. An additional 440 acres of land were surveyed for cultural resources; 360 of these acres were subsequently acquired by the City of Lubbock for use as wildlife mitigation lands. Nine prehistoric archeological sites and one isolated fmd were documented and evaluated for their eligibility for listing on the National Register of Historic Places. Five of these sites are considered to be ineligible for listing on the National Register, and five are potentially eligible for listing. Avoidance is recommended at these five sites, with testing recommended to determine their National Register eligibility if avoidance is not possible. Geological investigations provide information about depositional environments in and near the archeological sites. Two soils buried in the Double Mountain Fork floodplain are radiocarbon dated to 8~00 B.P. and 1700-1300 B.P.; fluvial sediments extend as much as 15 m below these soils in portions of the floodplain. An older terrace previously was identified 18 m above the modem river channel. Current work obtained a terminal date of 8690 B.P. from a buried soil that caps this older terrace. Another radiocarbon date of 3320 B.P. was obtained from fill in a gully that is eroded into the older terrace. These dates bracket an erosional episode when the older terrace was heavily dissected. The erosion coincides with the Altithermal, a period believed to have been characterized by a hot and dry climatic regime

Palliative care needs in patients hospitalized with heart failure (PCHF) study: rationale and design

Abstract Aims The primary aim of this study is to provide data to inform the design of a randomized controlled clinical trial (RCT) of a palliative care (PC) intervention in heart failure (HF). We will identify an appropriate study population with a high prevalence of PC needs defined using quantifiable measures. We will also identify which components a specific and targeted PC intervention in HF should include and attempt to define the most relevant trial outcomes. Methods An unselected, prospective, near-consecutive, cohort of patients admitted to hospital with acute decompensated HF will be enrolled over a 2-year period. All potential participants will be screened using B-type natriuretic peptide and echocardiography, and all those enrolled will be extensively characterized in terms of their HF status, comorbidity, and PC needs. Quantitative assessment of PC needs will include evaluation of general and disease-specific quality of life, mood, symptom burden, caregiver burden, and end of life care. Inpatient assessments will be performed and after discharge outpatient assessments will be carried out every 4 months for up to 2.5 years. Participants will be followed up for a minimum of 1 year for hospital admissions, and place and cause of death. Methods for identifying patients with HF with PC needs will be evaluated, and estimates of healthcare utilisation performed. Conclusion By assessing the prevalence of these needs, describing how these needs change over time, and evaluating how best PC needs can be identified, we will provide the foundation for designing an RCT of a PC intervention in HF

Testing And Data Recovery Excavations At The Jayroe Site (41HM51), Hamilton County, Texas

In 2003–2004, Prewitt and Associates, Inc., performed National Register of Historic Places testing and subsequent data recovery excavations at the Jayroe site (41HM51) in Hamilton County for the Texas Department of Transportation, Environmental Affairs Division, under Texas Antiquities Permit Nos. 3211 and 3405. The investigations were prompted by the planned replacement of the County Road 294 bridge at the Leon River (CSJ No. 0909-29-030), in compliance with Section 106 of the National Historic Preservation Act and its implementing regulations (36 CFR Part 800) and the Antiquities Code of Texas. Testing consisted of the excavation of 6 backhoe trenches and 19 test units, and the data recovery work consisted mainly of hand excavation of 153 contiguous 1x1-m units within a single block, with 2 backhoe trenches and 2 manual units apart from the block excavation. Combined, the testing and data recovery identified 16 cultural features interpreted as 3 open hearths, 4 shallow earth ovens or surface hearths, 8 scatters of various kinds of debris, and 1 knapping station. The excavations recovered 322 chipped stone tools, 26 cores, 6,589 pieces of unmodified debitage, 21 ground or battered stone tools, 38 potential pigment sources, 43 ceramic sherds, 15 modified bone artifacts, 7,649 animal bones, 1,200 mussel shells, and macrobotanical remains. Four analytical units are defined for the site, only one of which—the Toyah phase component— has much interpretive potential. It is interpreted as a campsite used at least several times, mostly in the a.d. 1470s, at which butchering of mostly bison and deer, late-stage lithic tool manufacture and repair, and other maintenance tasks figured prominently in the site activities. The artifacts recovered and records generated by the project are curated at the Center for Archaeological Studies, Texas State University