Multi-scalar remote sensing of the northern mixed prairie vegetation

Optimal scale of study and scaling are fundamental to ecological research, and have been made easier with remotely sensed (RS) data. With access to RS data at multiple scales, it is important to identify how they compare and how effectively information at a specific scale will potentially transfer between scales. Therefore, my research compared the spatial, spectral, and temporal aspects of scale of RS data to study biophysical properties and spatio-temporal dynamics of the northern mixed prairie vegetation. I collected ground cover, dominant species, aboveground biomass, and leaf area index (LAI) from 41 sites and along 3 transects in the West Block of Grasslands National Park of Canada (GNPC; +49°, -107°) between June-July of 2006 and 2007. Narrowband (VIn) and broadband vegetation indices (VIb) were derived from RS data at multiple scales acquired through field spectroradiometry (1 m) and satellite imagery (10, 20, 30 m). VIs were upscaled from their native scales to coarser scales for spatial comparison, and time-series imagery at ~5-year intervals was used for temporal comparison. Results showed VIn, VIb, and LAI captured the spatial variation of plant biophysical properties along topographical gradients and their spatial scales ranged from 35-200 m. Among the scales compared, RS data at finer scales showed stronger ability than coarser scales to estimate ground vegetation. VIn were found to be better predictors than VIb in estimating LAI. Upscaling at all spatial scales showed similar weakening trends for LAI prediction using VIb, however spatial regression methods were necessary to minimize spatial effects in the RS data sets and to improve the prediction results. Multiple endmember spectral mixture analysis (MESMA) successfully captured the spatial heterogeneity of vegetation and effective modeling of sub-pixel spectral variability to produce improved vegetation maps. However, the efficiency of spectral unmixing was found to be highly dependent on the identification of optimal type and number of region-specific endmembers, and comparison of spectral unmixing on imagery at different scales showed spectral resolution to be important over spatial resolution. With the development of a comprehensive endmember library, MESMA may be used as a standard tool for identifying spatio-temporal changes in time-series imagery. Climatic variables were found to affect the success of unmixing, with lower success for years of climatic extremes. Change-detection analysis showed the success of biodiversity conservation practices of GNPC since establishment of the park and suggests that its management strategies are effective in maintaining vegetation heterogeneity in the region. Overall, my research has advanced the understanding of RS of the northern mixed prairie vegetation, especially in the context of effects of scale and scaling. From an eco-management perspective, this research has provided cost- and time-effective methods for vegetation mapping and monitoring. Data and techniques tested in this study will be even more useful with hyperspectral imagery should they become available for the northern mixed prairie

Pleural fluid pseudocholinesterase and its ratio to serum pseudocholinesterase: For differentiating pleural transudates from exudates

BACK GROUNND: The lights criteria is the system that has stood the test of time in classifying pleural effusions into transudates and exudates. But studies have shown that there is significant number of misclassification with the lights criteria. Several newer parameters are being postulated as an alternative to lights criteria for classifying effusions. Pleural fluid pseudocholinesterase and its ratio to serum pseudocholinesterase is one such parameter. AIMS AND OBJECTIVES: To evaluate the usefulness of pleural fluid pseudocholinesterase(PChE) level and its ratio with serum pseudocholinesterase in order to differentiate between transudates and exudates. To compare the diagnostic efficacy of: (1) pleural fluid PChE value and (2) pleural fluid PChE to serum PChE ratio; with the efficacy of Light’s criteria. MATERIALS AND METHODS: 60 patients with pleural effusion with known etiology were selected and divided into transudates and exudates based on the etiology. lights criteria was applied to all patients. Pleural fluid PChE level and its ratio to serum PChE were estimated in all patients. ROC analysis and unpaired t test was done. RESULTS: There was significant difference between the values of both Pleural fluid PChE level and pleral fluid to serum PChE ratio between exudates and transudates. Misclassification was less with the new parameters compaired to lights criteria. Sensitivity,specificity,PPV,NPV of Pleural fluid PChE level(96.2%,85.36%,89.36%,97.6% respectively)and pleral fluid to serum PChE ratio(97.14%,91.6%,94.2%,98.3%) were better than that of lights criteria (93.3%,77.7%,83.3%,95.6%). CONCLUSION: Both pleural fluid PChE and P/S PChE ratio are reliable parameters in differentiating transudates and exudates. PChE and P/S PChE ratio are more efficient than lights criteria in differentiating transudates and exudates. P/S PChE ratio is the most sensitive and specific parameter among the parameters studied

Internet-based interventions to support recovery in youth: A systematic review

Personal recovery represents a paradigm shift in how individuals are seen to benefit from mental health interventions, from a narrow view of symptom reduction to a holistic, multi-dimensional view of well-being, functional gains and rehabilitation. Although there is a large body of evidence supporting the use of recovery-oriented care in adults, research on personal recovery amongst youth with mental health concerns is an emerging area of research. Efforts to promote youth mental health have also focussed on the use of digital applications and platforms as a means of overcoming barriers related to factors including stigma and lack of available services. This systematic review aims to review the literature on existing internet-based, youth mental health interventions with regard to (a) identifying elements of the programs that align with the personal recovery and (b) outcome measures utilised in assessing personal recovery. Eleven papers were identified that met the inclusion criteria. Five of the programs reviewed from these eleven papers showed efficacy for recovery processes. The results offer preliminary support and guidance for the use of internet-based mental health interventions in the promotion of personal recovery amongst youth. Future research and practice are suggested to further develop understanding in this area

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The impact of trisomy 21 on epidemiology, management, and outcomes of congenital duodenal obstruction: a population-based study

Abstract: Purpose: Congenital duodenal obstruction (CDO) is associated with trisomy 21 (T21), or Down’s syndrome, in around a third of infants. The aim of this study was to explore the impact of T21 on the epidemiology, management, and outcomes of infants with CDO. Methods: Data were prospectively collected from specialist neonatal surgical centres in the United Kingdom over a 12 month period from March 2016 using established population-based methodology for all babies with CDO. Infants with T21 were compared to those without any chromosomal anomaly. Results: Of 102 infants with CDO that underwent operative repair, T21 was present in 33 [32% (95% CI 23–41%)] babies. Cardiac anomalies were more common in those with T21 compared to those without a chromosomal anomaly (91 vs 17%, p < 0.001), whereas associated gastrointestinal anomalies were less common in infants with T21 (3 vs 12%, p = 0.03). Surgical management was not influenced by T21. Time to achieve full enteral feed, need for repeat related surgery, and mortality were similar between groups. Infants with T21 had a longer median initial inpatient stay (23 vs 16.5 days, p = 0.02). Conclusions: Infants with T21 have a higher incidence of cardiac anomalies and a longer initial inpatient stay; however, it does not change CDO management or outcomes. This information is important for prenatal and postnatal counselling of parents of infants with CDO and T21

The impact of trisomy 21 on epidemiology, management, and outcomes of congenital duodenal obstruction: a population-based study

Abstract: Purpose: Congenital duodenal obstruction (CDO) is associated with trisomy 21 (T21), or Down’s syndrome, in around a third of infants. The aim of this study was to explore the impact of T21 on the epidemiology, management, and outcomes of infants with CDO. Methods: Data were prospectively collected from specialist neonatal surgical centres in the United Kingdom over a 12 month period from March 2016 using established population-based methodology for all babies with CDO. Infants with T21 were compared to those without any chromosomal anomaly. Results: Of 102 infants with CDO that underwent operative repair, T21 was present in 33 [32% (95% CI 23–41%)] babies. Cardiac anomalies were more common in those with T21 compared to those without a chromosomal anomaly (91 vs 17%, p < 0.001), whereas associated gastrointestinal anomalies were less common in infants with T21 (3 vs 12%, p = 0.03). Surgical management was not influenced by T21. Time to achieve full enteral feed, need for repeat related surgery, and mortality were similar between groups. Infants with T21 had a longer median initial inpatient stay (23 vs 16.5 days, p = 0.02). Conclusions: Infants with T21 have a higher incidence of cardiac anomalies and a longer initial inpatient stay; however, it does not change CDO management or outcomes. This information is important for prenatal and postnatal counselling of parents of infants with CDO and T21

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Electrospun polyaniline nanofiber based chemiresistive nanobiosensor platform for DNA Hybridization detection

In recent times, nanoscale one-dimensional conductors such as nanotubes have been extensively used as high-gain field-effect sensors for monitoring a variety of biological events, including DNA hybridization. Conventionally, DNA hybridization biosensors are based on single stranded nucleotide (ssDNA) probes, which capture the target DNAs via hybridization with complementary sequences. The formation of this hybridized complex can be detected using several transduction principles [1]–[2]. The widely used colorimetric and electrochemical sensing schemes often involve complex chemistry and are predominately labeled approaches. Alternatively, we propose a label-free chemiresistive platform for DNA hybridization detection based on conductive polymer nanofibres wherein, the nanofibers are surface modified with ssDNA probes specific to a target sequence. Chemiresistive transduction utilizes the change in electrical conductivity of the nanofiber to indicate target analyte detection. DNA, being a negatively charged entity, is a suitable candidate for chemiresistive detection as the formation of the hybridized complex would affect the overall surface charge on the nanofibers. It has been previously illustrated that change in surface charge is likely to induce changes in the resulting conductivity of the nanofiber [3]–[4]. In lieu of this, in this work we report a chemiresistive platform derived from conductive polyaniline/poly-ethylene-oxide (PANi/PEO) nanofibers. In our previous communication [5], we have already demonstrated ultrasensitive detection of cardiac biomarkers using SU8/MWCNT nanofiber based chemiresistive devices. As opposed to the epoxy polymer SU8, the PANiIPEO polymer composite is inherently conductive, which eliminates the need of doping to induce conductivity

Localized polymerization using single photon photoinitiators in two-photon process for fabricating subwavelength structures

Localized polymerization in subwavelength volumes using two photon dyes has now become a well established method for fabrication of nano structures. Unfortunately, the two photon absorption dyes used in such process are not only expensive but also proprietary. Lucirin TPO-L is an inexpensive, easily available single photon photoinitiator and has been used extensively for single photon absorption of UV light for polymerization. These polymerization volumes however are not localized and extend to micron size resolution having limited applications. We have exploited high quantum yield of radicals of Lucirin TPO-L for absorption of two photons to achieve localized polymerization in subwavelength volumes, much below the diffraction limit. Critical concentration (10 wt%) of Lucirin TPO-L in acrylate (Sartomer) was found optimal to achieve subwavelength localized polymerization and has been demonstrated by fabricating 2D/3D complex nanostructures and functional devices such as variable polymeric gratings using two photon processes. Systematic studies on influence of Lucirin TPO-L concentration on two photon polymerization of Sartomer show that resolution of the fabricated structures critically depends on loading of Lucirin TPO-L. This is expected to unleash the true potential of two photon polymerization for fabrication of complex polymeric nano devices at a larger scale. (C) 2017 Elsevier Ltd. All rights reserved