366 research outputs found
Evaluation of SMAP Freeze/Thaw Retrieval Accuracy at Core Validation Sites in the Contiguous United States
Seasonal freeze-thaw (FT) impacts much of the northern hemisphere and is an important control on its water, energy, and carbon cycle. Although FT in natural environments extends south of 45°N, FT studies using the L-band have so far been restricted to boreal or greater latitudes. This study addresses this gap by applying a seasonal threshold algorithm to Soil Moisture Active Passive (SMAP) data (L3_SM_P) to obtain a FT product south of 45°N (‘SMAP FT’), which is then evaluated at SMAP core validation sites (CVS) located in the contiguous United States (CONUS). SMAP landscape FT retrievals are usually in good agreement with 0–5 cm soil temperature at SMAP grids containing CVS stations (\u3e70%). The accuracy could be further improved by taking into account specific overpass time (PM), the grid-specific seasonal scaling factor, the data aggregation method, and the sampling error. Annual SMAP FT extent maps compared to modeled soil temperatures derived from the Goddard Earth Observing System Model Version 5 (GEOS-5) show that seasonal FT in CONUS extends to latitudes of about 35–40°N, and that FT varies substantially in space and by year. In general, spatial and temporal trends between SMAP and modeled FT were similar
Laparoscopic-assisted percutaneous endoscopic gastrostomy: Insertion of a skin-level device using a tear-away sheath
Background: This study describes our experience with the placement of a skin-level gastrostomy device (MIC-KEY) in a single procedure. Methods: We identified infants, children and young adults who underwent laparoscopicassisted percutaneous endoscopic gastrostomy (LAPEG) tube insertion between October 2009 and June 2013. The steps of this procedure include upper endoscopy, single-port laparoscopy, gastropexy via percutaneous T-fasteners and placement of a skin-level gastrostomy device (MIC-KEY) using a push technique with a tearaway sheath. Results: We included 92 patients in our study. Mean age was 3.7 years (range 3 wk- 5 yr), and mean weight was 11.2 (range 2.8-54) kg. Median procedural time was 20 (range 12-76) minutes. Total median duration for the most recent 25 procedures was lower than that of the first 25 (62 v. 79 min, p = 0.004). There were no intraoperative complications or conversions to open surgery. Postoperative complications were observed in 6 (6.5%) patients. Three retained T-fasteners were assessed endoscopically (n = 1) or removed via local excision (n = 2). Two patients experienced early dislodged feeding tubes that were replaced via interventional radiology (n = 1) or repeat LAPEG (n = 1). There was also 1 intra-abdominal fluid collection that was drained percutaneously but ultimately required a laparotomy and washout. There were no major complications in the most recent 50 procedures. Conclusion: Our results suggest that LAPEG is a safe, minimally invasive procedure for infants, children and young adults. This approach allows for immediate use of a skin-level gastrostomy device without the need for postoperative tube exchanges
Making the transition from video-assisted thoracoscopic surgery to chest tube with fibrinolytics for empyema in children: Any change in outcomes?
Background: There is ongoing variation in the use of video-assisted thoracoscopic surgery (VATS) and chest tube with fibrinolytics (CTWF) for empyema in children. Our objective was to report outcomes from a centre that recently made the transition from VATS to CTWF as the primary treatment modality. Methods: We conducted a historical cohort study of children with empyema treated with either primary VATS (between 2005 and 2009) or CTWF (between 2009 and 2013). Results: Sixty-seven children underwent pleural drainage for empyema during the study period: 28 (42%) were treated with primary VATS, and 39 (58%) underwent CTWF. There were no significant differences between the VATS and CTWF groups for length of stay (8 v. 9 d, p = 0.61) or need for additional procedures (4% v. 13%, p = 0.19). Length of stay varied widely for both VATS (4-53 d) and CTWF (5-46 d). Primary VATS failed in 1 (4%) patient, who required an additional chest tube, and CTWF failed in 5 (13%) patients. Additional procedures included 3 rescue VATS, 2 additional chest tubes and 1 thoracotomy. All patients recovered and were discharged home. Conclusion: Primary VATS and CTWF were associated with similar outcomes in children with empyema. There appears to be a subset of children at risk for treatment failure with CTWF. Further research is needed to determine if these patients would benefit from primary VATS
Alcohol consumption, heavy episodic drinking and the perpetration of antisocial behaviours in Australia
Aims: This study aims to understand the dose-response relationship of the volume and patterns of alcohol consumption with alcohol-related antisocial behaviours (ASB) in the general population and assess whether these relationships are consistent across various sociodemographic subgroups. Methods: We used data from 30,275 respondents aged (14−69) from two waves (2013 and 2016) of the National Drug Strategy Household Survey (NDSHS). Average daily alcohol consumption and heavy episodic drinking (HED) frequencies were treated as the main independent variables and self-reported ASB perpetration as the dependent variable. Bivariable and multivariable logistic regression models predicting ASB with interaction terms between alcohol consumption and various sociodemographic variables were estimated. Findings: Compared with low-risk drinking (0.01–20 g of alcohol/day), respondents drinking at risky (20.01–40 g of alcohol/day) and high risk (>40 g of alcohol per day) levels had an increased prevalence of ASB perpetration with adjusted odds ratios of 3.63 (95% CI 2.98–4.42) and 8.07 (6.72–9.71). Increasing frequency of HED was also linked to increased self-report of ASB perpetration in bivariable and multivariable models. In our interaction models, we found higher probabilities of ASB perpetration among younger and unmarried respondents for a given level of drinking. Discussion and conclusions: Both average daily alcohol consumption and frequency of HED predict the probability of perpetrating alcohol-related ASB. Unsurprisingly, the risk of alcohol-specific ASB increased more quickly with consumption levels for younger and single respondents, suggesting interventions to reduce consumption among younger and unmarried persons will significantly impact ASB
Quality of life among adolescents with cerebral palsy: what does the literature tell us?
Developmental Medicine & Child Neurology, 49(3): pp. 225-231.This review describes trends in quality of life (QOL) and
health-related quality of life (HRQOL) among adolescents
with cerebral palsy (CP). Twenty original articles were
identified by a structured search of multiple databases and
grouped by design. Categories included descriptive crosssectional
studies (n=8), measurement validation studies
(n=9), and exploratory qualitative studies (n=3). Several
trends were apparent. First, individuals with CP are reported
to have decreased QOL and HRQOL compared with a
normative population in some but not all areas of well-being.
Second, functional status measures such as the Gross Motor
Function Classification System are reliable indicators of
variations in physical function, but do not correlate
consistently with psychosocial well-being. Third, although
adolescents with CP have different life issues than adults or
children, limited research on factors associated with QOL and
HRQOL has been described for this age range. We
recommend that clinicians and researchers interested in
assessing well-being among adolescents with CP include
participants from across the spectrum of motor impairment,
allow adolescents to self-report whenever possible, and assess
adolescents independently, rather than including them with
individuals from other age groups or clinical populations
Quality of life and health-related quality of life of adolescents with cerebral palsy
Developmental Medicine & Child Neurology, 49(7): pp. 516-521.This study assessed quality of life (QOL) and health-related
quality of life (HRQOL) of 203 adolescents with cerebral
palsy (111 males, 92 females; mean age 16y [SD 1y 9mo]).
Participants were classified using the Gross Motor Function
Classification System (GMFCS), as Level I (n=60), Level II
(n=33), Level III (n=28), Level IV (n=50), or Level V
(n=32). QOL was assessed by self (66.5%) or by proxy
(33.5%) with the Quality of Life Instrument for People With
Developmental Disabilities, which asks about the importance
and satisfaction associated with the QOL domains of Being,
Belonging, and Becoming; HRQOL was captured through
proxy reports with the Health Utilities Index, Mark 3
(HUI3), which characterizes health in terms of eight
attributes, each having five or six ordered levels of function.
GMFCS level was not a source of variation for QOL domain
scores but was significantly associated with the eight HRQOL
attributes and overall HUI3 utility scores (p<0.05). Some
QOL domain scores varied significantly by type of respondent
(self vs proxy; p<0.05). Overall HUI3 utility values were
significantly but weakly correlated with QOL Instrument
scores for Being (r=0.37), Belonging (r=0.17), Becoming
(r=0.20), and Overall QOL (r=0.28), and thus explain up to
14% of the variance (r2). These findings suggest that
although QOL and HRQOL are somewhat related
conceptually, they are different constructs and need to be
considered as separate dimensions of the lives of people with
functional limitations
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Using Automated Health Plan Data to Assess Infection Risk from Coronary Artery Bypass Surgery
We determined if infection indicators were sufficiently consistent across health plans to allow comparison of hospitals’ risks of infection after coronary artery bypass surgery. Three managed care organizations accounted for 90% of managed care in eastern Massachusetts, from October 1996 through March 1999. We searched automated inpatient and outpatient claims and outpatient pharmacy dispensing files for indicator codes suggestive of postoperative surgical site infection. We reviewed full text medical records of patients with indicator codes to confirm infection status. We compared the hospital-specific proportions of cases with an indicator code, adjusting for health plan, age, sex, and chronic disease score. A total of 536 (27%) of 1,953 patients had infection indicators. Infection was confirmed in 79 (53%) of 149 reviewed records with adequate documentation. The proportion of patients with an indicator of infection varied significantly (p<0.001) between hospitals (19% to 36%) and health plans (22% to 33%). The difference between hospitals persisted after adjustment for health plan and patients’ age and sex. Similar relationships were observed when postoperative antibiotic information was ignored. Automated claims and pharmacy data from different health plans can be used together to allow inexpensive, routine monitoring of indicators of postoperative infection, with the goal of identifying institutions that can be further evaluated to determine if risks for infection can be reduced
Three Small Planets Transiting a Hyades Star
We present the discovery of three small planets transiting K2-136 (LP 358
348, EPIC 247589423), a late K dwarf in the Hyades. The planets have orbital
periods of , , and
days, and radii of , , and , respectively. With an age of
600-800 Myr, these planets are some of the smallest and youngest transiting
planets known. Due to the relatively bright (J=9.1) host star, the planets are
compelling targets for future characterization via radial velocity mass
measurements and transmission spectroscopy. As the first known star with
multiple transiting planets in a cluster, the system should be helpful for
testing theories of planet formation and migration.Comment: Accepted to The Astronomical Journa
Exoplanets around Low-mass Stars Unveiled by K2
We present the detection and follow-up observations of planetary candidates
around low-mass stars observed by the K2 mission. Based on light-curve
analysis, adaptive-optics imaging, and optical spectroscopy at low and high
resolution (including radial velocity measurements), we validate 16 planets
around 12 low-mass stars observed during K2 campaigns 5-10. Among the 16
planets, 12 are newly validated, with orbital periods ranging from 0.96-33
days. For one of the planets (K2-151b) we present ground-based transit
photometry, allowing us to refine the ephemerides. Combining our K2 M-dwarf
planets together with the validated or confirmed planets found previously, we
investigate the dependence of planet radius on stellar insolation and
metallicity [Fe/H]. We confirm that for periods days, planets
with a radius are less common than planets with a
radius between 1-2. We also see a hint of the "radius valley"
between 1.5 and 2 that has been seen for close-in planets around
FGK stars. These features in the radius/period distribution could be attributed
to photoevaporation of planetary envelopes by high-energy photons from the host
star, as they have for FGK stars. For the M dwarfs, though, the features are
not as well defined, and we cannot rule out other explanations such as
atmospheric loss from internal planetary heat sources, or truncation of the
protoplanetary disk. There also appears to be a relation between planet size
and metallicity: those few planets larger than about 3 are found
around the most metal-rich M dwarfs.Comment: 29 pages, 21 figures, 6 tables, Accepted in Astronomical Journa
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