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For many us who have studied, researched, written, and taught about the influenza pandemic of 1918–19, the current period of the global viral pandemic is eerily and unpleasantly familiar. Today, the rapid global spread of a virus has prompted policies calling for widespread closures, social distancing, constant handwashing, and public mask wearing in additional to other non-pharmaceutical interventions (NPIs). We have also seen pushback and resistance to these directives as well as substantial mismanagement of resources and a flood of misinformation. Much health policy has been inconsistently set at the local rather than federal level. These responses to our current pandemic closely mirror those to the pandemic 102 years ago.
Emergency Medical Services (EMS) systems have developed protocols for prehospital activation of the cardiac catheterization laboratory for patients with suspected ST-elevation myocardial infarction (STEMI) to decrease first-medical-contact-to-balloon time (FMC2B). The rate of “false positive” prehospital activations is high. In order to decrease this rate and expedite care for patients with true STEMI, the American Heart Association (AHA; Dallas, Texas USA) developed the Mission Lifeline PreAct STEMI algorithm, which was implemented in Los Angeles County (LAC; California USA) in 2015. The hypothesis of this study was that implementation of the PreAct algorithm would increase the positive predictive value (PPV) of prehospital activation.
This is an observational pre-/post-study of the effect of the implementation of the PreAct algorithm for patients with suspected STEMI transported to one of five STEMI Receiving Centers (SRCs) within the LAC Regional System. The primary outcome was the PPV of cardiac catheterization laboratory activation for percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The secondary outcome was FMC2B.
A total of 1,877 patients were analyzed for the primary outcome in the pre-intervention period and 405 patients in the post-intervention period. There was an overall decrease in cardiac catheterization laboratory activations, from 67% in the pre-intervention period to 49% in the post-intervention period (95% CI for the difference, -14% to -22%). The overall rate of cardiac catheterization declined in post-intervention period as compared the pre-intervention period, from 34% to 30% (95% CI, for the difference -7.6% to 0.4%), but actually increased for subjects who had activation (48% versus 58%; 95% CI, 4.6%-15.0%). Implementation of the PreAct algorithm was associated with an increase in the PPV of activation for PCI or CABG from 37.9% to 48.6%. The overall odds ratio (OR) associated with the intervention was 1.4 (95% CI, 1.1-1.8). The effect of the intervention was to decrease variability between medical centers. There was no associated change in average FMC2B.
The implementation of the PreAct algorithm in the LAC EMS system was associated with an overall increase in the PPV of cardiac catheterization laboratory activation.
Pathological gambling is characterized in DSM IV-TR as one of the disorders of impulse control. Problem gambling is also part of what is considered behavioural addictions with intrusive thoughts about the game, are spending more and more important to play etc.
There is no epidemiological study in France, that's why we make an epidemiological study on the prevalence of pathological gambling.
We wanted to study the prevalence of pathological gambling in a sample of 529 persons: 368 gamers of Pari Mutuel Urbain and La Française des Jeux, and 161 persons in the general population.
We used as instruments: SOGS for screening of pathological gambling, BIS-10 for impulsiveness's evaluation, HAD scale to assess anxiety and depression and ASRS for the evaluation of attention deficit disorder / hyperactivity disorder.
The results show that the rate of pathological gambling in general population is 1.24% (this result is similar to those found in other countries such as Quebec)
Men are overrepresented in the group of pathological gamblers (88.9%), also with consumption of alcohol and tobacco. Depression and anxiety are particularly high, 40% of JPs with an anxiety score significantly higher.
It would be necessary to establish follow-up studies of populations and patients as well as specific studies on people who frequent casinos, racetracks and Internet gambling. Almost 20% of players have a gambling problem or risk and these people do not consult despite their psychological problems, family, work, debts…
Gambling behaviors of young adults may begin in adolescence and continue or even worsen in adulthood (Goudriaan et al., 2009).
Even if the young adult population is not an homogeneous group, studies show that almost 5% of young people, against 1% in general population showed pathological gambling (Dyke, 2009)
Our objective was to study the presence of problem gambling among a population of young adults in professional-schools.
We included 629 people, average age 20 and 66.4% of men. We used a battery of assessment scales of consumption of alcohol, tobacco, cannabis, pathological gambling, compulsive shopping, video games addiction, anxiety and depression.
The results show a prevalence of 1.6% of young people with a score of pathological gambling in the Canadian Problem Gambling Index (CPGI) and 7% with a score of problematic use.
The findings regarding depression, anxiety and other dependencies will be discussed.
Six on-farm studies determined the effects of a rolled rye cover crop, herbicide program, and planting technique on cotton stand, weed control, and cotton yield in Georgia. Treatments included: (1) rye drilled broadcast with 19-cm row spacing and a broadcast-herbicide program (2) rye drilled with a 25-cm rye-free zone in the cotton row and a broadcast-herbicide program (3) rye drilled with a 25-cm rye-free zone in the cotton row with PPI and PRE herbicides banded in the cotton planting row, and (4) no cover crop (i.e., weedy cover) with broadcast herbicides. At two locations, cotton stand was lowest with rye drilled broadcast; at these sites the rye-free zone maximized stand equal to the no-cover system. At a third location, cover crop systems resulted in greater stand, due to enhanced soil moisture preservation compared with the no-cover system. Treatments did not influence cotton stand at the other three locations and did not differ in the control of weeds other than Palmer amaranth at any location. Treatments controlled Palmer amaranth equally at three locations; however, differences were observed at the three locations having the greatest glyphosate-resistant plant densities. For these locations, when broadcasting herbicides, Palmer amaranth populations were reduced 82% to 86% in the broadcast rye and rye-free zone systems compared with the no-cover system at harvest. The system with banded herbicides was nearly 21 times less effective than the similar system broadcasting herbicides. At these locations, yields in the rye broadcast and rye-free zone systems with broadcast herbicides were increased 9% to 16% compared with systems with no cover or a rye-free zone with PPI and PRE herbicides banded. A rolled rye cover crop can lessen weed emergence and selection pressure while improving weed control and cotton yield, but herbicides should be broadcast in fields heavily infested with glyphosate-resistant Palmer amaranth.
Tracheocutaneous fistula represents one of the most troublesome complications of prolonged tracheostomy. Simple closure of a fistula can be ineffective, particularly in the context of prior surgery and adjuvant radiation. As such, modes of repair have expanded to include locoregional flaps and even free tissue transfers.
This paper describes a case of persistent tracheocutaneous fistula in an irradiated patient who had undergone previous unsuccessful attempts at repair.
Method and results
The use of regional fasciocutaneous supraclavicular flap with prefabricated conchal bowl cartilage resulted in successful closure of the tracheocutaneous fistula.
This represents a novel technique for closure of such fistulas in patients for whom previous attempts have failed. This mode of repair should be added to the surgeon's repertoire of reparative techniques.
During the summer of 2016, the Hawaii Department of Health responded to the second-largest domestic foodborne hepatitis A virus (HAV) outbreak in the post-vaccine era. The epidemiological investigation included case finding and investigation, sequencing of RNA positive clinical specimens, product trace-back and virologic testing and sequencing of HAV RNA from the product. Additionally, an online survey open to all Hawaii residents was conducted to estimate baseline commercial food consumption. We identified 292 confirmed HAV cases, of whom 11 (4%) were possible secondary cases. Seventy-four (25%) were hospitalised and there were two deaths. Among all cases, 94% reported eating at Oahu or Kauai Island branches of Restaurant Chain A, with 86% of those cases reporting raw scallop consumption. In contrast, a food consumption survey conducted during the outbreak indicated 25% of Oahu residents patronised Restaurant Chain A in the 7 weeks before the survey. Product trace-back revealed a single distributor that supplied scallops imported from the Philippines to Restaurant Chain A. Recovery, amplification and sequence comparison of HAV recovered from scallops revealed viral sequences matching those from case-patients. Removal of product from implicated restaurants and vaccination of those potentially exposed led to the cessation of the outbreak. This outbreak further highlights the need for improved imported food safety.
The Neotoma Paleoecology Database is a community-curated data resource that supports interdisciplinary global change research by enabling broad-scale studies of taxon and community diversity, distributions, and dynamics during the large environmental changes of the past. By consolidating many kinds of data into a common repository, Neotoma lowers costs of paleodata management, makes paleoecological data openly available, and offers a high-quality, curated resource. Neotoma’s distributed scientific governance model is flexible and scalable, with many open pathways for participation by new members, data contributors, stewards, and research communities. The Neotoma data model supports, or can be extended to support, any kind of paleoecological or paleoenvironmental data from sedimentary archives. Data additions to Neotoma are growing and now include >3.8 million observations, >17,000 datasets, and >9200 sites. Dataset types currently include fossil pollen, vertebrates, diatoms, ostracodes, macroinvertebrates, plant macrofossils, insects, testate amoebae, geochronological data, and the recently added organic biomarkers, stable isotopes, and specimen-level data. Multiple avenues exist to obtain Neotoma data, including the Explorer map-based interface, an application programming interface, the neotoma R package, and digital object identifiers. As the volume and variety of scientific data grow, community-curated data resources such as Neotoma have become foundational infrastructure for big data science.
Bribery is perhaps the most visible and most frequently studied form of corruption. Very little research, however, examines the individual decision to offer or accept a bribe, or how understanding that decision can help to effectively control bribery. This book brings together research by scholars from a variety of disciplines studying the mind and morality, who use their research to explain how and why decisions regarding participation in bribery are made. It first examines bribery from the perspective of brain structure, then approaches the decision to engage in bribery from a cognitive perspective. It examines the psychological costs imposed on a person who engages in bribery, and studies societal and organizational norms and their impact on bribery. This is an ideal read for scholars and other interested persons studying business ethics, bribery and corruption, corruption control, and the applications of neuroscience in a business environment.