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The aim of this study was to describe individuals seeking care for injury at a major emergency department (ED) in southern Puerto Rico in the months after Hurricane Maria on September 20, 2017.
After informed consent, we used a modified version of the Natural Disaster Morbidity Surveillance Form to determine why patients were visiting the ED during October 16, 2017–March 28, 2018. We analyzed visits where injury was reported as the primary reason for visit and whether it was hurricane-related.
Among 5 116 patients, 573 (11%) reported injury as the primary reason for a visit. Of these, 10% were hurricane-related visits. The most common types of injuries were abrasions, lacerations, and cuts (43% of all injury visits and 50% of hurricane-related visits). The most common mechanisms of injury were falls, slips, trips (268, 47%), and being hit by/or against an object (88, 15%). Most injury visits occurred during the first 3 months after the hurricane.
Surveillance after Hurricane Maria identified injury as the reason for a visit for about 1 in 10 patients visiting the ED, providing evidence on the patterns of injuries in the months following a hurricane. Public health and emergency providers can use this information to anticipate health care needs after a disaster.
OBJECTIVES/SPECIFIC AIMS: The Title V Cooperative Project of the UPR-MSC and UCC has demonstrated that educational interventions in CTR are very effective in fulfilling the objective of promoting awareness, stimulate interest and increase the knowledge, skills and opportunities, to US, GS and F (participants) in CTR. METHODS/STUDY POPULATION: The training sessions (TS) offered through the Title V initiative have become an engine for the involvement in CTR for participants from higher education institutions island-wide. TS consisted of cycles –level 1 and 2–: Research Education Towards Opportunities (RETO,I,II) and Mentorship Offering Training Opportunities for Research (MOTOR,I,II), ending in the formation of the Clinical and Translational Mentoring Teams (CTMT)s, in which participants, paired by their research interests, were mentored by a well-established CT researchers in their research project, to be developed in the Intensive Development and Experiences in Advancement of Research and Increased Opportunities (IDEARIO). RESULTS/ANTICIPATED RESULTS: Up to date, 4 TS-level 1 and 2 TS-level 2 were offered. Eighty (80) participants completed level 1, distributed: 42 (52.5%) US in RETO, 21 (26.25%) GS and 17 (21.25%) F in MOTOR and 17 participants completed level 2, distributed: 4 (23.52%) US in RETO, 6 (25.29%) GS and 7 (41.17%) F in MOTOR. From which, 15, with 8 CT researchers, formed 5 CTMTs in different research areas – cardio, neuro, liver, renal, Zika–. DISCUSSION/SIGNIFICANCE OF IMPACT: US, GS and F were integrated in the active process throughout educational levels for their development in CTR.
OBJECTIVES/SPECIFIC AIMS: The Title V Cooperative Project between the University of Puerto Rico- Medical Sciences Campus (UPR-MSC) and Universidad Central del Caribe (UCC) has trained US, GS and F (participants) of HSPs to engage them in CTR. METHODS/STUDY POPULATION: First stage of the training sessions (TS) dealt with the theory of CTR. After TS and responding to their research interests, as answered in a questionnaire, the participants formed a CTMT, under the mentorship of a well-established CT researcher. This, as a prelude to their hands-on experiences in Intensive Development and Experiences in Advancement of Research and Increased Opportunities (IDEARIO), for which a research proposal is needed. RESULTS/ANTICIPATED RESULTS: Five (5) CTMTs were formed in different research areas – cardio, neuro, liver, renal, Zika–, as submitted in their research concept papers.Eight (8) CT researchers are currently mentoring 2 US, 7 GS and 6 F of HSPs through the CTMTs. They have submitted a research proposal, as a bridge between the theory in the TS and the practice in IDEARIO. Five (5) proposals were received and 2 of them approved, while the other 3 are in the evaluation process. We will present the composition, research topics, development of research and the feedback of participants in IDEARIO and CTMTs. DISCUSSION/SIGNIFICANCE OF IMPACT: The CTMTs and their respective proposals are effective strategies for the mentoring of US, GS and F in CTR.
Breeding for resilience requires a better understanding of intra-flock variability and the related mechanisms responsible for robustness traits. Among such traits, the animals’ ability to cope with feed fluctuations by mobilizing or restoring body reserves (BR) is a key mechanism in ruminants. The objective of this work was to characterize individual variability in BR dynamics in productive Romane ewes reared in extensive conditions. The BR dynamics profiles were characterized by combining individual longitudinal measurements of BW and body condition scores (BCS) over several production cycles. Historical data, including up to 2628 records per trait distributed in 1146 ewes, underwent cluster analysis. Two to four trajectories were observed for BW depending on the cycle, while three trajectories were found for BCS, whatever the cycle. Most trajectories suggested that BR dynamics were similar but the level of BR may differ between ewes. Nevertheless, some trajectories suggested that both BR dynamics and levels were different for a proportion of ewes. Clustering on BW and BCS profiles adjusted for individual level trends, resulted in differences only in the level of BW or BCS, rather than differences in trajectories. Thus, the overall shape of trajectories was not changed considering or not the individual level trend across cycles. In addition to individual variability, the ewe’s age at first lambing and litter size contributed to the distribution of the ewes between the trajectories. Regarding the entire productive life, three trajectories were observed for BW and BCS changes over three productive cycles. Increase in BW at each cycle suggested that ewes kept growing up until 3 to 4 years old in our conditions. Similar alternation of BCS gains and losses across cycles suggested BR dynamics might be repeatable. Many individual trajectories remained the same throughout a ewe’s life, whatever the age at first lambing, parity or litter size. Our results demonstrate the relevance of using BW and BCS changes for characterizing the diversity of BR mobilization–accretion profiles in sheep in a long timespan perspective.
Allylamine (AA)-functionalized surfaces for cell adhesion and tissue engineering generated by plasma reactions present several disadvantages, such as amine degradation after 1 week of storage in air and difficulty in achieving a highly specific surface functionalization. In this work, polypropylene (PP) and polyethylene (PE) films were functionalized with AA by γ irradiation to enhance adhesion and compatibility without changing intrinsic bulk properties, thus avoiding the disadvantages of plasma synthesis. Irradiation grafting was realized by a direct and pre-irradiation oxidation method. The effect of different parameters studied were characterized by Fourier transform infrared spectra, thermogravimetric analysis, differential scanning calorimetry, scanning electron microscopy, and contact angle measurements.
The objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.
OBJECTIVES/SPECIFIC AIMS: The University of Puerto Rico-Medical Sciences Campus and Universidad Central del Caribe, through the Title V Cooperative Project, devised a clinical and translational research (CTR) platform to pipeline students/faculty of undergraduate health sciences programs into CTR. Educational interventions in CTR—introductory intervention (II) and Annual Symposium (AS)—were designed to promote awareness, stimulate interest of students and faculty in CTR. METHODS/STUDY POPULATION: In the II the participants (n=159) were surveyed before and after a presentation and panel discussion about CTR. In addition, after the sessions—plenary, panel, and workshop—about CTR, the participants of AS (n=42) were surveyed for satisfaction and learning experience in CTR. RESULTS/ANTICIPATED RESULTS: Most participants of the II, 134 (84.3%) were students. In total, 58 (58, 36.5%) completed the post II survey. Of these, 53.4% satisfactorily defined the CTR concept Versus only 31.0% that could define CTR in the pre survey, 47 (81.7%) were unable to identify a CTR researcher and 45 (78.3 %) expressed interest in learning about CTR. In total, 28 (28, 66.7%) participants of the AS completed the satisfaction survey, out of which 17 (60.6%) were students. One hundred percent (100%) agreed that the AS served as a vehicle to increase their knowledge in CTR. DISCUSSION/SIGNIFICANCE OF IMPACT: The educational interventions demonstrated to be an effective strategy to promote awareness and stimulate interest of students and faculty in CTR. In addition, the results obtained, provided valuable baseline information for the planning—development of training cycles in CTR.
The main limitation for determining feed efficiency of freely grazing ruminants is measurement of daily individual feed intake. This paper describes an investigation that assessed a method for estimating intake of forage based on changes in BW of ewes. A total of 24 dry and non-pregnant Romane ewes (12 hoggets, HOG; mean±SD 51.8±2.8 kg BW; body condition score (BCS) 2.6±0.2; and 12 adults, ADU; 60.4±8.5 kg BW; BCS 2.7±0.8) were selected for the study and moved from their rangeland system to a confined pen with controlled conditions and equipped with individual automatic feeders. The experiment lasted for 28 days (21 days adaptation and 7 days feed intake measurement). Ewes were fed hay and trained to use the electronic feeders (one feeding station per ewe) in which actual daily intake (Hintake24) was measured. The pens were designed to maximize movement of trained ewes through an automated Walk-over-Weighing device, by using water and mineral salts as attractants. Total individual intake of hay measured in the automatic feeder at each meal (Hintake) was compared with indirect estimates of feed intake determined using differences in the BW of the ewes (∆BW) before and 1 h following morning and afternoon feeding at fixed times. The BW, BCS, Hintake, Hintake24, as well as plasma non-esterified fatty acids (NEFA), glucose and insulin profiles were determined. The BW was higher in ADU v. HOG but BCS was not affected by parity. The Hintake24 was affected by day of experiment as a consequence of reduced availability and intake of water on one day. Plasma glucose, NEFA and insulin were not affected by parity or day of experiment. The HIntake was and ∆BW tended to be higher in the morning in HOG, whereas Hintake was and ∆BW tended to be higher in ADU at the afternoon meal. Irrespective of parity or feeding time, there was very strong correlation (r2=0.93) between Hintake and ∆BW. This relationship confirms that our indirect method of estimating individual forage intake was reliable within the strictly controlled conditions of the present experiment. The method appears suitable for use in short-term intensive group feeding situations, and has potential to be further developed for longer-term forage intake studies, with a view to developing a method for freely grazing ruminants.
This study aimed to examine the association between vitamin B6, folate and vitamin B12 biomarkers and plasma fatty acids in European adolescents. A subsample from the Healthy Lifestyle in Europe by Nutrition in Adolescence study with valid data on B-vitamins and fatty acid blood parameters, and all the other covariates used in the analyses such as BMI, Diet Quality Index, education of the mother and physical activity assessed by a questionnaire, was selected resulting in 674 cases (43 % males). B-vitamin biomarkers were measured by chromatography and immunoassay and fatty acids by enzymatic analyses. Linear mixed models elucidated the association between B-vitamins and fatty acid blood parameters (changes in fatty acid profiles according to change in 10 units of vitamin B biomarkers). DHA, EPA) and n-3 fatty acids showed positive associations with B-vitamin biomarkers, mainly with those corresponding to folate and vitamin B12. Contrarily, negative associations were found with n-6:n-3 ratio, trans-fatty acids and oleic:stearic ratio. With total homocysteine (tHcy), all the associations found with these parameters were opposite (for instance, an increase of 10 nmol/l in red blood cell folate or holotranscobalamin in females produces an increase of 15·85 µmol/l of EPA (P value <0·01), whereas an increase of 10 nmol/l of tHcy in males produces a decrease of 2·06 µmol/l of DHA (P value <0·05). Positive associations between B-vitamins and specific fatty acids might suggest underlying mechanisms between B-vitamins and CVD and it is worth the attention of public health policies.
The small red brocket deer Mazama bororo is endemic to the Brazilian Atlantic Forest, a biome that has been greatly fragmented and altered by human activities. This elusive species is morphologically similar to the red brocket deer Mazama americana and the Brazilian dwarf brocket deer Mazama nana, and genetic typing is necessary for reliable identification. To determine the geographical range of M. bororo more accurately, we conducted non-invasive genetic sampling using scat detection dogs trained to locate deer faeces. We surveyed 46 protected areas located within the species’ potential distribution and collected a total of 555 scat samples in 30 of the protected areas. Using a polymerase chain reaction–restriction fragment length polymorphism approach, we genotyped 497 scat samples (89%) and detected M. bororo in seven localities in three Brazilian states. The results support a range extension of the small red brocket deer to latitudes 23 and 28°S and longitudes 47 and 49°W. We show that the species’ distribution is associated with 37,517 km2 of the Ombrophilous Dense Forest in the Brazilian Atlantic Forest, and this conclusion is supported by species distribution modelling. The small red brocket deer is the largest endemic species in Brazil and may have the smallest geographical distribution of any Neotropical deer species. This species occupies fragmented landscapes and is threatened by human encroachment, poaching, and predation by dogs, and based on our findings we recommend policy intervention for conservation planning of the Ombrophilous Dense Forest.
Agroecology uses ecological processes and local resources rather than chemical inputs to develop productive and resilient livestock and crop production systems. In this context, breeding innovations are necessary to obtain animals that are both productive and adapted to a broad range of local contexts and diversity of systems. Breeding strategies to promote agroecological systems are similar for different animal species. However, current practices differ regarding the breeding of ruminants, pigs and poultry. Ruminant breeding is still an open system where farmers continue to choose their own breeds and strategies. Conversely, pig and poultry breeding is more or less the exclusive domain of international breeding companies which supply farmers with hybrid animals. Innovations in breeding strategies must therefore be adapted to the different species. In developed countries, reorienting current breeding programmes seems to be more effective than developing programmes dedicated to agroecological systems that will struggle to be really effective because of the small size of the populations currently concerned by such systems. Particular attention needs to be paid to determining the respective usefulness of cross-breeding v. straight breeding strategies of well-adapted local breeds. While cross-breeding may offer some immediate benefits in terms of improving certain traits that enable the animals to adapt well to local environmental conditions, it may be difficult to sustain these benefits in the longer term and could also induce an important loss of genetic diversity if the initial pure-bred populations are no longer produced. As well as supporting the value of within-breed diversity, we must preserve between-breed diversity in order to maintain numerous options for adaptation to a variety of production environments and contexts. This may involve specific public policies to maintain and characterize local breeds (in terms of both phenotypes and genotypes), which could be used more effectively if they benefited from the scientific and technical resources currently available for more common breeds. Last but not least, public policies need to enable improved information concerning the genetic resources and breeding tools available for the agroecological management of livestock production systems, and facilitate its assimilation by farmers and farm technicians.
Agroecology uses natural processes and local resources rather than chemical inputs to ensure production while limiting the environmental footprint of livestock and crop production systems. Selecting to achieve a maximization of target production criteria has long proved detrimental to fitness traits. However, since the 1990s, developments in animal breeding have also focussed on animal robustness by balancing production and functional traits within overall breeding goals. We discuss here how an agroecological perspective should further shift breeding goals towards functional traits rather than production traits. Breeding for robustness aims to promote individual adaptive capacities by considering diverse selection criteria which include reproduction, animal health and welfare, and adaptation to rough feed resources, a warm climate or fluctuating environmental conditions. It requires the consideration of genotype×environment interactions in the prediction of breeding values. Animal performance must be evaluated in low-input systems in order to select those animals that are adapted to limiting conditions, including feed and water availability, climate variations and diseases. Finally, we argue that there is no single agroecological animal type, but animals with a variety of profiles that can meet the expectations of agroecology. The standardization of both animals and breeding conditions indeed appears contradictory to the agroecological paradigm that calls for an adaptation of animals to local opportunities and constraints in weakly artificialized systems tied to their physical environment.
Carbon nanotubes (CNTs) were synthesized by Chemical Vapor Deposition (CVD) from diethyl ether, butanol, hexane and ethyl acetate. A quartz tube with a stainless steel tube catalyst core with 0.019 m diameter and 0.6 m large formed the reactor. To avoid combustion, argon was used as the carrier gas. Time process ranged 30 to 60 min. The range of CNTs synthesis temperature was 680-850 °C for different precursors. Scanning Electron Microscopy micrographs have demonstrated tangled CNTs growth in all samples, thus presenting difficult length measurement. The CNTs diameters from diethyl ether are 45-200 nm, butanol diameter range from 55-230 nm, hexane diameter range is 50-130 nm and ethyl acetate range from 100 to 300 nm. Carbon content for all samples was higher than 93 %, CNTs from butanol showed carbon concentration up to 99%. FTIR, Raman and X-Ray Spectroscopies spectra for all samples demonstrated the characteristics signals present in carbon nanotubes. This research proposes a simple, effective and innovative method to synthesize CNTs by CVD on iron stainless steel catalyst in combination with diethyl ether, ethyl acetate, butanol and hexane as precursors by applying the principles of green chemistry, sustainability and its ease to be scaled.
RZ Cas is an Algol-type eclipsing binary system where the primary component was recently discovered as a δ Set pulsator. A three-continent multisite photometric campaign was carried out during 1999. Preliminary results are reported here indicating a semi-detached system where the secondary fills its Roche lobe. The light curves also suggest a hot spot on the surface of the primary component as a consequence of the impact of the mass stream from the secondary. The pulsational behaviour can be well described with only one frequency.
Dendrochronological studies are limited in tropical regions because not many tree species form annual growth rings. This work reports an evaluation of the dendrochronological potential of tropical ash (Fraxinus uhdei) and its use as a bioindicator of fossil CO2 concentration in urban areas by means of radiocarbon analysis on growth rings. We analyzed a cross-section of a tree that grew during the period 1932–2007 in San Luis Potosí, one of the most industrialized cities in Mexico. The Δ14C values obtained follow the same variation pattern as the calibration curve of the Northern Hemisphere (NH) zone 2 (Hua and Barbetti 2004), with the peak centered in 1964, but they are lower by up to 124′. The high correlation coefficient (r = 0.990, p < 0.001) between the variation patterns indicates that this species does form annual growth rings, and the lower values can be attributed to the 14C dilution caused by fossil CO2 emissions. The magnitude of the Suess effect varied between −6.9% and −0.5%, equivalent to fossil CO2 concentrations ranging between 21.9 and 1.5 ppmv. The Suess effect and fossil CO2 values have significant variations with no apparent monotone increasing trend, suggesting that the CO2 emissions during the studied period have diverse sources. It is concluded that F. uhdei has potential for dendrochronological studies in tropical areas because its growth rings are formed annually and, furthermore, it can be used as a bioindicator of atmospheric 14C variations and fossil CO2 concentration in urban areas.
Few randomised clinical trials have examined the efficacy of an
intervention aimed at improving psychosocial functioning in bipolar
To examine changes in psychosocial functioning in a group that has been
enrolled in a functional remediation programme 1 year after baseline.
This was a multicentre, randomised, rater-masked clinical trial comparing
three patient groups: functional remediation, psychoeducation and
treatment as usual over 1-year follow-up. The primary outcome was change
in psychosocial functioning measured by means of the Functioning
Assessment Short Test (FAST). Group×time effects for overall psychosocial
functioning were examined using repeated-measures ANOVA (trial
There was a significant group×time interaction for overall psychosocial
functioning, favouring patients in the functional remediation group
(F = 3.071, d.f. = 2, P =
Improvement in psychosocial functioning is maintained after 1-year
follow-up in patients with bipolar disorder receiving functional
Lolium rigidum L. (rigid ryegrass) is one of the most extensive and harmful weeds in winter cereal crops. A bioclimatic model for this species was developed using CLIMEX. The model was validated with records from North America and Oceania and used to assess the global potential distribution of L. rigidum under the current climate and under two climate change scenarios. Both scenarios represent contrasting temporal patterns of economic development and carbon dioxide (CO2) emissions. The projections under current climatic conditions indicated that L. rigidum does not occupy the full extent of the climatically suitable area available to it. Under future climate scenarios, the suitable potential area increases by 3·79% in the low-emission CO2 scenario and by 5·06% under the most extreme scenario. The model's projection showed an increase in potentially suitable areas in North America, Europe, South America and Asia; while in Africa and Oceania it indicated regression. These results provide the necessary knowledge for identifying and highlighting the potential invasion risk areas and for establishing the grounds on which to base the planning and management measures required.
Functional remediation is a novel intervention with demonstrated efficacy at improving functional outcome in euthymic bipolar patients. However, in a previous trial no significant changes in neurocognitive measures were detected. The objective of the present analysis was to test the efficacy of this therapy in the enhancement of neuropsychological functions in a subgroup of neurocognitively impaired bipolar patients.
A total of 188 out of 239 DSM-IV euthymic bipolar patients performing below two standard deviations from the mean of normative data in any neurocognitive test were included in this subanalysis. Repeated-measures analyses of variance were conducted to assess the impact of the treatment arms [functional remediation, psychoeducation, or treatment as usual (TAU)] on participants’ neurocognitive and functional outcomes in the subgroup of neurocognitively impaired patients.
Patients receiving functional remediation (n = 56) showed an improvement on delayed free recall when compared with the TAU (n = 63) and psychoeducation (n = 69) groups as shown by the group × time interaction at 6-month follow-up [F2,158 = 3.37, degrees of freedom (df) = 2, p = 0.037]. However, Tukey post-hoc analyses revealed that functional remediation was only superior when compared with TAU (p = 0.04), but not with psychoeducation (p = 0.10). Finally, the patients in the functional remediation group also benefited from the treatment in terms of functional outcome (F2,158 = 4.26, df = 2, p = 0.016).
Functional remediation is effective at improving verbal memory and psychosocial functioning in a sample of neurocognitively impaired bipolar patients at 6-month follow-up. Neurocognitive enhancement may be one of the active ingredients of this novel intervention, and, specifically, verbal memory appears to be the most sensitive function that improves with functional remediation.