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Hurricane Maria caused catastrophic damage in Puerto Rico, increasing the risk for morbidity and mortality in the post-impact period. We aimed to establish a syndromic surveillance system to describe the number and type of visits at 2 emergency health-care settings in the same hospital system in Ponce, Puerto Rico.
We implemented a hurricane surveillance system by interviewing patients with a short questionnaire about the reason for visit at a hospital emergency department and associated urgent care clinic in the 6 mo after Hurricane Maria. We then evaluated the system by comparing findings with data from the electronic medical record (EMR) system for the same time period.
The hurricane surveillance system captured information from 5116 participants across the 2 sites, representing 17% of all visits captured in the EMR for the same period. Most visits were associated with acute illness/symptoms (79%), followed by injury (11%). The hurricane surveillance and EMR data were similar, proportionally, by sex, age, and visit category.
The hurricane surveillance system provided timely and representative data about the number and type of visits at 2 sites. This system, or an adapted version using available electronic data, should be considered in future disaster settings.
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.
From simple averaging to more sophisticated registration and restoration strategies, such as super-resolution (SR), there exist different computational techniques that use a series of images of the same object to generate enhanced images where noise and other distortions have been reduced. In this work, we provide qualitative and quantitative measurements of this enhancement for high-angle annular dark-field scanning transmission electron microscopy imaging. These images are compared in two ways, qualitatively through visual inspection in real and reciprocal space, and quantitatively, through the calculation of objective measurements, such as signal-to-noise ratio and atom column roundness. Results show that these techniques improve the quality of the images. In this paper, we use an SR methodology that allows us to take advantage of the information present in the image frames and to reliably facilitate the analysis of more difficult regions of interest in experimental images, such as surfaces and interfaces. By acquiring a series of cross-sectional experimental images of magnetite (Fe3O4) thin films (111), we have generated interpolated images using averaging and SR, and reconstructed the atomic structure of the very top surface layer that consists of a full monolayer of Fe, with topmost Fe atoms in tetrahedrally coordinated sites.
The disease caused by the influenza virus is a global public health problem due to its high rates of morbidity and mortality. Thus, analysis of the information generated by epidemiological surveillance systems has vital importance for health decision making. A retrospective analysis was performed using data generated by the four molecular diagnostic laboratories of the Mexican Social Security Institute between 2010 and 2016. Demographics, influenza positivity, seasonality, treatment choices and vaccination status analyses were performed for the vaccine according to its composition for each season. In all cases, both the different influenza subtypes and different age groups were considered separately. The circulation of A/H1N1pdm09 (48.7%), influenza A/H3N2 (21.1%), influenza B (12.6%), influenza A not subtyped (11%) and influenza A/H1N1 (6.6%) exhibited well-defined annual seasonality between November and March, and there were significant increases in the number of cases every 2 years. An inadequate use of oseltamivir was determined in 38% of cases, and the vaccination status in general varied between 12.1 and 18.5% depending on the season. Our results provide current information about influenza in Mexico and demonstrate the need to update both operational case definitions and medical practice guidelines to reduce the inappropriate use of antibiotics and antivirals.
Physical punishment of children is linked to negative developmental outcomes. The widely used Positive Parenting Program (Triple P) promotes alternative responses to physical punishment. Data on the effectiveness of the Triple P Seminar Series is limited. In this study, Canadian parents’ reports of physical punishment, non-physical punishment, and non-punitive responses were compared before and after they attended the Triple P Seminar Series. Twenty-seven parents of children aged 2 to 6 years attended the Seminar Series and completed pre- and post-intervention questionnaires measuring the number of times they used various physical punishments, non-physical punishments, and non-punitive responses in the past month. Hypotheses were tested using univariate descriptive analyses, paired samples t tests, and Wilcoxon Signed Rank Tests. Parents’ reports of physical punishment decreased on only one of the four physical punishment items (shaking/grabbing) from pre- to post-intervention. Over the course of the Seminar Series, parents became more likely to emphasise rules and to punish their children by taking things away from them. The findings suggest that the Seminar Series has limited effectiveness in reducing physical punishments or increasing non-punitive responses. Further research on this question is needed.
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.
The climate of north-western Spain, with high temperatures and relative humidity during the grapevine vegetative cycle, can especially favour the development of fungal diseases in vineyards. One of the most important diseases is downy mildew, caused by the fungus Plasmopara viticola. The aim of the current study is to propose a system containing phenological data, biological sensors of pathogen indicator and the agrometeorological Goidanich Index in order to optimize the application of downy mildew fungicide treatments. The study was conducted in a vineyard of the ‘Ribeiro’ Designation of Origin region from 2005 to 2016 during the Vitis vegetative period. Aerobiological sampling was performed using a LANZONI VPPS-2000 volumetric trap. The highest number of infection cycles was recorded during the 2009 harvest, with a total of 16 cycles. Years with fewer infection cycles were 2008, 2011 and 2012 (13 cycles). Primary infections were produced during the third fortnight of April and a high amount of secondary infection cycles were detected by the Goidanich algorithm during the fruit development and berry ripening stages. The best estimators of the P. viticola spore concentrations were the fungus spore levels during the previous day, the average temperature 5 days before and rainfall 2 days before. The regression equation obtained accounted for the 95.9% of the spore concentration variation. The combination of the Goidanich index and biological sensors provides a valuable tool to establish an accurate, modern, integrated downy mildew pest-management strategy.
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.
OBJECTIVES/SPECIFIC AIMS: High-grade serous ovarian carcinoma (HGSOC) is the most common and malignant histological subtype of epithelial ovarian cancer. While the majority of HGSOC patients initially respond to platinum-based chemotherapy, they often present with recurrent chemoresistant disease, which is extremely fatal. Therefore, there is an urgent need to identify predictive biomarkers of platinum response and to develop rational, targeted therapies to improve the outcome of patients with HGSOC. The objectives of the present study are to profile and assess the clinical significance of MYC network dysregulation in HGSOC. METHODS/STUDY POPULATION: We will conduct a retrospective cohort study of Puerto Rican Hispanics with HGSOC who underwent surgery followed by platinum-based chemotherapy at clinical institutions in Puerto Rico. Medical records, pathology reports, and cancer registries will be reviewed to extract data on clinicopathological features, disease recurrence, and death. For eligible patients, formalin-fixed, paraffin-embedded (FFPE) tissue samples will be processed and analyzed by quantitative Real Time PCR (qRT-PCR) and immunohistochemistry (IHC). RESULTS/ANTICIPATED RESULTS: Expression levels of MYC and MYC-related molecules are expected to correlate with clinicopathological features and prognosis of HGSOC. DISCUSSION/SIGNIFICANCE OF IMPACT: The identification and validation of clinically-relevant alterations in HGSOC, such as dysregulation of the MYC network, will be crucial to guide therapy regimen, maximize clinical benefit, and improve patient outcome.
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.
Thermoelectric (TE) thin films have promise for harvesting electrical energy from waste heat. We demonstrate TE materials and thermocouples deposited by aqueous spray deposition on glass. The n-type material was CdO doped with Mn and Sn. Two p-type materials were investigated, namely PbS with co-growth of CdS and doped with Na and Na2CoO4. Seebeck coefficients, resistivity, and power generation for thermocouples were characterized.
With the recent discovery of a dozen dusty star-forming galaxies and around 30 quasars at z > 5 that are hyper-luminous in the infrared (μ LIR > 1013 L⊙, where μ is a lensing magnification factor), the possibility has opened up for SPICA, the proposed ESA M5 mid-/far-infrared mission, to extend its spectroscopic studies toward the epoch of reionisation and beyond. In this paper, we examine the feasibility and scientific potential of such observations with SPICA’s far-infrared spectrometer SAFARI, which will probe a spectral range (35–230 μm) that will be unexplored by ALMA and JWST. Our simulations show that SAFARI is capable of delivering good-quality spectra for hyper-luminous infrared galaxies at z = 5 − 10, allowing us to sample spectral features in the rest-frame mid-infrared and to investigate a host of key scientific issues, such as the relative importance of star formation versus AGN, the hardness of the radiation field, the level of chemical enrichment, and the properties of the molecular gas. From a broader perspective, SAFARI offers the potential to open up a new frontier in the study of the early Universe, providing access to uniquely powerful spectral features for probing first-generation objects, such as the key cooling lines of low-metallicity or metal-free forming galaxies (fine-structure and H2 lines) and emission features of solid compounds freshly synthesised by Population III supernovae. Ultimately, SAFARI’s ability to explore the high-redshift Universe will be determined by the availability of sufficiently bright targets (whether intrinsically luminous or gravitationally lensed). With its launch expected around 2030, SPICA is ideally positioned to take full advantage of upcoming wide-field surveys such as LSST, SKA, Euclid, and WFIRST, which are likely to provide extraordinary targets for SAFARI.
This work combines very detailed measurements from terrestrial laser scanner (TLS), ground-based interferometry radar (GB-SAR) and ground-penetrating radar (GPR) to diagnose current conditions and to analyse the recent evolution of the Monte Perdido Glacier in the Spanish Pyrenees from 2011 to 2017. Thus, this is currently one of the best monitored small glacier (<0.5 km2) worldwide. The evolution of the glacier surface was surveyed with a TLS evidencing an important decline of 6.1 ± 0.3 m on average, with ice losses mainly concentrated over 3 years (2012, 2015 and 2017). Ice loss is unevenly distributed throughout the study period, with 10–15 m thinning in some areas while unchanged areas in others. GB-SAR revealed that areas with higher ice losses are those that are currently with no or very low ice motion. In contrast, sectors located beneath the areas with less ice loss are those that still exhibit noticeable ice movement (average 2–4.5 cm d─1 in summer, and annual movement of 9.98 ma─1 from ablation stakes data). GPR informed that ice thickness was generally <30 m, though locally 30–50 m. Glacier thinning is still accelerating and will lead to extinction of the glacier over the next 50 years.
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.