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Pigweed is difficult to manage in grain sorghum because of widespread herbicide resistance, a limited number of registered effective herbicides, and the synchronous emergence of pigweed with grain sorghum in Kansas. The combination of cultural and mechanical control tactics with an herbicide program are commonly recognized as best management strategies; however, limited information is available to adapt these strategies to dryland systems. Our objective for this research was to assess the influence of four components, including a winter wheat cover crop (CC), row-crop cultivation, three row widths, with and without a herbicide program, on pigweed control in a dryland system. Field trials were implemented during 2017 and 2018 at three locations for a total of 6 site-years. The herbicide program component resulted in excellent control (>97%) in all treatments at 3 and 8 weeks after planting (WAP). CC provided approximately 50% reductions in pigweed density and biomass for both timings in half of the site-years; however, mixed results were observed in the remaining site-years, ranging from no attributable difference to a 170% increase in weed density at 8 WAP in 1 site-year. Treatments including row-crop cultivation reduced pigweed biomass and density in most site-years 3 and 8 WAP. An herbicide program is required to achieve pigweed control and should be integrated with row-crop cultivation or narrow row widths to reduce the risk of herbicide resistance. Additional research is required to optimize the use of CC as an integrated pigweed management strategy in dryland grain sorghum.
Successful pigweed management requires an integrated strategy to delay the development of resistance to any single control tactic. Field trials were implemented during 2017 and 2018 in three counties in Kansas on dryland (limited rainfall, nonirrigated), glufosinate-resistant soybean. The objective was to assess pigweed control with combinations of a winter wheat cover crop (CC), three soybean row widths (76, 38, and 19 cm), row-crop cultivation 2.5 weeks after planting (WAP), and an herbicide program to develop integrated pigweed management recommendations. All combinations of the four components were assessed by 16 treatments. All treatments with the herbicide program resulted in excellent (>97%) pigweed control and were analyzed separately from the other components. Treatments containing row-crop cultivation reduced pigweed density and biomass 3 and 8 WAP in all locations compared with the 76-cm row width plus no CC treatment. CC impacts were mixed. In Riley County, Palmer amaranth density and biomass were reduced; in Reno County, no additional Palmer amaranth control was observed; in Franklin County, the CC had greater waterhemp density and biomass compared with the treatments containing no CC. Narrow row widths achieved the most consistent results of all cultural components when data were pooled across locations: Decreasing row widths from 76 to 38 cm resulted in a 23% reduction in pigweed biomass 8 WAP and decreasing row width from 38 to 19 cm achieved a 15% reduction. Row-crop cultivation should be incorporated where possible as a mechanical option to manage pigweed, and narrow row widths should be used to suppress late-season pigweed growth when feasible. Inconsistent pigweed control from CC was achieved and should be given special consideration before implementation. The integral use of these components with an herbicide program as a system should be recommended to achieve the best pigweed control and reduce the risk of developing herbicide resistance.
Despite United States national learning objectives referencing research fundamentals and the critical appraisal of medical literature, many paramedic programs are not meeting these objectives with substantive content.
The objective was to develop and implement a journal club educational module for paramedic training programs, which is all-inclusive and could be distributed to Emergency Medical Services (EMS) educators and EMS medical directors to use as a framework to adapt to their program.
Four two-hour long journal club sessions were designed. First, the educator provided students with four types of articles on a student-chosen topic and discussed differences in methodology and structures. Next, after a lecture about peer-review, students used search engines to verify references of a trade magazine article. Third, the educator gave a statistics lecture and critiqued the results section of several articles found by students on a topic. Finally, students found an article on a topic of personal interest and presented it to their classmates, as if telling their paramedic partner about it at work. Before and after the series, students from two cohorts (2017, 2018) completed a survey with questions about demographics and perceptions of research. Students from one cohort (2017) received a follow-up survey one year later.
For the 2016 cohort, 13 students participated and provided qualitative feedback. For the 2017 and 2018 cohorts, 33 students participated. After the series, there was an increased self-reported ability to find, evaluate, and apply medical research articles, as well as overall positive trending opinions of participating in and the importance of prehospital research. This ability was demonstrated by every student during the final journal club session. McNemar’s and Related-Samples Cochran’s Q testing of questionnaire responses suggested a statistically significant improvement in student approval of exceptions from informed consent.
The framework for this paramedic journal club series could be adapted by EMS educators and medical directors to enable paramedics to search for, critically appraise, and discuss the findings of medical literature.
To evaluate the association between novel pre- and post-operative biomarker levels and 30-day unplanned readmission or mortality after paediatric congenital heart surgery.
Children aged 18 years or younger undergoing congenital heart surgery (n = 162) at Johns Hopkins Hospital from 2010 to 2014 were enrolled in the prospective cohort. Collected novel pre- and post-operative biomarkers include soluble suppression of tumorgenicity 2, galectin-3, N-terminal prohormone of brain natriuretic peptide, and glial fibrillary acidic protein. A model based on clinical variables from the Society of Thoracic Surgery database was developed and evaluated against two augmented models.
Unplanned readmission or mortality within 30 days of cardiac surgery occurred among 21 (13%) children. The clinical model augmented with pre-operative biomarkers demonstrated a statistically significant improvement over the clinical model alone with a receiver-operating characteristics curve of 0.754 (95% confidence interval: 0.65–0.86) compared to 0.617 (95% confidence interval: 0.47–0.76; p-value: 0.012). The clinical model augmented with pre- and post-operative biomarkers demonstrated a significant improvement over the clinical model alone, with a receiver-operating characteristics curve of 0.802 (95% confidence interval: 0.72–0.89; p-value: 0.003).
Novel biomarkers add significant predictive value when assessing the likelihood of unplanned readmission or mortality after paediatric congenital heart surgery. Further exploration of the utility of these novel biomarkers during the pre- or post-operative period to identify early risk of mortality or readmission will aid in determining the clinical utility and application of these biomarkers into routine risk assessment.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.
This user-friendly textbook introduces complex analysis at the beginning graduate or advanced undergraduate level. Unlike other textbooks, it follows Weierstrass' approach, stressing the importance of power series expansions instead of starting with the Cauchy integral formula, an approach that illuminates many important concepts. This view allows readers to quickly obtain and understand many fundamental results of complex analysis, such as the maximum principle, Liouville's theorem, and Schwarz's lemma. The book covers all the essential material on complex analysis, and includes several elegant proofs that were recently discovered. It includes the zipper algorithm for computing conformal maps, as well as a constructive proof of the Riemann mapping theorem, and culminates in a complete proof of the uniformization theorem. Aimed at students with some undergraduate background in real analysis, though not Lebesgue integration, this classroom-tested textbook will teach the skills and intuition necessary to understand this important area of mathematics.