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Disaster Medicine (DM) education for Emergency Medicine (EM) residents is highly variable due to time constraints, competing priorities, and program expertise. The investigators’ aim was to define and prioritize DM core competencies for EM residency programs through consensus opinion of experts and EM professional organization representatives.
Investigators utilized a modified Delphi methodology to generate a recommended, prioritized core curriculum of 40 DM educational topics for EM residencies.
The DM topics recommended and outlined for inclusion in EM residency training included: patient triage in disasters, surge capacity, introduction to disaster nomenclature, blast injuries, hospital disaster mitigation, preparedness, planning and response, hospital response to chemical mass-casualty incident (MCI), decontamination indications and issues, trauma MCI, disaster exercises and training, biological agents, personal protective equipment, and hospital response to radiation MCI.
This expert-consensus-driven, prioritized ranking of DM topics may serve as the core curriculum for US EM residency programs.
The provision of artificial nests can improve the conservation status of threatened bird species that are limited by nest-site availability. The shortage of natural cavity nesting sites is one factor limiting the population growth of the Southern Ground Hornbill Bucorvus leadbeateri. In an 1,800 km2 study area in north-eastern South Africa, 31 wooden nest-boxes were installed during 2002–2015. We investigated the relationships between nests, as well as environmental and social factors, with breeding. Generalised linear mixed models were fitted to the observational data and identified positive relationships between breeding attempts and each of home range size and the previous year’s rainfall; as well as positive relationships between breeding success (amongst the groups that attempt breeding) and each of earlier breeding, nest height and thickness of the nest cavity wall. The provision of nest-boxes increased the number of breeding groups and although breeding success also increased initially, it later declined as the density of breeding groups increased above 20 groups. Although nest-boxes alone did not increase overall breeding success, they are an effective conservation tool to enhance the population of Southern Ground Hornbills if spaced optimally, to enhance reproductive output in areas where suitable nest-sites are scarce or lacking.
Concentrate inclusion levels in dairy cow diets are often adjusted so that the milk yield responses remain economic. While changes in concentrate level on performance is well known, their impact on other biological parameters, including immune function, is less well understood. The objective of this study was to evaluate the effect of concentrate inclusion level in a grass silage-based mixed ration on immune function. Following calving 63 (45 multiparous and 18 primiparous) Holstein Friesian dairy cows were allocated to one of three isonitrogenous diets for the first 70 days of lactation. Diets comprised of a mixture of concentrates and grass silage, with concentrates comprising either a low (30%, LC), medium (50%, MC) or high (70%, HC) proportion of the diet on a dry matter (DM) basis. Daily DM intakes, milk yields and BW were recorded, along with weekly body condition score, milk composition and vaginal mucus scores. Blood biochemistry was measured using a chemistry analyzer, neutrophil phagocytic and oxidative burst assessed using commercial kits and flow cytometry, and interferon-γ production evaluated by ELISA after whole blood stimulation. Over the study period cows on HC had a higher total DM intake, milk yield, fat yield, protein yield, fat+protein yield, protein content, mean BW and mean daily energy balance, and a lower BW loss than cows on MC, whose respective values were higher than cows on LC. Cows on HC and MC had a lower serum non-esterified fatty acid concentration than cows on LC (0.37, 0.37 and 0.50 mmol/l, respectively, P=0.005, SED=0.032), while cows on HC had a lower serum β-hydroxybutyrate concentration than cows on MC and LC (0.42, 0.55 and 0.55 mmol/l, respectively, P=0.002, SED=0.03). Concentrate inclusion level had no effect on vaginal mucus scores. At week 3 postpartum, cows on HC tended to have a higher percentage of oxidative burst positive neutrophils than cows on LC (43.2% and 35.3%, respectively, P=0.078, SED=3.11), although at all other times concentrate inclusion level in the total mixed ration had no effect on neutrophil phagocytic or oxidative burst characteristics, or on interferon-γ production by pokeweed mitogen stimulated whole blood culture. This study demonstrates that for high yielding Holstein Friesian cows managed on a grass silage-based diet, concentrate inclusion levels in early lactation affects performance but has no effect on neutrophil or lymphocyte immune parameters.
Replication is already mainstream in areas of psychology that use small-N designs. Replication failures often result from weak theory, weak measurement, and weak control over error variance. These are hallmarks of phenomenon-based research with sparse data. Small-N designs, which focus on understanding processes, treat the individual rather than the experiment as the unit of replication and largely circumvent these problems.
The present study evaluated the behaviour of the AusBeef model for beef production as part of a 2 × 2 study simulating performance on forage-based and concentrate-based diets from Oceania and North America for four methane (CH4)-relevant outputs of interest. Three sensitivity analysis methods, one local and two global, were conducted. Different patterns of sensitivity were observed between forage-based and concentrate-based diets, but patterns were consistent within diet types. For the local analysis, 36, 196, 47 and 8 out of 305 model parameters had normalized sensitivities of 0, >0, >0·01 and >0·1 across all diets and outputs, respectively. No parameters had a normalized local sensitivity >1 across all diets and outputs. However, daily CH4 production had the greatest number of parameters with normalized local sensitivities >1 for each individual diet. Parameters that were highly sensitive for global and local analyses across the range of diets and outputs examined included terms involved in microbial growth, volatile fatty acid (VFA) yields, maximum absorption rates and their inhibition due to pH effects and particle exit rates. Global sensitivity analysis I showed the high sensitivity of forage-based diets to lipid entering the rumen, which may be a result of the use of a feedlot-optimized model to represent high-forage diets and warrants further investigation. Global sensitivity analysis II showed that when all parameter values were simultaneously varied within ±10% of initial value, >96% of output values were within ±20% of the baseline, which decreased to >50% when parameter value boundaries were expanded to ±25% of their original values, giving a range for robustness of model outputs with regards to potential different ‘true’ parameter values. There were output-specific differences in sensitivity, where outputs that had greater maximum local sensitivities displayed greater degrees of non-linear interaction in global sensitivity analysis I and less variance in output values for global sensitivity analysis II. For outputs with less interaction, such as the acetate : propionate ratio and microbial protein production, the single most sensitive term in global sensitivity analysis I contributed more to the overall total-order sensitivity than for outputs with more interaction, with an average of 49, 33, 15 and 14% of total-order sensitivity for microbial protein production, acetate : propionate ratio, CH4 production and energy from absorbed VFAs, respectively. Future studies should include data collection for highly sensitive parameters reported in the present study to improve overall model accuracy.
As demand for animal products, such as meat and milk, increases, and concern over environmental impact grows, mechanistic models can be useful tools to better represent and understand ruminant systems and evaluate mitigation options to reduce greenhouse gas emissions without compromising productivity. The objectives of the present study were to describe the representation of processes for growth and enteric methane (CH4) production in AusBeef, a whole-animal, dynamic, mechanistic model for beef production; evaluate AusBeef for its ability to predict daily methane production (DMP, g/day), gross energy intake (GEI, MJ/day) and methane yield (MJ CH4/MJ GEI) using an independent data set; and to compare AusBeef estimates to those from the empirical equations featured in the current National Academies of Sciences, Engineering and Medicine (NASEM, 2016) beef cattle requirements for growth and the Ruminant Nutrition System (RNS), a dynamic, mechanistic model of Tedeschi & Fox, 2016. AusBeef incorporates a unique fermentation stoichiometry that represents four microbial groups: protozoa, amylolytic bacteria, cellulolytic bacteria and lactate-utilizing bacteria. AusBeef also accounts for the effects of ruminal pH on microbial degradation of feed particles. Methane emissions are calculated from net ruminal hydrogen balance, which is defined as the difference between inputs from fermentation and outputs due to microbial use and biohydrogenation. AusBeef performed similarly to the NASEM empirical model in terms of prediction accuracy and error decomposition, and with less root mean square predicted error (RMSPE) than the RNS mechanistic model when expressed as a percentage of the observed mean (RMSPE, %), and the majority of error was non-systematic. For DMP, RMSPE for AusBeef, NASEM and RNS were 24·0, 19·8 and 50·0 g/day for the full data set (n = 35); 25·6, 18·2 and 56·2 g/day for forage diets (n = 19); and 21·8, 21·5 and 41·5 g/day for mixed diets (n = 16), respectively. Concordance correlation coefficients (CCC) were highest for GEI, with all models having CCC > 0·66, and higher CCC for forage diets than mixed, while CCC were lowest for MY, particularly forage diets. Systematic error increased for all models on forage diets, largely due to an increase in error due to mean bias, and while all models performed well for mixed diets, further refinements are required to improve the prediction of CH4 on forage diets.
Much of the evidence for theories in visual search (including Hulleman & Olivers' [H&O's]) comes from inferences made using changes in mean RT as a function of the number of items in a display. We have known for more than 40 years that these inferences are based on flawed reasoning and obscured by model mimicry. Here we describe a method that avoids these problems.
This paper analyzes in detail the role of environmental and economic shocks in the migration of the 1930s. The 1940 US Census of Population asked every inhabitant where they lived five years earlier, a unique source for understanding migration flows and networks. Earlier research documented migrant origins and destinations, but we will show how short-term and annual weather conditions at sending locations in the 1930s explain those flows, and how they operated through agricultural success. Beyond demographic data, we use data about temperature and precipitation, plus data about agricultural production from the agricultural census. The widely known migration literature for the 1930s describes an era of relatively low migration, with much of the migration that did occur radiating outward from the Dust Bowl region and the cotton South. Our work about the complete United States will provide a fuller examination of migration in this socially and economically important era.
This study aimed to review available disaster training options for health care providers, and to provide specific recommendations for developing and delivering a disaster-response-training program for non-disaster-trained emergency physicians, residents, and trainees prior to acute deployment.
A comprehensive review of the peer-reviewed and grey literature of the existing training options for health care providers was conducted to provide specific recommendations.
A comprehensive search of the Pubmed, Embase, Web of Science, Scopus, and Cochrane databases was performed to identify publications related to courses for disaster preparedness and response training for health care professionals. This search revealed 7,681 unique titles, of which 53 articles were included in the full review. A total of 384 courses were found through the grey literature search, and many of these were available online for no charge and could be completed in less than six hours. The majority of courses focused on management and disaster planning; few focused on clinical care and acute response.
There is need for a course that is targeted toward emergency physicians and trainees without formal disaster training. This course should be available online and should utilize a mix of educational modalities, including lectures, scenarios, and virtual simulations. An ideal course should focus on disaster preparedness, and the clinical and non-clinical aspects of response, with a focus on an all-hazards approach, including both terrorism-related and environmental disasters.
HansotiB, KelloggDS, AberleSJ, BroccoliMC, FedenJ, FrenchA, LittleCM, MooreB, SabatoJJr., SheetsT, WeinbergR, ElmesP, KangC. Preparing Emergency Physicians for Acute Disaster Response: A Review of Current Training Opportunities in the US. Prehosp Disaster Med. 2016;31(6):643–647.
The Cycadales are a group of significant global conservation concern and have the highest extinction risk of all seed plants. Understanding the synchronisation of reproductive phenology of Cycadales may be useful for conservation by enabling the targeting of pollen and seed collection from wild populations and identifying the window of fertilisation to aid in the cultivation of Cycadales. Phenological data for 11 species of Zamia were gathered from herbarium specimens. Four phenological characters were coded with monthly character states. DNA was isolated and sequenced for 26S, CAB, NEEDLY, matK and rbcL, and a simultaneous phylogenetic analysis of phenology and DNA sequence data was carried out. Three major clades were recovered: a Caribbean clade, a Central American clade and a South American clade. Eight species showed statistically significant synchronisation in microsporangiate and ovulate phenological phases, indicating the time of fertilisation. Close reproductive synchronisation was consistently observed throughout the Caribbean clade (statistically significant in four of five species) but was less consistent in the Central American clade (statistically significant in one of two species) and South American clade (statistically significant in three of four species). Ultimately, phenology is shown to be a potential driver of speciation in some clades of Zamia and in others to be a potential barrier to hybridisation.
The status and potential of aquaculture is considered as part of a broader food landscape of wild aquatic and terrestrial food sources. The rationale and resource base required for the development of aquaculture are considered in the context of broader societal development, cultural preferences and human needs. Attention is drawn to the uneven development and current importance of aquaculture globally as well as its considerable heterogeneity of form and function compared with established terrestrial livestock production. The recent drivers of growth in demand and production are examined and the persistent linkages between exploitation of wild stocks, full life cycle culture and the various intermediate forms explored. An emergent trend for sourcing aquaculture feeds from alternatives to marine ingredients is described and the implications for the sector with rapidly growing feed needs discussed. The rise of non-conventional and innovative feed ingredients, often shared with terrestrial livestock, are considered, including aquaculture itself becoming a major source of marine ingredients. The implications for the continued expected growth of aquaculture are set in the context of sustainable intensification, with the challenges that conventional intensification and emergent integration within, and between, value chains explored. The review concludes with a consideration of the implications for dependent livelihoods and projections for various futures based on limited resources but growing demand.
The number and size of free-range laying hen (Gallus gallus domesticus) production systems are increasing within Australia in response to consumer demand for perceived improvement in hen welfare. However, variation in outdoor stocking density has generated consumer dissatisfaction leading to the development of a national information standard on free-range egg labelling by the Australian Consumer Affairs Ministers. The current Australian Model Code of Practice for Domestic Poultry states a guideline of 1500 hens/ha, but no maximum density is set. Radio-frequency identification (RFID) tracking technology was used to measure daily range usage by individual ISA Brown hens housed in six small flocks (150 hens/flock – 50% of hens tagged), each with access to one of three outdoor stocking density treatments (two replicates per treatment: 2000, 10 000, 20 000 hens/ha), from 22 to 26, 27 to 31 and 32 to 36 weeks of age. There was some variation in range usage across the sampling periods and by weeks 32 to 36 individual hens from the lowest stocking density on average used the range for longer each day (P<0.001), with fewer visits and longer maximum durations per visit (P<0.001). Individual hens within all stocking densities varied in the percentage of days they accessed the range with 2% of tagged hens in each treatment never venturing outdoors and a large proportion that accessed the range daily (2000 hens/ha: 80.5%; 10 000 hens/ha: 66.5%; 20 000 hens/ha: 71.4%). On average, 38% to 48% of hens were seen on the range simultaneously and used all available areas of all ranges. These results of experimental-sized flocks have implications for determining optimal outdoor stocking densities for commercial free-range laying hens but further research would be needed to determine the effects of increased range usage on hen welfare.
The circumstellar shells of M stars produce emission features due to amorphous silicates peaking around 10 and 18 μm, with additional emission at 11 μm due to crystalline olivine and at 13.1 μm (unknown carrier). C stars are associated with SiC dust emission at 11.2 μm with additional emission around 8.9 μm, whereas S stars have a relatively weak 10.5 μm emission feature which is due neither to silicates nor to SiC.
The strong unidentified radio source 1733-565 (≡ PKS 1733-56) was chosen as a test source during the commissioning of the Molonglo Observatory Synthesis Telescope (MOST) in 1981 July. Previous radio maps have been obtained at 1410 MHz with the Parkes interferometer (Schwarz et al. 1974), at 408 MHz with the Molonglo Cross (Schilizzi & McAdam 1975) and at 1415 MHz with the Fleurs Synthesis Telescope (Christiansen et al. 1977).
We have measured the excess IR emission from carbon mira and SR variable stars from IRAS LRS spectra. The 8-22μm excess is defined as the ratio of flux above a 2500K energy distribution fit to the LRS spectrum at about 8μm. The carbon star LRS spectra show both emission and absorption features, which are incorporated into our 8-22pm excess. The most prominent feature in carbon stars is the 11.2μm SiC dust emission feature extending from 10μm to 13.8 μm. We observe another emission feature of unknown origin which peaks between 8.4-8.7μm. The SiC emission feature is occasionally blended on the red side by an absorption feature (attributed to gaseous HCN + C2H2) which extends from about 12-16μm. Many of the spectra appear to turn down at the 8μm end due (?) to an HCN + C2H2 absorption feature located at 7.1μm. Carbon stars do not generally show as large an excess as the M mira variables do. The figure below shows our measured excesses for both carbon miras and carbon semi-regular variables. There appears to be little correlation of excess with period, however the mira variables show about twice the range of variation of excess that the semi-regular variables do. We find little correlation between our measured 8-22μm excess and the excesses of Jura (Ap. J., 303, 327, 1986) based on the ratio of 12μm flux to 2μm flux. Our data do support hi s conclusion that longer period variable stars show larger average excesses, but this is only true for mira variables in our analysis.
Tc is detected in many AGB stars providing unambiguous proof that recent nuclear s-processing and mixing (the third dredge-up) has taken place. During this evolutionary episode the atmospheres of AGB stars are progressively enhanced with helium burning products (primari ly l2C) and s-process elements as they evolve from M->MS->S->SC->C stars. The increase in s-process elements can be traced most easily by the presence and increasing strength of the Tc I lines accompanying this progression. We also find that the third dredge-up phase is accompanied by an increase in the amplitude of light variation since no non-variable or low amplitude variable M, MS, SC, or S (with one exception) have Tc lines. M star Mira variables show Tc if P > 300d (low mass Pop I stars). No Pop II star is known to have Tc. Nor do supergiants show Tc I lines. The significant fraction of MS, S and C stars that do not show Tc, are surmised to be cooler analogues to the Ba II stars, i.e. binaries. The source to provide the neutrons for the s-process is most likely the 13C(a, n)16O reaction since most of the stars in which we observe Tc are thought to have masses less than 3 solar masses.