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We examine the degree of consensus in quality ratings of prominent U.S. wine publications. For the purposes of wine consumption and research, are ratings on the ubiquitous 100-point scale reliable measures of quality? The value of expert judgment has been called into question by a number of studies, especially in the context of wine competitions and tasting events. Using data on 853 wines, we find a moderately high level of consensus, measured by the correlation coefficient, between most pairs of publications, similar to the level found by Ashton (2013). Rank and intraclass correlations are similar. Consensus is not found to be related to the blinding policies (or lack thereof) of the critical publications. (JEL Classifications: C93, D46)
Two new demosponges, Megaciella pituitosa and Cladocroce toxifera, are described from the Aleutian Islands, fostering our contention that the region is a hotspot of poriferan biodiversity. Seven of the thirteen species of Megaciella now known worldwide occur in the Sea of Okhotsk or around the Aleutian Islands. Similarly, five of the sixteen species of Cladocroce known worldwide occur in Alaska. Megaciella pituitosa sp. nov. possesses two categories of choanosomal styles and spicules of different sizes that differentiate it from all known congeners. Cladocroce toxifera sp. nov. differs from all known congeners by possessing toxa and an ectosomal tangential arrangement of oxeas.
A new species of Geodia is described from the North Pacific, collected in the summer of 2012 in the western Aleutian Islands. Geodia starki sp. nov. differs from all known species of Geodia by the possession of two categories of sterrasters and exceptionally large megascleres. The new species is compared with congeners of the North Pacific Ocean, Bering Sea, Arctic and the North Atlantic Oceans.
The present study investigated the relationship between the milk protein content of a rehydration solution and fluid balance after exercise-induced dehydration. On three occasions, eight healthy males were dehydrated to an identical degree of body mass loss (BML, approximately 1·8 %) by intermittent cycling in the heat, rehydrating with 150 % of their BML over 1 h with either a 60 g/l carbohydrate solution (C), a 40 g/l carbohydrate, 20 g/l milk protein solution (CP20) or a 20 g/l carbohydrate, 40 g/l milk protein solution (CP40). Urine samples were collected pre-exercise, post-exercise, post-rehydration and for a further 4 h. Subjects produced less urine after ingesting the CP20 or CP40 drink compared with the C drink (P< 0·01), and at the end of the study, more of the CP20 (59 (sd 12) %) and CP40 (64 (sd 6) %) drinks had been retained compared with the C drink (46 (sd 9) %) (P< 0·01). At the end of the study, whole-body net fluid balance was more negative for trial C ( − 470 (sd 154) ml) compared with both trials CP20 ( − 181 (sd 280) ml) and CP40 ( − 107 (sd 126) ml) (P< 0·01). At 2 and 3 h after drink ingestion, urine osmolality was greater for trials CP20 and CP40 compared with trial C (P< 0·05). The present study further demonstrates that after exercise-induced dehydration, a carbohydrate–milk protein solution is better retained than a carbohydrate solution. The results also suggest that high concentrations of milk protein are not more beneficial in terms of fluid retention than low concentrations of milk protein following exercise-induced dehydration.
The genus Histodermella grows to four species with the addition of H. kagigunensis sp. nov. from the North Pacific. The new species is described and compared with all congeners. Histodermella kagigunensis shows affinities to H. ingolfi Lundbeck 1910 as it has the same spicule types but differs clearly in size, habitus and the dimensions of two occurring spicule types. The discovery of H. kagigunensis represents the first record of the genus Histodermella in the North Pacific Ocean.
To identify risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) acquisition in long-term care facility (LTCF) residents.
Multicenter, prospective cohort followed over 6 months.
Three Veterans Affairs (VA) LTCFs.
All current and new residents except those with short stay (<2 weeks).
MRSA carriage was assessed by serial nares cultures and classified into 3 groups: persistent (all cultures positive), intermittent (at least 1 but not all cultures positive), and noncarrier (no cultures positive). MRSA acquisition was defined by an initial negative culture followed by more than 2 positive cultures with no subsequent negative cultures. Epidemiologic data were collected to identify risk factors, and MRSA isolates were typed by pulsed-field gel electrophoresis (PFGE).
Among 412 residents at 3 LTCFs, overall MRSA prevalence was 58%, with similar distributions of carriage at all 3 facilities: 20% persistent, 39% intermittent, 41% noncarriers. Of 254 residents with an initial negative swab, 25 (10%) acquired MRSA over the 6 months; rates were similar at all 3 LTCFs, with no clusters evident. Multivariable analysis demonstrated that receipt of systemic antimicrobials during the study was the only significant risk factor for MRSA acquisition (odds ratio, 7.8 [95% confidence interval, 2.1–28.6]; P = .002). MRSA strains from acquisitions were related by PFGE to those from a roommate in 9/25 (36%) cases; 6 of these 9 roommate sources were persistent carriers.
MRSA colonization prevalence was high at 3 separate VA LTCFs. MRSA acquisition was strongly associated with antimicrobial exposure. Roommate sources were often persistent carriers, but transmission from roommates accounted for only approximately one-third of MRSA acquisitions.
To obtain patient-generated data relating to the management of their chronic obstructive pulmonary disease (COPD) in Primary Care before hospitalisation with exacerbation.
Previous audits of COPD have shown high rates of hospital admission and readmission. There is significant interest in understanding the reasons so that useful preventative strategies may be developed. As part of the 2008 UK COPD audit, which comprised 9716 cases of COPD admission across 97% of acute units, we obtained a sample of patient-generated data to assess understanding of COPD, use of healthcare resources, access to care and self-management in Primary Care prior to hospitalisation with exacerbation. We anticipated the data would provide useful insight for directing improvement strategies.
A paper-based, anonymised survey was completed by patients identified as having exacerbation by participating hospital teams. Response rate was an estimated 46%.
Understanding and awareness of COPD was very variable. Patients noticed symptoms of COPD exacerbation, particularly change in sputum, for some time prior to hospitalisation but tended not to react promptly to these changes. A minority had self-care plans, many bypassed Primary Care Services and there was variable access to a named health professional or advice. Patients using home oxygen and nebulisers were at particular risk of admission.
We conclude these sick patients use a lot of resources and the data suggest a need to support and educate them in the proactive management of exacerbation. There needs to be better ‘exacerbation planning’ so patients know how to recognise and treat flare-up but also whom to contact in the event of decline. Targetted support should be considered for the most vulnerable, particularly those using home oxygen and nebulisers, who have very high rates of hospitalisation.
The natural world provides numerous cases for analogy and inspiration in engineering design. During the early stages of design, particularly during concept generation when several variants are created, biological systems can be used to inspire innovative solutions to a design problem. However, identifying and presenting the valuable knowledge from the biological domain to an engineering designer during concept generation is currently a somewhat disorganized process or requires extensive knowledge of the biological system. To circumvent the knowledge requirement problem, we developed a computational approach for discovering biological inspiration during the early stages of design that integrates with established function-based design methods. This research defines and formalizes the information identification and knowledge transfer processes that enable systematic development of biologically inspired designs. The framework that supports our computational design approach is provided along with an example of a smart flooring device to demonstrate the approach. Biologically inspired conceptual designs are presented and validated through a literature search and comparison to existing products.
In substantial numbers of affected populations, disasters adversely affect well-being and influence the development of emotional problems and dysfunctional behaviors. Nowhere is the integration of mental and behavioral health into broader public health and medical preparedness and response activities more crucial than in disasters such as the 2009-2010 H1N1 influenza pandemic. The National Biodefense Science Board, recognizing that the mental and behavioral health responses to H1N1 were vital to preserving safety and health for the country, requested that the Disaster Mental Health Subcommittee recommend actions for public health officials to prevent and mitigate adverse behavioral health outcomes during the H1N1 pandemic. The subcommittee's recommendations emphasized vulnerable populations and concentrated on interventions, education and training, and communication and messaging. The subcommittee's H1N1 activities and recommendations provide an approach and template for identifying and addressing future efforts related to newly emerging public health and medical emergencies. The many emotional and behavioral health implications of the crisis and the importance of psychological factors in determining the behavior of members of the public argue for a programmatic integration of behavioral health and science expertise in a comprehensive public health response.
(Disaster Med Public Health Preparedness. 2012;6:67–71)
The close interplay between mental health and physical health makes it critical to integrate mental and behavioral health considerations into all aspects of public health and medical disaster management. Therefore, the National Biodefense Science Board (NBSB) convened the Disaster Mental Health Subcommittee to assess the progress of the US Department of Health and Human Services (HHS) in integrating mental and behavioral health into disaster and emergency preparedness and response activities. One vital opportunity to improve integration is the development of clear and directive national policy to firmly establish the role of mental and behavioral health as part of a unified public health and medical response to disasters. Integration of mental and behavioral health into disaster preparedness, response, and recovery requires it to be incorporated in assessments and services, addressed in education and training, and founded on and advanced through research. Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice.
(Disaster Med Public Health Preparedness. 2012;6:60–66)