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Field studies were conducted in 2016 and 2017 in Clinton, NC, to determine the interspecific and intraspecific interference of Palmer amaranth (Amaranthus palmeri S. Watson) or large crabgrass [Digitaria sanguinalis (L.) Scop.] in ‘Covington’ sweetpotato [Ipomoea batatas (L.) Lam.]. Amaranthus palmeri and D. sanguinalis were established 1 d after sweetpotato transplanting and maintained season-long at 0, 1, 2, 4, 8 and 0, 1, 2, 4, 16 plants m−1 of row in the presence and absence of sweetpotato, respectively. Predicted yield loss for sweetpotato was 35% to 76% for D. sanguinalis at 1 to 16 plants m−1 of row and 50% to 79% for A. palmeri at 1 to 8 plants m−1 of row. Weed dry biomass per meter of row increased linearly with increasing weed density. Individual dry biomass of A. palmeri and D. sanguinalis was not affected by weed density when grown in the presence of sweetpotato. When grown without sweetpotato, individual weed dry biomass decreased 71% and 62% from 1 to 4 plants m−1 row for A. palmeri and D. sanguinalis, respectively. Individual weed dry biomass was not affected above 4 plants m−1 row to the highest densities of 8 and 16 plants m−1 row for A. palmeri and D. sanguinalis, respectively.
Field and greenhouse studies were conducted in 2016 and 2017 to determine sweetpotato tolerance to herbicides applied to plant propagation beds. Herbicide treatments included PRE application of flumioxazin (107 g ai ha−1), S-metolachlor (800 g ai ha−1), fomesafen (280 g ai ha−1), flumioxazin plus S-metolachlor (107 g ai ha−1 + 800 g ai ha−1), fomesafen plus S-metolachlor (280 g ai ha−1 + 800 g ai ha−1), fluridone (1,120 or 2,240 g ai ha−1), fluridone plus S-metolachlor (1,120 g ai ha−1 + 800 g ai ha−1), napropamide (1,120 g ai ha−1), clomazone (420 g ai ha−1), linuron (560 g ai ha−1), linuron plus S-metolachlor (560 g ai ha−1 + 800 g ai ha−1), bicyclopyrone (38 or 49.7 g ai ha−1), pyroxasulfone (149 g ai ha−1), pre-mix of flumioxazin plus pyroxasulfone (81.8 g ai ha−1 + 104.2 g ai ha−1), or metribuzin (294 g ai ha−1). Paraquat plus non-ionic surfactant (280 g ai ha−1 + 0.25% v/v) POST was also included. After plants in the propagation bed were cut and sweetpotato slip number, length, and weight had been determined, the slips were then transplanted to containers and placed either in the greenhouse or on an outdoor pad to determine any effects from the herbicide treatments on initial sweetpotato growth. Sweetpotato slip number, length, and/or weight were affected by flumioxazin with or without S-metolachlor, S-metolachlor with or without fomesafen, clomazone, and all fluridone treatments. In the greenhouse studies, initial root growth of plants after transplanting was inhibited by fluridone (1,120 g ai ha−1) and fluridone plus S-metolachlor. However, by 5 wk after transplanting few differences were observed between treatments. Fomesafen, linuron with or without S-metolachlor, bicyclopyrone (38 or 49.7 g ai ha−1), pyroxasulfone with or without flumioxazin, metribuzin, and paraquat did not cause injury to sweetpotato slips in any of the studies conducted.
The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)–pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D–pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (Prace difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (Prace difference=0·56). Among EA, the 25(OH)D–FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
Older adults are a potentially medically vulnerable population with increased mortality rates during and after disasters. To evaluate the impact of a natural disaster on this population, we performed a temporal and geospatial analysis of emergency department (ED) use by adults aged 65 years and older in New York City (NYC) following Hurricane Sandy’s landfall.
We used an all-payer claims database to analyze demographics, insurance status, geographic distribution, and health conditions for post-disaster ED visits among older adults. We compared ED patterns of use in the weeks before and after Hurricane Sandy throughout NYC and the most afflicted evacuation zones.
We found significant increases in ED utilization by older adults (and disproportionately higher in those aged ≥85 years) in the 3 weeks after Hurricane Sandy, especially in NYC evacuation zone one. Primary diagnoses with notable increases included dialysis, electrolyte disorders, and prescription refills. Secondary diagnoses highlighted homelessness and care access issues.
Older adults display heightened risk for worse health outcomes with increased ED visits after a disaster. Our findings suggest the need for dedicated resources and planning for older adults following a natural disaster by ensuring access to medical facilities, prescriptions, dialysis, and safe housing and by optimizing health care delivery needs to reduce the burden of chronic disease. (Disaster Med Public Health Preparedness. 2018;12:184–193)
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
Recent archaeological investigations at Pueblo Bonito in Chaco Canyon reveal that residents constructed a large diversion channel during the eleventh century A.D. as dramatic growth resulted in the expansion of the building onto the main valley floor. Sediments in the diversion channel reflect repeated episodes of flooding, rather than slow moving water typically found in irrigation canals, and archaeobotanical data indicate deposition during late summer or early fall. Although an agricultural function is possible, the channel may have been built primarily to divert floodwaters away from Pueblo Bonito while providing a nearby water source for construction and domestic use. The diversion channel was destroyed by the entrenchment of the “Bonito paleo-channel” in the late A.D. 1000s, and then buried by a combination of cultural debris and valley flooding. Although the canyon stream system changed throughout the occupation of Pueblo Bonito, there is no evidence that the formation of a deep natural channel in the floodplain had any negative effect on the growth of the great house
To assess the impact of an emergency intensive care unit (EICU) established concomitantly with a freestanding emergency department (ED) during the aftermath of Hurricane Sandy.
We retrospectively reviewed records of all patients in Bellevue’s EICU from freestanding ED opening (December 10, 2012) until hospital inpatient reopening (February 7, 2013). Temporal and clinical data, and disposition upon EICU arrival, and ultimate disposition were evaluated.
Two hundred twenty-seven patients utilized the EICU, representing approximately 1.8% of freestanding ED patients. Ambulance arrival occurred in 31.6% of all EICU patients. Median length of stay was 11.55 hours; this was significantly longer for patients requiring airborne isolation (25.60 versus 11.37 hours, P<0.0001 by Wilcoxon rank sum test). After stabilization and treatment, 39% of EICU patients had an improvement in their disposition status (P<0.0001 by Wilcoxon signed rank test); upon interhospital transfer, the absolute proportion of patients requiring ICU and SDU resources decreased from 37.8% to 27.1% and from 22.2% to 2.7%, respectively.
An EICU attached to a freestanding ED achieved significant reductions in resource-intensive medical care. Flexible, adaptable care systems should be explored for implementation in disaster response. (Disaster Med Public Health Preparedness. 2016;10:496–502)
We aimed to characterize the geographic distribution of post-Hurricane Sandy emergency department use in administrative flood evacuation zones of New York City.
Using emergency claims data, we identified significant deviations in emergency department use after Hurricane Sandy. Using time-series analysis, we analyzed the frequency of visits for specific conditions and comorbidities to identify medically vulnerable populations who developed acute postdisaster medical needs.
We found statistically significant decreases in overall post-Sandy emergency department use in New York City but increased utilization in the most vulnerable evacuation zone. In addition to dialysis- and ventilator-dependent patients, we identified that patients who were elderly or homeless or who had diabetes, dementia, cardiac conditions, limitations in mobility, or drug dependence were more likely to visit emergency departments after Hurricane Sandy. Furthermore, patients were more likely to develop drug-resistant infections, require isolation, and present for hypothermia, environmental exposures, or administrative reasons.
Our study identified high-risk populations who developed acute medical and social needs in specific geographic areas after Hurricane Sandy. Our findings can inform coherent and targeted responses to disasters. Early identification of medically vulnerable populations can help to map “hot spots” requiring additional medical and social attention and prioritize resources for areas most impacted by disasters. (Disaster Med Public Health Preparedness. 2016;10:351–361)
Biological control has been an important tactic in the management of Canadian forests for over a century, but one that has had varied success. Here, we review the history of biological control programmes using vertebrate and invertebrate parasitoids and predators against insects in Canadian forests. Since roughly 1882, 41 insect species have been the target of biological control, with approximately equal numbers of both native and non-native species targeted. A total of 161 species of biological control agents have been released in Canadian forests, spanning most major orders of insects, as well as mites and mammals. Biological control has resulted in the successful suppression of nine pest species, and aided in the control of an additional six species. In this review, we outline the chronological history of major projects across Canadian forests, focussing on those that have had significant influence for the development of biological control. The historical data clearly illustrate a rise and fall in the use of biological control as a tactic for managing forest pests, from its dominance in the 1940s and 1950s to its current low level. The strategic implementation of these biological control programmes, their degree of success, and the challenges faced are discussed, along with the discipline’s shifting relationship to basic science and the environmental viewpoints surrounding its use.
We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012.
We retrospectively reviewed EMS activity and call types within New York City’s 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue’s closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services.
A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, “pedestrian struck,” unconsciousness, altered mental status, and emotionally disturbed persons.
EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery. (Disaster Med Public Health Preparedness. 2016;10:333–343)
We report the observation of two isolated clouds of positrons inside an active thunderstorm. These observations were made by the Airborne Detector for Energetic Lightning Emissions (ADELE), an array of six gamma-ray detectors, which flew on a Gulfstream V jet aircraft through the top of an active thunderstorm in August 2009. ADELE recorded two 511 keV gamma-ray count rate enhancements, 35 s apart, each lasting approximately 0.2 s. The enhancements, which were approximately a factor of 12 above background, were both accompanied by electrical activity as measured by a flat-plate antenna on the underside of the aircraft. The energy spectra were consistent with a source mostly composed of positron annihilation gamma rays, with a prominent 511 keV line clearly visible in the data. Model fits to the data suggest that the aircraft was briefly immersed in clouds of positrons, more than a kilometre across. It is not clear how the positron clouds were created within the thunderstorm, but it is possible they were caused by the presence of the aircraft in the electrified environment.
Sudden hospital closures displace patients from usual sources of care and force them to access facilities that lack their prior medical records. For patients with complex needs and for nearby hospitals already strained by high volume, disaster-related hospital closures induce a public health emergency. Our objective was to analyze responses of patients from public versus private emergency departments after closure of their usual hospital after Hurricane Sandy. Using a statewide database of emergency visits, we followed patients with an established pattern of accessing 1 of 2 hospitals that closed after Hurricane Sandy: Bellevue Hospital Center and NYU Langone Medical Center. We determined how these patients redistributed for emergency care after the storm. We found that proximity strongly predicted patient redistribution to nearby open hospitals. However, for patients from the closed public hospital, this redistribution was also influenced by hospital ownership, because patients redistributed to other public hospitals at rates higher than expected by proximity alone. This differential response to hospital closures demonstrates significant differences in how public and private patients respond to changes in health care access during disasters. Public health response must consider these differences to meet the needs of all patients affected by disasters and other public health emergencies. (Disaster Med Public Health Preparedness. 2015;9:256-264).