To see the other types of publications on this topic, follow the link: Disaster medicine – United States – Data processing.
Journal articles on the topic 'Disaster medicine – United States – Data processing'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Disaster medicine – United States – Data processing.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Grams, Ralph R., Georgina C. Peck, James K. Massey, and James J. Austin. "Review of Hospital Data Processing in the United States (1982?1984)." Journal of Medical Systems 9, no. 4 (August 1985): 175–269. http://dx.doi.org/10.1007/bf00992884.
Full text
2
Sharma, Aishwarya, and Sharon Mace. "Reviewing Disasters: Hospital Evacuations in the United States from 2000 to 2017." Prehospital and Disaster Medicine 34, s1 (May 2019): s22. http://dx.doi.org/10.1017/s1049023x19000633.
Full textAbstract:
Introduction:Between 2000 to 2017, there were over 150 hospital evacuations in the United States. Data received from approximately 35 states were primarily concentrated in California, Florida, and Texas. This analysis will provide disaster planners and administrators statistics on hazards that cause disruptions to hospital facilities.Aim:The aim of this study is to investigate US hospital evacuations by compiling the data into external, internal, and man-made disasters thus creating a risk assessment for disaster planning.Methods:Hospital reports were retrieved from LexisNexis, Google, and PubMed databases and categorized according to evacuees, duration, location, and type. These incidents were grouped into three classifications: external, internal, and man-made. Both partial and full evacuations were included in the study design.Results:There were a total of 154 reported evacuations in the United States. 110 (71%) were due to external threats, followed by 24 (16%) man-made threats, and 20 (13%) internal threats. Assessing the external causes, 60 (55%) were attributed to hurricanes, 21 (19%) to wildfires, and 8 (7%) to storms. From the internal threats, 8 (40%) were attributed to hospital fires and 4 (20%) chemical fumes. From the man-made threats, 6 (40%) were attributed to bomb threats and 4 (27%) gunmen. From the 20 total reported durations of evacuations, 9 (45%) lasted between 2 to 11:59 hours, 6 (30%) lasted over 24 hours, and 5 (25%) lasted up to 1:59 hours.Discussion:Over 70% of hospital evacuations in the US were due to natural disasters. Compared to 1971-1999, there was an increase in internal and man-made threats. Exact statistics on evacuees, durations, injuries, and mortality rates were unascertainable due to a lack of reporting. It is critical to implement a national registry to report specifics on incidences of evacuations to further assist with disaster and infrastructure planning.
3
Bellquist, Lyall, Vienna Saccomanno, Brice X. Semmens, Mary Gleason, and Jono Wilson. "The rise in climate change-induced federal fishery disasters in the United States." PeerJ 9 (April 22, 2021): e11186. http://dx.doi.org/10.7717/peerj.11186.
Full textAbstract:
Commercial, recreational, and indigenous fisheries are critical to coastal economies and communities in the United States. For over three decades, the federal government has formally recognized the impact of fishery disasters via federal declarations. Despite these impacts, national syntheses of the dynamics, impacts, and causes of fishery disasters are lacking. We developed a nationwide Federal Fishery Disaster database using National Oceanic and Atmospheric Administration (NOAA) fishery disaster declarations and fishery revenue data. From 1989-2020, there were 71 federally approved fishery disasters (eleven are pending), which spanned every federal fisheries management region and coastal state in the country. To date, we estimate fishery disasters resulted in $2B (2019 USD) in Congressional allocations, and an additional, conservative estimate of $3.2B (2019 USD) in direct revenue loss. Despite this scale of impact, the disaster assistance process is largely ad hoc and lacks sufficient detail to properly assess allocation fairness and benefit. Nonetheless, fishery disasters increased in frequency over time, and the causes of disasters included a broad range of anthropogenic and environmental factors, with a recent shift to disasters now almost exclusively caused by extreme environmental events (e.g., marine heatwaves, hurricanes, and harmful algal blooms). Nationwide, 84.5% of fishery disasters were either partially or entirely attributed to extreme environmental events. As climate change drives higher rates of such extreme events, and as natural disaster assistance requests reach an all-time high, the federal system for fisheries disaster declaration and mitigation must evolve in order to effectively protect both fisheries sustainability and societal benefit.
4
Gable, Brad D., Asit Misra, Devin M. Doos, Patrick G. Hughes, Lisa M. Clayton, and Rami A. Ahmed. "Disaster Day: A Simulation-Based Disaster Medicine Curriculum for Novice Learners." Journal of Medical Education and Curricular Development 8 (January 2021): 238212052110207. http://dx.doi.org/10.1177/23821205211020751.
Full textAbstract:
Background: Mass casualty and multi-victim incidents have increased in recent years due to a number of factors including natural disasters and terrorism. The Association of American Medical Colleges (AAMC) recommends that medical students be trained in disaster preparedness and response. However, a majority of United States medical students are not provided such education. Objective: The goal of this study was to evaluate the effectiveness of a 1 day, immersive, simulation-based Disaster Day curriculum. Settings and Design: Learners were first and second year medical students from a single institution. Materials and Methods: Our education provided learners with information on disaster management, allowed for application of this knowledge with hands-on skill stations, and culminated in near full-scale simulation where learners could evaluate the knowledge and skills they had acquired. Statistical analysis used: To study the effectiveness of our Disaster Day curriculum, we conducted a single-group pretest-posttest and paired analysis of self-reported confidence data. Results: A total of 40 first and second year medical students participated in Disaster Day as learners. Learners strongly agreed that this course provided new information or provided clarity on previous training, and they intended to use what they learned, 97.6% and 88.4%, respectively. Conclusions: Medical students’ self-reported confidence of key disaster management concepts including victim triage, tourniquet application, and incident command improved after a simulation-based disaster curriculum. This Disaster Day curriculum provides students the ability to apply concepts learned in the classroom and better understand the real-life difficulties experienced in a resource limited environment.
5
Smith, J. Stanley. "Hospital Disaster and Evacuation Planning." Prehospital and Disaster Medicine 5, no. 4 (December 1990): 357–62. http://dx.doi.org/10.1017/s1049023x00027114.
Full textAbstract:
The world population is becoming increasingly reliant upon nuclear fission for the generation of electric power. In the wake of this activity, there have been two major accidents: Three Mile Island (TMI), near Harrisburg, Pennsylvania, United States, in 1979; and Chernobyl, near Kiev, Ukraine, Soviet Union, in 1986. It is noteworthy that both of these accidents were related to human error and not to malfunction of the emergency back-up systems. So far, nuclear energy production plant accidents have occurred when either the data were misinterpreted or systems misguided by human function.The major problem associated with a nuclear energy generating plant accident is the release of radiation. Even though the medical facilities may not be destroyed physically, they may be rendered useless because of contamination by radiation. Unfortunately, in the event of such an accidental release of radiation, all of the health-care facilities in the area will be contaminated. Therefore, all patients in hospitals and nursing homes will need to be evacuated to facilities outside of the contaminated area and not just relocated within the contaminated area.
6
Mace, MD, FACEP, FAAP, Sharon E., and Aishwarya Sharma, BS. "Hospital evacuations due to disasters in the United States in the twenty-first century." American Journal of Disaster Medicine 15, no. 1 (January 1, 2020): 7–22. http://dx.doi.org/10.5055/ajdm.2020.0351.
Full textAbstract:
Hospitals, which care for some of the most vulnerable individuals, have been impacted by disasters in the past and are likely to be affected by future disasters. Yet data on hospital evacuations are infrequent and outdated, at best. This goal of this study was to determine the characteristics and frequency of disasters in the United States that have resulted in hospital evacuations by an appraisal of the literature from 2000 to 2017. There were 158 hospital evacuations in the United States over 18 years. The states with the highest number of evacuations were Florida (N = 39), California (N = 30), and. Texas (N = 15). The reason for the evacuation was “natural” in 114 (72.2 percent), made-man “intentional” 14 (8.9 percent), and man-made “unintentional” or technological related to internal hospital infrastructure 30 (19 percent).The most common natural threats were hurricanes (N = 65) (57 percent), wildfires (N = 21) (18.4 percent), floods (N = 10) (8.8 percent), and storms (N = 8) (7 percent). Bombs/ bomb threats were the most common reason (N = 8) (57.1 percent) for a hospital evacuation resulting from a manmade intentional disaster, followed by armed gunman (N = 4) (28.6 percent). The most frequent infrastructure problems included hospital fires/smoke (N = 9) (30 percent), and chemical fumes (N = 7) (23.3 percent). Of those that reported the duration and number of evacuees, 30 percent of evacuations lasted over 24 h and the number of evacuees was 100 in over half (55.2 percent) the evacuations. This information regarding hospital evacuations should allow hospital administrators, disaster planners, and others to better prepare for disasters that result in the need for hospital evacuation.
7
Zhou, Liang, Ping Zhang, Zhigang Zhang, Lidong Fan, Shuo Tang, Kunpeng Hu, Nan Xiao, and Shuguang Li. "A Bibliometric Profile of Disaster Medicine Research from 2008 to 2017: A Scientometric Analysis." Disaster Medicine and Public Health Preparedness 13, no. 02 (May 2, 2018): 165–72. http://dx.doi.org/10.1017/dmp.2018.11.
Full textAbstract:
ABSTRACTThis study analyzed and assessed publication trends in articles on “disaster medicine,” using scientometric analysis. Data were obtained from the Web of Science Core Collection (WoSCC) of Thomson Reuters on March 27, 2017. A total of 564 publications on disaster medicine were identified. There was a mild increase in the number of articles on disaster medicine from 2008 (n=55) to 2016 (n=83). Disaster Medicine and Public Health Preparedness published the most articles, the majority of articles were published in the United States, and the leading institute was Tohoku University. F. Della Corte, M. D. Christian, and P. L. Ingrassia were the top authors on the topic, and the field of public health generated the most publications. Terms analysis indicated that emergency medicine, public health, disaster preparedness, natural disasters, medicine, and management were the research hotspots, whereas Hurricane Katrina, mechanical ventilation, occupational medicine, intensive care, and European journals represented the frontiers of disaster medicine research. Overall, our analysis revealed that disaster medicine studies are closely related to other medical fields and provides researchers and policy-makers in this area with new insight into the hotspots and dynamic directions. (Disaster Med Public Health Preparedness. 2019;13:165–172)
8
Andress, K. "(A332) Increasing Medical Situational Awareness and Interoperability via “Virtual USA”." Prehospital and Disaster Medicine 26, S1 (May 2011): s93. http://dx.doi.org/10.1017/s1049023x11003165.
Full textAbstract:
IntroductionHistory is replete with interoperability and resource reporting deficits during disaster that impact medical response and planning. Situational awareness for disaster and emergency medical response includes communicating health hazards as well as infrastructure and resource status, capability and GIS location. The need for actionable, real-time data is crucial to response. Awareness facilitates medical resource placement, response and recovery. A number of internet, web-based disaster resource and situational status reporting applications exist but may be limited or restricted by functional, jurisdictional, proprietary and/or financial requirements. Restrictions prohibit interoperability and inhibit information sharing that could affect health care delivery. Today multiple United States jurisdictions are engaged in infrastructure and resource situation status reporting via “virtual” states and regional projects considered components of “Virtual USA”.MethodsThis report introduces the United States' Department of Homeland Security's “Virtual USA” initiative and demonstrates a health application and interoperability via “Virtual Louisiana's” oil spill related exposure reporting during the 2010, British Petroleum Gulf Horizon catastrophe. Five weekly Louisiana Department of Health and Hospital summary reports from the Louisiana Poison Center; Hospital Surveillance Systems; Public Health Hotline; and Physician Clinic Offices were posted on the Louisiana Office of Homeland Security and Emergency Preparedness's “Virtual Louisiana”.Results227 total spill-related, exposure cases from five reporting weeks were provided by five Louisiana source agencies and reported in Virtual Louisiana. Cases were reported weekly and classified as “workers” or “population”; associated with the parish exposure locations (8), offshore (1), or unknown (1); and shared with four other virtual states.ConclusionsReal-time health and medical situation status, resource awareness, and incident impact could be facilitated through constructs demonstrated by “Virtual USA”.
9
Crowe, Remle P., Roger Levine, Severo Rodriguez, Ashley D. Larrimore, and Ronald G. Pirrallo. "Public Perception of Emergency Medical Services in the United States." Prehospital and Disaster Medicine 31, S1 (November 25, 2016): S112—S117. http://dx.doi.org/10.1017/s1049023x16001126.
Full textAbstract:
AbstractObjectiveThe objective of this study was to assess the public’s experience, expectations, and perceptions related to Emergency Medical Services (EMS).MethodsA population-based telephone interview of adults in the United States was conducted. The survey instrument consisted of 112 items. Demographic variables including age, race, political beliefs, and household income were collected. Data collection was performed by trained interviewers from Kent State University’s (Kent, Ohio USA)Social Research Laboratory. Descriptive statistics were calculated. Comparative analyses were conducted between those who used EMS at least once in the past five years and those who did not use EMS using χ2andttests.ResultsA total of 2,443 phone calls were made and 1,348 individuals agreed to complete the survey (55.2%). There were 297 individuals who requested to drop out of the survey during the phone interview, leaving a total of 1,051 (43.0%) full responses. Participants ranged in age from 18 to 94 years with an average age of 57.5 years. Most were Caucasian or white (83.0%), married (62.8%), and held conservative political beliefs (54.8%). Three-fourths of all respondents believed that at least 40% of patients survive cardiac arrest when EMS services are received. Over half (56.7%) believed that Emergency Medical Technician (EMT)-Basics and EMT-Paramedics provide the same level of care. The estimated median hours of training required for EMT-Basics was 100 hours (IQR: 40-200 hours), while the vast majority of respondents estimated that EMT-Paramedics are required to take fewer than 1,000 clock hours of training (99.3%). The majority believed EMS professionals should be screened for illegal drug use (97.0%), criminal background (95.9%), mental health (95.2%), and physical fitness (91.3%). Over one-third (37.6%) had used EMS within the past five years. Of these individuals, over two-thirds (69.6%) rated their most recent experience as “excellent.” More of those who used EMS at least once in the past five years reported a willingness to consent to participate in EMS research compared with those who had not used EMS (69.9% vs. 61.4%,P=.005).ConclusionsMost respondents who had used EMS services rated their experience as excellent. Nevertheless, expectations related to survival after cardiac arrest in the out-of-hospital setting were not realistic. Furthermore, much of the public was unaware of the differences in training hour requirements and level of care provided by EMT-Basics and EMT-Paramedics.CroweRP,LevineR,RodriguezS,LarrimoreAD,PirralloRG.Public perception of Emergency Medical Services in the United States.Prehosp Disaster Med.2016;31(Suppl.1):s112–s117.
10
Kabel, Allison, and Catherine Chmidling. "Disaster Prepper: Health, Identity, and American Survivalist Culture." Human Organization 73, no. 3 (August 20, 2014): 258–66. http://dx.doi.org/10.17730/humo.73.3.l34252tg03428527.
Full textAbstract:
The survivalist movement in the United States has spawned the "disaster prep" phenomenon and has become a lifestyle and identity with potential health-related consequences. "Preppers" anticipate either a natural or man-made apocalypse which will result in the total collapse of civil society, prompting them to "prep" by securing places to shelter during the chaos and stockpiling their homes with food, water, fuel, medicine, and supplies. The purpose of this article was to document the impact of survivalist identity upon health-related decision making and health-seeking behavior, as well as examine the identity building and community formation processes as they unfold in virtual contexts. Data were collected from publicly available survivalism and the Prepper web logs (blogs). Results included discussion about the maintenance of chronic conditions, ethical dilemmas regarding medical dependency, and anticipatory changes to health behavior, with implications for future research on identity building and virtual community participation.
11
Rumbaugh, Jack R. "Operation Pacific Haven: Humanitarian Medical Support for Kurdish Evacuees." Military Medicine 163, no. 5 (May 1, 1998): 269–71. http://dx.doi.org/10.1093/milmed/163.5.269.
Full textAbstract:
Abstract This article reviews the medical aspects of the humanitarian assistance mission Joint Task Force Operation Pacific Haven from September 1996 to April 1997. It reviews the effectiveness of the deployable medical units used to support the medical screening, treatment, and processing of more than 6,600 Kurdish evacuees applying for political asylum in the United States. The distinct cultural mores and language barriers of the Kurdish population made the provision of even basic medical care a challenge. Designed for combat service support, these deployable medical units were successful in the performance of the comprehensive public health and humanitarian assistance medical support mission because of the support of two on-island military treatment facilities. In short, for military medicine to successfully conduct humanitarian assistance and/or disaster relief missions, deployable medical units need to be designed, equipped, staffed, and trained to perform these operations.
12
Pijawka, K. David, Beverly A. Cuthbertson, and Richard S. Olson. "Coping with Extreme Hazard Events: Emerging themes in Natural and Technological Disaster Research." OMEGA - Journal of Death and Dying 18, no. 4 (June 1988): 281–97. http://dx.doi.org/10.2190/pn24-al37-f96j-rcnp.
Full textAbstract:
The field of thanatology has given extensive attention to death as an outcome of illness. A more comprehensive picture, however, would also encompass the hazards of natural and technological disasters. Deaths from both natural and technological disasters continue to increase in the United States, despite intensified government efforts to reverse this trend, and despite improved understanding of the cognitive processes of people who face either long-term or impending catastrophes. Key findings are reviewed in the areas of vulnerability to natural hazards, disaster behavior and risk perception, societal concern over technological hazard, and the social-psychological effects of disasters. It is noted that findings based upon natural disasters cannot necessarily be extrapolated to technological disasters, such as the Three Mile Island nuclear accident. Furthermore, data on long-term emotional recovery from natural disasters are inconsistent. Among areas requiring more extensive research is the role of the media, and the measurement of secondary consequences to disaster exposure. Improved methodologies for measuring distress over long periods of time must be developed. The disaster may never end for technological disaster victims because of the long latency period between exposure and disease manifestation.
13
Norii, T., Y. Terasaka, M. Miura, T. Nishinaka, R. Lueken, H. Sasaki, and A. Alseidi. "(P1-9) Multinational Disaster Response Exercise: Critical Look and Lessons Learned." Prehospital and Disaster Medicine 26, S1 (May 2011): s101. http://dx.doi.org/10.1017/s1049023x11003414.
Full textAbstract:
IntroductionInternational collaboration for disaster response is an increasing phenomenon. Japan-United States joint field exercises have been conducted annually since 2004, triggered by an incident in which a US helicopter crashed into a university campus in Okinawa, Japan. The fifth Japan-US disaster field exercise was conducted testing the disaster response of the Okinawa government and US military.MethodsThe simulated exercise involved a US Navy aircraft that crashed into a city center in Okinawa, Japan. There were 16 simulated casualties that included US military members and Japanese citizens. The participants in this exercise were US military members, including the Disaster Assistance Response Team (DART) and local rescue and medical teams including the Okinawa Disaster Medical Assistance Team (DMAT). Data were gathered from the joint debriefing session held by both medical teams. Furthermore, interviews with team leaders from both nations were conducted and feedback obtained.ResultsLack of communication and inaccurate communication remained the root of most problems encountered. There were several miscommunications at the scene due to the language barrier and ignorance of different medical teams' capability and method of practice. Due to the unclear signage of the initial triage zone, another triage zone was developed later by a second medical team. Confusion regarding gathering information and order of transport also was witnessed. The capabilities of team members were not well known between teams, resulting in inappropriate expectations and difficulty in effective cooperation.ConclusionsUnderstanding the systems and backgrounds of each medical team is essential. Signs or symbols of key elements including triage areas should be clear, universal, and multilingual. Communication remains the Achilles' heel of multi-national disaster response activities.
14
Houtchens, Bruce A., Terry P. Clemmer, Harry C. Holloway, Alexander A. Kiselev, James S. Logan, Ronald C. Merrell, Arnauld E. Nicogossian, et al. "Telemedicine and International Disaster Response: Medical Consultation to Armenia and Russia Via a Telemedicine Spacebridge." Prehospital and Disaster Medicine 8, no. 1 (March 1993): 57–66. http://dx.doi.org/10.1017/s1049023x00040024.
Full textAbstract:
AbstractIntroduction:The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa.Methods:During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas.Results:Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47 and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent.Conclusion:These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.
15
Hardwick, Jason M., Sean D. Murnan, Daphne P. Morrison-Ponce, and John J. Devlin. "Field Expedient Vasopressors During Aeromedical Evacuation: A Case Series from the Puerto Rico Disaster Response." Prehospital and Disaster Medicine 33, no. 6 (November 9, 2018): 668–72. http://dx.doi.org/10.1017/s1049023x18000973.
Full textAbstract:
AbstractIntroductionEmergency physicians are using bolus-dose vasopressors to temporize hypotensive patients until more definitive blood pressure support can be established. Despite a paucity of clinical outcome data, emergency department applications are expanding into the prehospital setting. This series presents two cases of field expedient vasopressor use by emergency medicine providers for preflight stabilization during aeromedical evacuation to a hospital ship as part of the United States Navy disaster response in Puerto Rico. A critical approach and review of the literature are discussed.Case ReportTwo critically ill patients were managed in an austere environment as a result of the devastation from Hurricane Maria (Yabucoa, Puerto Rico; 2017). They both exhibited signs of respiratory distress, hemodynamic instability, and distributive shock requiring definitive airway management and hemodynamic support prior to aeromedical evacuation.DiscussionThe novel use of field expedient vasopressors prior to induction for rapid sequence intubation was successfully and safely employed in both cases. Both patients had multiple risk factors for peri-induction cardiac arrest given their presenting hemodynamics. Despite their illness severity, both patients were induced, transported, and ultimately admitted to the intensive care unit (ICU) in stable condition following administration of the field expedient vasopressors.Conclusion:Field expedient vasopressors were safely and effectively employed in an austere field environment during a disaster response. This case series contributes to the growing body of literature of safe bolus-dose vasopressor use by emergency physicians to temporize hypotensive patients in resource-constrained situations.HardwickJM, MurnanSD, Morrison-PonceDP, DevlinJJ. Field expedient vasopressors during aeromedical evacuation: a case series from the Puerto Rico disaster response. Prehosp Disaster Med. 2018;33(6):668–672.
16
Keim, Mark. "Managing Disaster-Related Health Risk: A Process for Prevention." Prehospital and Disaster Medicine 33, no. 3 (June 2018): 326–34. http://dx.doi.org/10.1017/s1049023x18000419.
Full textAbstract:
AbstractIn 1994, the first World Conference on Natural Disaster Reduction held in Yokohama, Japan affirmed that “Disaster prevention, mitigation, and preparedness are better than disaster response in achieving the goals and objectives of the decade. Disaster response alone is not sufficient, as it yields only temporary results in a very high cost.” Since then, disaster risk reduction has become the mainstay for international development related to disasters.According to the National Research Council (Washington, DC USA), “Disaster research, which has focused historically on emergency response and recovery, is incomplete without the simultaneous study of the societal hazards and risks associated with disasters, which includes data on the vulnerability of people living in hazard prone areas.” Despite over 25 years of global policy development, the National Academies of Sciences, Engineering, and Medicine (Washington, DC USA) recently noted that, “while some disaster management and public health preparedness programming may be viewed as tangentially related, a multi-sectoral and inter-disciplinary national platform for coordination and policy guidance on involving disaster risk reduction in the United States does not exist.” Today, one of the world’s “seven targets in seven years” as agreed upon in the Sendai Framework for Disaster Risk Reduction is to substantially reduce global mortality by 2030. Significant reductions in health risk (including mortality) have historically required a comprehensive approach for disease management that includes both a preventive and a curative approach. Disaster risk management has arisen as a primary means for the world’s populations to address disaster losses, including those related to health. Prevention has been proven as an effective approach for managing health risk. This report describes the role of disease prevention in managing health risk due to disasters.KeimM. Managing disaster-related health risk: a process for prevention. Prehosp Disaster Med. 2018;33(3):326-334.
17
Sabra, John P., José G. Cabañas, John Bedolla, Shirley Borgmann, James Hawley, Kevin Craven, Carlos Brown, Chris Ziebell, and Steve Olvey. "Medical Support at a Large-scale Motorsports Mass-gathering Event: The Inaugural Formula One United States Grand Prix in Austin, Texas." Prehospital and Disaster Medicine 29, no. 4 (July 28, 2014): 392–98. http://dx.doi.org/10.1017/s1049023x14000636.
Full textAbstract:
AbstractIntroductionFormula One returned to the United States on November 16-18, 2012, with the inaugural United States Grand Prix in Austin, Texas. Medical preparedness for motorsports events represents a unique challenge due to the potential for a high number of spectators seeking medical attention, and the possibility for a mass-casualty situation. Adequate preparation requires close collaboration across public safety agencies and hospital networks to minimize impact on Emergency Medical Services (EMS) resources.Hypothesis/ProblemTo report the details of preparation for an inaugural mass-gathering motorsports event, and to describe the details of the medical care rendered during the 3-day event.MethodsA retrospective analysis was completed utilizing postevent summaries, provided by the medical planning committee, by the Federation Internationale de L'Automobile (FIA), and Austin Travis County Emergency Medical Services (ATCEMS). Patient data were collected from standardized patient care records for descriptive analysis. Medical usage rates (MURs) are reported as a rate of patients per 10,000 (PPTT) participants.ResultsA total of 566 patients received medical care over the 3-day period with the on-site care rate of 95%. Overall, MUR was 21.3 PPTT attendees. Most patients had minor problems, and there were no driver injuries or deaths.ConclusionThis mass-gathering motorsport event had a moderate number of patients requiring medical attention. The preparedness plan was implemented successfully with minimal impact on EMS resources and local medical facilities. This medical preparedness plan may serve as a model to other cities preparing for an inaugural motorsports event.SabraJP, CabañasJG, BedollaJ, BorgmannS, HawleyJ, CravenK, BrownC, ZiebellC, OlveyS. Medical support at a large-scale motorsports mass-gathering event: the inaugural Formula One United States Grand Prix in Austin, Texas. Prehosp Disaster Med. 2014;29(4):1-7.
18
Markenson, D., and M. Reilly. "(P1-102) Developing Methodologies to Assess Resource Needs and Ability to Provide Interventions and Care for Children in Disasters, Terrorism and Public Health Emergencies." Prehospital and Disaster Medicine 26, S1 (May 2011): s132. http://dx.doi.org/10.1017/s1049023x11004353.
Full textAbstract:
IntroductionIn emergency preparedness there is the need to prospectively develop an approach to which interventions can be provided with available resources and the maximal amount of clinical effectiveness which can be attained by staff.MethodsA panel of pediatric emergency preparedness experts employed our previously validated evidence based consensus process with a modified Delphi process for topic selection and approval. Interventions were chosen such that resources and staff efficiency would not exceed previously published data for non-disaster emergency care but allowing for standard emergency preparedness planning alterations in standards of care such as the assumption that usual numbers of staff would care for a disaster surge of four times the usual number of patients.ResultsUsing standard emergency preparedness assumptions of limited resources and staff efficiency, the panel agreed upon both methodologies for resource allocation and feasible interventions. A number of standard interventions would not be feasible and included detailed recording of vital signs, administration of vasoactive agents, prolonged resuscitation and central venous access.ConclusionBy employing this approach to resource utilization described combined with the unique aspects of pediatric care, we can improve our planning and responses. This can be accomplished by understanding the needs of the population being served, learning how to focus on both pediatric needs and the expectations of the community with regard to care of children, adopting what has been learned in prior events in the United States and abroad, and developing prospective recommendations regarding essential interventions which can be performed in a disaster.
19
Determann, Lothar. "Healthy Data Protection." Michigan Technology Law Review, no. 26.2 (2020): 229. http://dx.doi.org/10.36645/mtlr.26.2.healthy.
Full textAbstract:
Modern medicine is evolving at a tremendous speed. On a daily basis, we learn about new treatments, drugs, medical devices, and diagnoses. Both established technology companies and start-ups focus on health-related products and services in competition with traditional healthcare businesses. Telemedicine and electronic health records have the potential to improve the effectiveness of treatments significantly. Progress in the medical field depends above all on data, specifically health information. Physicians, researchers, and developers need health information to help patients by improving diagnoses, customizing treatments and finding new cures. Yet law and policymakers are currently more focused on the fact that health information can also be used to harm individuals. Even after the outbreak of the COVID-19 pandemic (which occurred after the manuscript for this article was largely finalized), the California Attorney General Becera made a point of announcing that he will not delay enforcement of the California Consumer Privacy Act (“CCPA”), which his office estimated imposes a $55 billion cost (approximately 1.8% of California Gross State Product) for initial compliance, not including costs of ongoing compliance, responses to data subject requests, and litigation. Risks resulting from health information processing are very real. Contact tracing and quarantines in response to SARS, MERS, and COVID-19 outbreaks curb civil liberties with similar effects to law enforcement investigations, arrests, and imprisonment. Even outside the unusual circumstances of a global pandemic, employers or insurance companies may disfavor individuals with pre-existing health conditions in connections with job offers and promotions as well as coverage and eligibility decisions. Some diseases carry a negative stigma in social circumstances. To reduce the risks of such harms and protect individual dignity, governments around the world regulate the collection, use, and sharing of health information with ever-stricter laws. European countries have generally prohibited the processing of personal data, subject to limited exceptions, for which companies have to identify and then document or apply. The General Data Protection Regulation (“GDPR”) that took effect in 2018 confirms and amplifies a rigid regulatory regime that was first introduced in the German State Hessen in 1970 and demands that organizations minimize the amount of data they collect, use, share, and retain. Healthcare and healthtech organizations have struggled to comply with this regime and have found EU data protection laws fundamentally hostile to data-driven progress in medicine. The United States, on the other hand, has traditionally relied on sector- and harm-specific laws to protect privacy, including data privacy and security rules under the federal Health Insurance Portability and Accountability Act (“HIPAA”) and numerous state laws including the Confidentiality of Medical Information Act (“CMIA”) in California, which specifically address the collection and use of health information. So long as organizations observe the specific restrictions and prohibitions in sector-specific privacy laws, they may collect, use, and share health information. As a default rule in the United States, businesses are generally permitted to process personal information, including health information. Yet, recently, extremely broad and complex privacy laws have been proposed or enacted in some states, including the California Consumer Privacy Act of 2018 (“CCPA”), which have a potential to render compliance with data privacy laws impractical for most businesses, including those in the healthcare and healthtech sectors. Meanwhile, the People’s Republic of China is encouraging and incentivizing data-driven research and development by Chinese companies, including in the healthcare sector. Data-related legislation is focused on cybersecurity and securing access to data for Chinese government agencies and much less on individual privacy interests. In Europe and the United States, the political pendulum has swung too far in the direction of ever more rigid data regulation and privacy laws, at the expense of potential benefits through medical progress. This is literally unhealthy. Governments, businesses, and other organizations need to collect, use and share more personal health information, not less. The potential benefits of health data processing far outweigh privacy risks, which can be better tackled by harm-specific laws. If discrimination by employers and insurance companies is a concern, then lawmakers and law enforcement agencies need to focus on anti-discrimination rules for employers and insurance companies - not prohibit or restrict the processing of personal data, which does not per se harm anyone. The notion of only allowing data processing under specific conditions leads to a significant hindrance of medical progress by slowing down treatments, referrals, research, and development. It also prevents the use of medical data as a tool for averting dangers for the public good. Data “anonymization” and requirements for specific consent based on overly detailed privacy notices do not protect patient privacy effectively and unnecessarily complicate the processing of health data for medical purposes. Property rights to personal data offer no solutions. Even if individuals - not companies creating databases - were granted property rights to their own data originally, this would not ultimately benefit individuals. Given that transfer and exclusion rights are at the core of property regimes, data property rights would threaten information freedom and privacy alike: after an individual sells her data, the buyer and new owner could exercise his data property rights to enjoin her and her friends and family from continued use of her personal data. Physicians, researchers, and developers would not benefit either; they would have to deal with property rights in addition to privacy and medical confidentiality requirements. Instead of overregulating data processing or creating new property rights in data, lawmakers should require and incentivize organizations to earn and maintain the trust of patients and other data subjects and penalize organizations that use data in specifically prohibited ways to harm individuals. Electronic health records, improved notice and consent mechanisms, and clear legal frameworks will promote medical progress, reduce risks of human error, lower costs, and make data processing and sharing more reliable. We need fewer laws like the GDPR or the CCPA that discourage organizations from collecting, using, retaining, and sharing personal information. Physicians, researchers, developers, drug companies, medical device manufacturers and governments urgently need better and increased access to personal health information. The future of medicine offers enormous opportunities. It depends on trust and healthy data protection. Some degree of data regulation is necessary, but the dose makes the poison. Laws that require or intend to promote the minimization of data collection, use, and sharing may end up killing more patients than hospital germs. In this article, I promote a view that is decidedly different from that supported by the vast majority of privacy scholars, politicians, the media, and the broader zeitgeist in Europe and the United States. I am arguing for a healthier balance between data access and data protection needs in the interest of patients’ health and privacy. I strive to identify ways to protect health data privacy without excessively hindering healthcare and medical progress. After an introduction (I), I examine current approaches to data protection regulation, privacy law, and the protection of patient confidentiality (II), risks associated with the processing of health data (III), needs to protect patient confidence (IV), risks for healthcare and medical progress (V), and possible solutions (VI). I conclude with an outlook and call for healthier approaches to data protection (VII).
20
Andress, K., and E. Downey. "(A146) Disaster Patient Tracking – Local, State and Federal Interoperability during a Multi-Hospital Evacuation Exercise." Prehospital and Disaster Medicine 26, S1 (May 2011): s42. http://dx.doi.org/10.1017/s1049023x11001476.
Full textAbstract:
IntroductionAssociated with hospital evacuation is the need to track multiple patient evacuees from point of origination to final hospital reception. Patient tracking, a component of the hospital emergency operations plan, is vital to patient care; family association, resource management, financial reimbursement, risk management, and repatriation. Tracking strategies and plans can include a variety of vendors, hardware, software, and coordination issues. Hospital evacuee tracking plans and platforms exist at multiple jurisdictional levels but may not be interoperable.MethodsThree patient tracking platforms representing a local, state and federal application were used during a multi-hospital evacuation exercise, initiated in New Orleans, Louisiana, May 2010. Simulated patients were flown and tracked to multiple patient reception centers in the southern United States, including the Federal Coordinating Center in Shreveport, Louisiana, and receiving National Disaster Medical System hospitals. This review summarizes tracking operations, patient data characteristics captured and interoperability at the Shreveport reception location.Results7 New Orleans hospitals entered 51 patients for evacuation into Louisiana's web-based, At-Risk-Registry (ARR) database including 8 patient identifiers each. ARR data was shared with federal and Louisiana Region 7 patient evacuee receivers for flight manifest construction and reception planning. 34 ARR evacuee patients were indicated for the Shreveport, Louisiana, reception site. 34 patients with 6 identifying characteristics were entered from ARR into EMTrack, the local patient tracking system. A C130 arrived with a TRAC2ES manifest of 20 simulated patients with 6 patient data characteristics. The local tracking system was reconfigured for the hardcopy manifest; simulated patients were received at the airport; transported and received at local hospitals.ConclusionsTracking system interoperability may be challenged by tracking technologies, jurisdictional requirements and degree of implementation at the local, state and federal level. Tracking should be standardized based on national recommendations with local systems remaining flexible for just-in-time requirements.
21
Tillyer, Rob, and Richard Hartley. "The Use and Impact of Fast-Track Departures." Crime & Delinquency 62, no. 12 (July 10, 2016): 1624–47. http://dx.doi.org/10.1177/0011128713505481.
Full textAbstract:
Fast-track programs allow prosecutors in authorized jurisdictions to expedite case processing for offenders charged with immigration violations. We explore whether disparities from fast-track usage exist by utilizing multilevel modeling techniques to analyze 2008 United States Sentencing Commission data on the federal sentencing of illegal entry defendants. Results indicate that the use of fast-track programs, the amount of sentence reduction applied in fast-track cases, and the overall sentence length is differentially impacted by various legal, extralegal, case processing, and district-level variables. These findings suggest some support for previous theoretical explanations for decision-making, but also indicate that these processes may differ slightly in the context of fast-track programs.
22
Tan, Judy Y., Lila A Sheira, Edward A. Frongillo, Adaora A Adimora, Phyllis C. Tien, Deborah Konkle-Parker, Elizabeth T. Golub, et al. "Food insecurity and neurocognitive function among women living with or at risk for HIV in the United States." American Journal of Clinical Nutrition 112, no. 5 (August 25, 2020): 1280–86. http://dx.doi.org/10.1093/ajcn/nqaa209.
Full textAbstract:
ABSTRACT Background Neurocognitive impairment (NCI) persists among women living with HIV. Food insecurity is also common among women and may be an important modifiable contributor of NCI. Objective The goal of this study was to determine the association of food insecurity with neurocognitive function among women living with or without HIV. Methods From 2013 to 2015, we analyzed data from a cross-sectional sample from the Women's Interagency HIV Study (WIHS). Measures included food insecurity and a comprehensive neuropsychological test battery assessing executive function, processing speed, attention/working memory, learning, memory, fluency, and motor function. We conducted multivariable linear regressions to examine associations between food insecurity and domain-specific neurocognitive performance, adjusting for relevant sociodemographic, behavioral, and clinical factors. Results Participants (n = 1,324) were predominantly HIV seropositive (68%), Black/African-American (68%) or Hispanic (16%), and low income (48% reported <$12,000/y), with a median age of 49.6 y (IQR = 43.1, 55.5). Approximately one-third (36%, n = 479) were food insecure. Food insecurity was associated with poorer executive function (b = −1.45, SE = 0.58, P ≤ 0.01) and processing speed (b = −1.30, SE = 0.59, P ≤ 0.05). HIV serostatus modified the association between food insecurity and learning, memory, and motor function (P values <0.05). Food insecurity was positively associated with learning among women living with HIV (b = 1.58, SE = 0.77, P ≤ 0.05) and negatively associated with motor function among HIV-negative women (b = −3.57, SE = 1.08, P ≤ 0.001). Conclusions Food insecurity was associated with domain-specific neurocognitive function in women, and HIV serostatus modified associations. Food security may be an important point of intervention for ethnically diverse women with low socioeconomic status. Longitudinal studies are warranted to determine potential pathways by which food insecurity is associated with neurocognitive function among women living with or at risk for HIV.
23
Saleh, Sameh Nagui, Christoph U. Lehmann, and Richard J. Medford. "Early Crowdfunding Response to the COVID-19 Pandemic: Cross-sectional Study." Journal of Medical Internet Research 23, no. 2 (February 9, 2021): e25429. http://dx.doi.org/10.2196/25429.
Full textAbstract:
Background As the number of COVID-19 cases increased precipitously in the United States, policy makers and health officials marshalled their pandemic responses. As the economic impacts multiplied, anecdotal reports noted the increased use of web-based crowdfunding to defray these costs. Objective We examined the web-based crowdfunding response in the early stage of the COVID-19 pandemic in the United States to understand the incidence of initiation of COVID-19–related campaigns and compare them to non–COVID-19–related campaigns. Methods On May 16, 2020, we extracted all available data available on US campaigns that contained narratives and were created between January 1 and May 10, 2020, on GoFundMe. We identified the subset of COVID-19–related campaigns using keywords relevant to the COVID-19 pandemic. We explored the incidence of COVID-19–related campaigns by geography, by category, and over time, and we compared the characteristics of the campaigns to those of non–COVID-19–related campaigns after March 11, when the pandemic was declared. We then used a natural language processing algorithm to cluster campaigns by narrative content using overlapping keywords. Results We found that there was a substantial increase in overall GoFundMe web-based crowdfunding campaigns in March, largely attributable to COVID-19–related campaigns. However, as the COVID-19 pandemic persisted and progressed, the number of campaigns per COVID-19 case declined more than tenfold across all states. The states with the earliest disease burden had the fewest campaigns per case, indicating a lack of a case-dependent response. COVID-19–related campaigns raised more money, had a longer narrative description, and were more likely to be shared on Facebook than other campaigns in the study period. Conclusions Web-based crowdfunding appears to be a stopgap for only a minority of campaigners. The novelty of an emergency likely impacts both campaign initiation and crowdfunding success, as it reflects the affective response of a community. Crowdfunding activity likely serves as an early signal for emerging needs and societal sentiment for communities in acute distress that could be used by governments and aid organizations to guide disaster relief and policy.
24
Khalilnejad, Arash, Ahmad M. Karimi, Shreyas Kamath, Rojiar Haddadian, Roger H. French, and Alexis R. Abramson. "Automated pipeline framework for processing of large-scale building energy time series data." PLOS ONE 15, no. 12 (December 1, 2020): e0240461. http://dx.doi.org/10.1371/journal.pone.0240461.
Full textAbstract:
Commercial buildings account for one third of the total electricity consumption in the United States and a significant amount of this energy is wasted. Therefore, there is a need for “virtual” energy audits, to identify energy inefficiencies and their associated savings opportunities using methods that can be non-intrusive and automated for application to large populations of buildings. Here we demonstrate virtual energy audits applied to large populations of buildings’ time-series smart-meter data using a systematic approach and a fully automated Building Energy Analytics (BEA) Pipeline that unifies, cleans, stores and analyzes building energy datasets in a non-relational data warehouse for efficient insights and results. This BEA pipeline is based on a custom compute job scheduler for a high performance computing cluster to enable parallel processing of Slurm jobs. Within the analytics pipeline, we introduced a data qualification tool that enhances data quality by fixing common errors, while also detecting abnormalities in a building’s daily operation using hierarchical clustering. We analyze the HVAC scheduling of a population of 816 buildings, using this analytics pipeline, as part of a cross-sectional study. With our approach, this sample of 816 buildings is improved in data quality and is efficiently analyzed in 34 minutes, which is 85 times faster than the time taken by a sequential processing. The analytical results for the HVAC operational hours of these buildings show that among 10 building use types, food sales buildings with 17.75 hours of daily HVAC cooling operation are decent targets for HVAC savings. Overall, this analytics pipeline enables the identification of statistically significant results from population based studies of large numbers of building energy time-series datasets with robust results. These types of BEA studies can explore numerous factors impacting building energy efficiency and virtual building energy audits. This approach enables a new generation of data-driven buildings energy analysis at scale.
25
Klain, Miroslav, Edmund Ricci, Peter Safar, Victor Semenov, Ernesto Pretto, Samuel Tisherman, Joel Abrams, and Louise Comfort. "Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results." Prehospital and Disaster Medicine 4, no. 2 (December 1989): 135–52. http://dx.doi.org/10.1017/s1049023x00029939.
Full textAbstract:
AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).
26
Adelman, Brenna. "Confusion, Chaos, and Bridging the Gap: A Prospective Study Gauging Disaster Triage Methodologies and Usage Across First Responder Professions." Prehospital and Disaster Medicine 34, s1 (May 2019): s111. http://dx.doi.org/10.1017/s1049023x19002346.
Full textAbstract:
Introduction:Disasters are unique in that they impact all socioeconomic, class, and social divides. They are complex, hard to conceptualize and operationally define, and occur sporadically without warning. However, regardless of each disasters innate unpredictability, there is one common need that directly impacts patient morbidity and mortality: effective triage.Aim:Currently the United States has no uniform triage mandate. The purpose of this study is to gather descriptive data on the type of mass-casualty triage currently being utilized by first responders (Emergency Medical Services/Fire/Nurses) and improve our understanding regarding the prevalence of mass casualty triage.Methods:A descriptive mixed methods survey is being distributed to first responders/nurses in the Appalachian region. This survey collects respondents demographics, profession, and MCI triage data. Data will be analyzed and descriptive statistics will be generated. GIS will be utilized to graph findings and visualize local and national trends.Results:Results of this study are pending.Discussion:Organizations have addressed the need for a standard triage protocol, even going so far as to create uniform criteria which each triage system should meet. However, the literature does not describe how individual professions train their members in disaster triage, or what triage is currently being utilized in each profession. Nurses and first-responders serve as linchpins in many communities. They remain in a community, both before, during, and after a mass casualty event, but they do not perform in a vacuum. During an MCI (mass-casualty incident) their scope of practice may vary, but they have common foci: the affected community. A better understanding of the type of MCI triage that each profession is using is vital in understanding how triage is being applied, and vital in identifying gaps in application that may impact the effectiveness of field triage, and affect local and national policy, practice, and future research.
27
Stanley, Steven, Anthony Basile, Anaissa Ruiz Tejada, Ellinor Hjelm, and Karen Sweazea. "Effect of Food Processing on Total Antioxidant Capacity." Current Developments in Nutrition 5, Supplement_2 (June 2021): 370. http://dx.doi.org/10.1093/cdn/nzab037_080.
Full textAbstract:
Abstract Objectives Ultra-processed foods (UPF) make up the majority of energy intake in the United States. Consumption of these foods is correlated with poor health outcomes related to chronic inflammation. The objective of this study is to examine the relationship between food processing and total antioxidant capacity (TAC). It was hypothesized that TAC will be highest in Minimally Processed (MIN), lower in Processed (PRO), and lowest in Ultra-processed foods (UPF). Methods TAC (mmol/100g) data were obtained for 3,139 foods from a published data set. Food items were coded to agreement by the research team into three groups of the NOVA classification (MIN, PRO, UPF) as well as MyPyramid food groups (with alcohol and beverage groups added). A Kruskal-Wallis and Mann-Whitney U Test were used to determine significance across and between groups, respectively, with an alpha of 0.05. Results The mean TAC of all three NOVA groups for all food items were significantly different (MIN: 11.66 ± 46.29; PRO: 0.85 ± 1.79; UPF: 0.80 ± 1.93; P < 0.001). While all MyPyramid groups had significant differences in mean TAC between food processing groups (P < 0.05 for all), Fruits, Alcohol, and Bean, Nuts, and Seeds supported the hypothesis. Whereas, mixed results were found for all other MyPyramid groups and did not support the hypothesis (i.e., mean TAC was not always lower in higher processed foods). Conclusions Generally, foods that were more processed were lower in TAC. However, this trend does not hold for all MyPyramid food groups which could be attributed to the varying food processing techniques (e.g., fortification and additives). The lower total antioxidant capacity, on average, of UPFs could be a mechanism through which consumption of these foods promotes inflammatory chronic disease. Funding Sources None.
28
Werbin, Zoey R., Briana Hackos, Michael C. Dietze, and Jennifer M. Bhatnagar. "The National Ecological Observatory Network’s soil metagenomes: assembly and basic analysis." F1000Research 10 (April 19, 2021): 299. http://dx.doi.org/10.12688/f1000research.51494.1.
Full textAbstract:
The National Ecological Observatory Network (NEON) annually performs shotgun metagenomic sequencing to sample genes within soils at 47 sites across the United States. NEON serves as a valuable educational resource, thanks to its open data policies and programming tutorials, but there is currently no introductory tutorial for performing analyses with the soil shotgun metagenomic dataset. Here, we describe a workflow for processing raw soil metagenome sequencing reads using the Sunbeam bioinformatics pipeline. The workflow includes cleaning and processing raw reads, taxonomic classification, assembly into contigs, annotation of predicted genes using custom protein databases, and exporting assemblies to the KBase platform for downstream analysis. This workflow is designed to be robust to annual data releases from NEON, and the underlying Snakemake framework can manage complex software dependencies. The workflow presented here aims to increase the accessibility of NEON’s shotgun metagenome data, which can provide important clues about soil microbial communities and their ecological roles.
29
Deka, Deepanwita, Avra Pratim Chowdhury, Arabinda Ghosh, and Moni P. Bhuyan. "A HYPOTHETICAL DESIGN TO INHIBIT COVID 19 DISEASE DISASTER BY DIAGRAMMATIC MODEL." Journal of Experimental Biology and Agricultural Sciences 9, no. 3 (June 25, 2021): 311–24. http://dx.doi.org/10.18006/2021.9(3).311.324.
Full textAbstract:
SARS-CoV-2 is a new entity in the globe studied vigorously in the present world. The estimated populations are around 47 million people who are affected by the virus and around 300,000 (16th May 2020) deaths resulted from the outbreak. The rate might keep on increasing due to the non-availability of a proper vaccine, following proper management with epidemiological studies, and displacement of contact individuals as a source of transmission in particular viral-prone regions. CoVID 19 is on its vigorous spread leading to a global impact on lots of sectors. The outreaching impacts play a role in international politics, scientific developments, and economic crises over the world, and global relations among the countries. This model attempts to determine the possible impacts and outcomes of the Pandemic over the international level and some possible ways to handle it effectively. An unpredictable catastrophe in the present scenario of the world is following a high range of public health hazards. Analytical plotted data assembles for imposing in multidisciplinary segments to cure and control morbidity, a mortality rate of disease clusters, and hotspots zone. The contagious outbreak was reprogrammed as a pandemic from Wuhan in China through the transmissible chain of human contacts. Currently, the infective chain is spreading day by day with high morbidity in the United States, Europe, Scandinavian countries, and India. The transmissible chain of the virus needs to break until any effective medicine or vaccine is launched.
30
Madamala, Kusuma, Claudia R. Campbell, Edbert B. Hsu, Yu-Hsiang Hsieh, and James James. "Characteristics of Physician Relocation Following Hurricane Katrina." Journal of Medical Regulation 95, no. 1 (March 1, 2009): 6–12. http://dx.doi.org/10.30770/2572-1852-95.1.6.
Full textAbstract:
ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P < .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.
31
Wang, Jing, Huan Deng, Bangtao Liu, Anbin Hu, Jun Liang, Lingye Fan, Xu Zheng, Tong Wang, and Jianbo Lei. "Systematic Evaluation of Research Progress on Natural Language Processing in Medicine Over the Past 20 Years: Bibliometric Study on PubMed." Journal of Medical Internet Research 22, no. 1 (January 23, 2020): e16816. http://dx.doi.org/10.2196/16816.
Full textAbstract:
Background Natural language processing (NLP) is an important traditional field in computer science, but its application in medical research has faced many challenges. With the extensive digitalization of medical information globally and increasing importance of understanding and mining big data in the medical field, NLP is becoming more crucial. Objective The goal of the research was to perform a systematic review on the use of NLP in medical research with the aim of understanding the global progress on NLP research outcomes, content, methods, and study groups involved. Methods A systematic review was conducted using the PubMed database as a search platform. All published studies on the application of NLP in medicine (except biomedicine) during the 20 years between 1999 and 2018 were retrieved. The data obtained from these published studies were cleaned and structured. Excel (Microsoft Corp) and VOSviewer (Nees Jan van Eck and Ludo Waltman) were used to perform bibliometric analysis of publication trends, author orders, countries, institutions, collaboration relationships, research hot spots, diseases studied, and research methods. Results A total of 3498 articles were obtained during initial screening, and 2336 articles were found to meet the study criteria after manual screening. The number of publications increased every year, with a significant growth after 2012 (number of publications ranged from 148 to a maximum of 302 annually). The United States has occupied the leading position since the inception of the field, with the largest number of articles published. The United States contributed to 63.01% (1472/2336) of all publications, followed by France (5.44%, 127/2336) and the United Kingdom (3.51%, 82/2336). The author with the largest number of articles published was Hongfang Liu (70), while Stéphane Meystre (17) and Hua Xu (33) published the largest number of articles as the first and corresponding authors. Among the first author’s affiliation institution, Columbia University published the largest number of articles, accounting for 4.54% (106/2336) of the total. Specifically, approximately one-fifth (17.68%, 413/2336) of the articles involved research on specific diseases, and the subject areas primarily focused on mental illness (16.46%, 68/413), breast cancer (5.81%, 24/413), and pneumonia (4.12%, 17/413). Conclusions NLP is in a period of robust development in the medical field, with an average of approximately 100 publications annually. Electronic medical records were the most used research materials, but social media such as Twitter have become important research materials since 2015. Cancer (24.94%, 103/413) was the most common subject area in NLP-assisted medical research on diseases, with breast cancers (23.30%, 24/103) and lung cancers (14.56%, 15/103) accounting for the highest proportions of studies. Columbia University and the talents trained therein were the most active and prolific research forces on NLP in the medical field.
32
Hsu, Edbert B., Jurek G. Grabowski, Rashid A. Chotani, Jason A. Winslow, Donald W. Alves, and Michael J. VanRooyen. "Effects on Local Emergency Departments of Large-Scale Urban Chemical Fire With Hazardous Materials Spill." Prehospital and Disaster Medicine 17, no. 4 (December 2002): 196–201. http://dx.doi.org/10.1017/s1049023x00000492.
Full textAbstract:
AbstractIntroduction:On 18 July 2001, a train hauling hazardous materials, including hydrochloric acid, hydrofluoric acid, and acetic acid, derailed in the city of Baltimore, Maryland, resulting in a fire that burned under a downtown street for five days. Firefighters were stymied in their efforts to extinguish the fire, and the city was subjected to thick smoke for several days.Objectives:To determine whether an urban chemical fire with a hazardous materials spill resulted in a detectable public health impact, and to demo-graphically describe the at-risk population for potential smoke and chemical exposure.Methods:The United States Centers for Disease Control and Prevention (CDC) was consulted about possible side effects from chemical exposure. Total numbers of emergency department (ED) patients and admissions from 15:00 hours (h), 15 July 2001 to 15:00 h, 21 July 2001 were collected from five local hospitals. Patient encounters citing specified chief complaints from 15:00 h, 15 July to 15:00 h, 18 July (pre-accident) were compared with the period from 15:00 h, July 18 to 15:00 h, 21 July (post-accident). Data were analyzed using Fisher's exact test. The United States Census Bureau's Topologically Integrated Geographic Encoding and Referencing (TIGER) digital database of geographic features and ArcView Geographic Information Systems (GIS) were used to create maps of Baltimore and to identify populations at-risk using attribute census data. Results: There were 62,808 people residing in the immediate, affected area. The mean of the values for age was 33.7 ±3.2 years (standard deviation; range = 16 yrs) with 49% (30,927) males and 51% (31,881) females. A total of 2,922 ED patient encounters were screened. Chief complaints included shortness of breath, pre-event = 109 vs. post-event = 148; chest complaints = 90 vs. 113; burns and/or skin irritation = 45 vs. 42; eye irritation 26 vs. 34; throat irritation = 33 vs. 27; and smoke exposure = 0 vs. 15. There was a statistically significant increase (p <0.05) for shortness of breath and smoke exposure-related complaints. No statistically significant increase in numbers of admitted patients with these complaints was found.Conclusions:In the setting of a large-scale urban chemical fire, local EDs can expect a significant increase in the number of patients presenting to EDs with shortness of breath and/or smoke inhalation. Most do not require inpatient hospitalization. Careful assessment of impact on local EDs should be considered in future city-accident planning. Some official warnings were widely misinterpreted or ignored. Public education on potential hazards and disaster preparedness targeted to populations at-risk should receive a high priority. Geographic information systems (GIS) may serve as useful tools for identifying demographics of populations at-risk for disaster planning and responses.
33
Melanson, Stacy E. F., Neal I. Lindeman, and Petr Jarolim. "Selecting Automation for the Clinical Chemistry Laboratory." Archives of Pathology & Laboratory Medicine 131, no. 7 (July 1, 2007): 1063–69. http://dx.doi.org/10.5858/2007-131-1063-saftcc.
Full textAbstract:
Abstract Context.—Laboratory automation proposes to improve the quality and efficiency of laboratory operations, and may provide a solution to the quality demands and staff shortages faced by today's clinical laboratories. Several vendors offer automation systems in the United States, with both subtle and obvious differences. Arriving at a decision to automate, and the ensuing evaluation of available products, can be time-consuming and challenging. Although considerable discussion concerning the decision to automate has been published, relatively little attention has been paid to the process of evaluating and selecting automation systems. Objective.—To outline a process for evaluating and selecting automation systems as a reference for laboratories contemplating laboratory automation. Design.—Our Clinical Chemistry Laboratory staff recently evaluated all major laboratory automation systems in the United States, with their respective chemistry and immunochemistry analyzers. Our experience is described and organized according to the selection process, the important considerations in clinical chemistry automation, decisions and implementation, and we give conclusions pertaining to this experience. Results.—Including the formation of a committee, workflow analysis, submitting a request for proposal, site visits, and making a final decision, the process of selecting chemistry automation took approximately 14 months. We outline important considerations in automation design, preanalytical processing, analyzer selection, postanalytical storage, and data management. Conclusions.—Selecting clinical chemistry laboratory automation is a complex, time-consuming process. Laboratories considering laboratory automation may benefit from the concise overview and narrative and tabular suggestions provided.
34
Ghumman, Usman, and Jennifer Horney. "Characterizing the Impact of Extreme Heat on Mortality, Karachi, Pakistan, June 2015." Prehospital and Disaster Medicine 31, no. 3 (April 5, 2016): 263–66. http://dx.doi.org/10.1017/s1049023x16000273.
Full textAbstract:
AbstractIntroductionKarachi, Pakistan was affected by a heat wave in June 2015 during the Muslim holy month of Ramadan. Many media reports attributed the excess deaths in part to the practice of daylight fasting during Ramadan. As much of the published research reports on heat-related mortality in Europe and the United States, an exploration of the effects of extreme heat on residents of a South Asian mega-city address a gap in current disaster research.Hypothesis/ProblemThis report investigated potential risk factors for excess mortality associated with the June 2015 heat wave in Karachi, Pakistan.MethodsData were obtained through manual review of death certificates at public hospitals and private clinics in Karachi, Pakistan, conducted from July 1 through July 31, 2015 by a trained physician. Demographic data for any deaths with a primary cause of death of heat-related illness were recorded in Microsoft Excel (Microsoft Corp.; Redmond, Washington USA). EpiSheet (2012; Rothman. Modern Epidemiology. Lippincott Williams & Wilkins; Philadelphia, Pennsylvania USA) was used to calculate risk differences (RD), rate ratios (RR), and 95% confidence intervals (95% CI).ResultsOverall, residents of Karachi were approximately 17 times as likely to die of a heat-related cause of death during June 2015 (RR=17.68; 95% CI, 13.87-22.53) when compared with the reference period of June 2014. Residents with a monthly income lower than 20,000 Pakistani Rupees (US $196; RD=0.03; 95% CI, 0.01-0.05) and those with less than a fifth grade education (RD=0.03; 95% CI, 0.00-0.05) were at significantly higher risk of death during the 2015 heat wave compared to the reference period.ConclusionFasting during Ramadan was not a significant risk factor for mortality from heat-related causes during the Karachi heat wave of June 2015. A large number of excess deaths were reported across all demographic groups, which due to the burden of record keeping in an under-resourced health system during a public health emergency, are almost certainly an underestimate.GhummanU, HorneyJ. Characterizing the impact of extreme heat on mortality, Karachi, Pakistan, June 2015. Prehosp Disaster Med. 2016;31(3):263–266.
35
Swienton, A., Daniel Goldberg, Tracy Hammond, Andrew Klein, and Jennifer Horney. "Effect of Tornado Outbreaks on Morbidity and Mortality in Texas." Prehospital and Disaster Medicine 34, s1 (May 2019): s50. http://dx.doi.org/10.1017/s1049023x19001171.
Full textAbstract:
Introduction:In the United States, tornadoes are the third leading cause of fatalities from natural disasters1. To aid prevention and mitigation of tornado-related morbidity and mortality, improvement in standardizing tornado specific threat analysis terminology was assessed. The largest number of tornado-related fatalities has occurred in the state of Texas for over a hundred years. The occurrence of tornadic clusters or “outbreaks” has not been formally standardized. The concept of “tornado outbreaks” is better defined and its role in fatality mitigation is addressed in this Institutional Review Board (IRB) approved study.Aim:To understand the role of “tornado outbreaks” related clusters in Texas in relationship to morbidity and mortality.Methods:This IRB approved (IRB2017- 0507) research study utilized GIS tools and statistical analysis of historical data to examine the relationship between tornado severity (based on the Fujita Scale), the number of tornadoes, and the trends in morbidity and mortality. This study was funded in part from The National Science Foundation grant (NSF Grant #1560106) in support of the CyberHealthGIS Research Experience for Undergraduates (REU).Results:A statistically significant difference was demonstrated between the severity of a tornado and related morbidity and mortality during “tornado outbreaks” in Texas during a defined 30-year period.Discussion:Understanding the role and discerning the impacts of “tornado outbreaks” as related to tornado severity has critical implications to disaster preparedness. Applications of this conclusion may improve shelter planning/preparation, timely warning, and educating the at-risk public. Subsequently, examining the likelihood and improved descriptions of “tornado outbreaks” may aid in reducing the number of tornado-related injuries and fatalities nationally.
36
Kieeva, L. P., and S. V. Maksimov. "Open Science: a Critique of a New UNESCO Project." Russian competition law and economy, no. 1 (August 20, 2021): 22–29. http://dx.doi.org/10.47361/2542-0259-2021-1-25-22-29.
Full textAbstract:
The subject of the authors’ research is a preliminary draft of the United Nations Educational, Scientific and Cultural Organization (UNESCO) Recommendation on Open Science, which was presented to the world community at the end of September 2020. According to the draft Recommendation, “open science” is understood as a framework concept of various institutions and forms of activity aimed at “making scientific knowledge, methods, data and facts open and accessible to all”. According to the authors, making the fruits of science available to all mankind and making them the property of all mankind is not the same thing.The declaration of free access to “scientific raw materials” does not mean that all countries receive equal opportunities for its “extraction”, processing, creation of new goods on its basis and receiving income from their sale. These opportunities today are focused on the “global North”, or rather in that part of it, which essentially monopolized the world markets for collecting, storing, processing, examining and publishing the primary results of scientific research.According to the authors, the concept of “Open Science” proposed to the world community in relation to modern economic and legal realities is the concept of devaluation of “scientific raw materials” in order to obtain the maximum profit from the turnover of goods created with its use by a narrow circle of beneficiaries.The interests of Russia, most of the world’s states and scientists are not to consist in supplying the collective world dominant with “scientific raw materials” at a negative cost, i.e. paying extra for it, and then buying everything new, science-intensive and useful from it.An alternative to the instrument of “soft” dictate against national governments and the majority of scientists, proposed on behalf of UNESCO, could be the initiation of a general Convention on Science, which would solve real economic and legal problems of the circulation of scientific results, including issues of their receipt, global monitoring, storage, processing, expertise, assessment, remuneration of scientists’ labor.The article’s authors propose at the political level to openly abandon the previously chosen model of organization and legal regulation of Russian science, focused on the interests of the global North.
37
Koterov, A. N., L. N. Ushenkova, M. V. Kalinina, and A. P. Biryukov. "Comparison of the Risk of Mortality from Solid Cancers after Radiation Incidents and Occupational Exposures." Disaster Medicine, no. 3 (September 2021): 34–41. http://dx.doi.org/10.33266/2070-1004-2021-3-34-41.
Full textAbstract:
The purpose of the study was to compare the excess relative risk of mortality (ERR per 1 Sv) from solid cancers during acute — catastrophic or accidental and occupational, fractionated or chronic — exposure. Study materials and methods. Materials of the study: maintained database (source database) on nuclear industry workers from about 40 countries, based on which a pooled analysis of data was conducted to determine the integral value of ERR per 1 Gy for mortality from solid cancers; indicators of cohorts exposed to catastrophic and accidental radiation: the cohort LSS victims of the atomic bombings in Japan; residents of the Techa River — radioactive contamination resulting from releases from "Mayak" production association; Russian liquidators of the Chernobyl nuclear accident. Study results and analysis. Comparison of the ERR of 1 Sv deaths from solid cancers for workers in the global nuclear industry (pooling analysis of data from 37 studies) with those of the LSS cohort; Techa River residents and Chernobyl accident liquidators showed no logical and principled differences, with the risks for the latter two cohorts being the highest. Although the findings partly support the approach of the UN Scientific Committee on the Effects of Atomic Radiation that the carcinogenic effects of acute (catastrophic or accidental) and occupational (fractionated or chronic) radiation exposure are independent of the dose rate factor (DDREF), this issue cannot be considered unequivocally resolved, given the biological mechanisms and radiobiological experimental data. Based on the ERR per 1 Sv, the average external dose, and the annual background cancer mortality rates in Russia and the United States, the expected cancer mortality increase for 100,000 workers in the nuclear industry would be an average of 32-69 people over 10 years — 0.032-0.069% of the group. Such risks, due to multiple carcinogenic non-radiation factors of life and work, as well as fluctuating background values, cannot be taken into account in the practice of disaster medicine and public health.
38
Berman, Mark, and Elliot Lander. "A Prospective Safety Study of Autologous Adipose-Derived Stromal Vascular Fraction Using a Specialized Surgical Processing System." American Journal of Cosmetic Surgery 34, no. 3 (February 1, 2017): 129–42. http://dx.doi.org/10.1177/0748806817691152.
Full textAbstract:
Autologous adipose-derived stromal vascular fraction (SVF) has been proposed as a remedy for a number of inflammatory, autoimmune, and degenerative conditions. This procedure had mainly been evaluated in veterinary medicine and outside the United States when this study was initiated. This study looks at adverse events to evaluate safety as its primary objective and secondarily follows efficacy of SVF as deployed through intra-articular injections and intravenous infusions for a variety of orthopedic and non-orthopedic conditions. We hypothesized that autologous SVF deployment using a specialized surgical processing system (the CSN Time Machine® system, trademark name for the MediKhan Lipokit/Maxstem system; MediKhan, Los Angeles, California) was safe (ie, minimally acceptable adverse events) and that clinical efficacy could be demonstrated. This was a prospective case series. After institutional review board approval, 1698 SVF deployment procedures were performed between 2011 and 2016 by us and other affiliates with our same system trained by us as a nearly closed sterile surgical lipotransfer procedure on 1524 patients with various degenerative, inflammatory, and autoimmune conditions with a majority involving the musculoskeletal system. All outcome test data were collected in an online database over a 5-year period. Our study shows a very low number of reported adverse events and a reduction in pain ratings after 6 months or more across a variety of musculoskeletal diseases and improvements in a variety of other degenerative conditions. Our system for producing adipose-derived SVF therapy for our patients was safe and benefits could be measured for a long time after SVF deployment. Further controlled long-term studies for specific disease conditions with large patient populations are necessary to further investigate the benefits observed.
39
Scharf, Becca M., Rick A. Bissell, Jamie L. Trevitt, and J. Lee Jenkins. "Diagnosis Prevalence and Comorbidity in a Population of Mobile Integrated Community Health Care Patients." Prehospital and Disaster Medicine 34, no. 1 (December 27, 2018): 46–55. http://dx.doi.org/10.1017/s1049023x18001140.
Full textAbstract:
AbstractIntroductionFrequent calls to 911 and requests for emergency services by individuals place a costly burden on emergency response systems and emergency departments (EDs) in the United States. Many of the calls by these individuals are non-emergent exacerbations of chronic conditions and could be treated more effectively and cost efficiently through another health care service. Mobile integrated community health (MICH) programs present a possible partial solution to the over-utilization of emergency services by addressing factors which contribute to a patient’s likelihood of frequent Emergency Medical Services (EMS) use. To provide effective care to eligible individuals, MICH providers must have a working understanding of the common conditions they will encounter.ObjectiveThe purpose of this descriptive study was to evaluate the diagnosis prevalence and comorbidity among participants in the Queen Anne’s County (Maryland USA) MICH Program. This fundamental knowledge of the most common medical conditions within the MICH Program will inform future mobile integrated health programs and providers.MethodsThis study examined preliminary data from the MICH Program, as well as 2017 Maryland census data. It involved secondary analysis of de-identified patient records and descriptive statistical analysis of the disease prevalence, degree of comorbidity, insurance coverage, and demographic characteristics among 97 program participants. Diagnoses were grouped by their ICD-9 classification codes to determine the most common categories of medical conditions. Multiple linear regression models and chi-squared tests were used to assess the association between age, sex, race, ICD-9 diagnosis groups, and comorbidity among program enrollees.ResultsResults indicated the most prevalent diagnoses included hypertension, high cholesterol, esophageal reflux, and diabetes mellitus. Additionally, 94.85% of MICH patients were comorbid; the number of comorbidities per patient ranged from one to 13 conditions, with a mean of 5.88 diagnoses per patient (SD=2.74).ConclusionOverall, patients in the MICH Program are decidedly medically complex and may be well-suited to additional community intervention to better manage their many conditions. The potential for MICH programs to simultaneously improve patient outcomes and reduce health care costs by expanding into larger public health and addressing the needs of the most vulnerable citizens warrants further study.ScharfBM, BissellRA, TrevittJL, JenkinsJL.Diagnosis prevalence and comorbidity in a population of mobile integrated community health care patients.Prehosp Disaster Med. 2019;34(1):46–55.
40
O’Neil, Sharon H., Ashley M. Whitaker, Kimberly Kayser, Mary Baron Nelson, Jonathan L. Finlay, Girish Dhall, and Stephen Sands. "Neuropsychological outcomes on Head Start III: a prospective, multi-institutional clinical trial for young children diagnosed with malignant brain tumors." Neuro-Oncology Practice 7, no. 3 (February 3, 2020): 329–37. http://dx.doi.org/10.1093/nop/npz071.
Full textAbstract:
Abstract Background Current pediatric brain tumor treatment focuses on titrating toxicity based on risk factors while simultaneously improving survivorship. The Head Start (HS) protocols I to IV (1991-present) use high-dose chemotherapy (HDCTx) with an aim of reducing or eliminating cranial irradiation in very young children, the most vulnerable to its effects. Methods We examined estimated Full Scale IQ, overall Adaptive Functioning, Working Memory, Processing Speed, and Verbal and Nonverbal Memory outcome data for 43 HS III patients diagnosed between ages 2 months and 7 years from 15 institutions in the United States and Canada. Results At a mean of 5.12 years postdiagnosis, the HS III patients performed within the average to low-average ranges across these variables; however, individual variability was noted with scores ranging from superior to impaired, and the sample as a whole performed lower than age expectations. Performance did not significantly differ by sex or ethnicity, diagnosis, or for those treated with an intravenous methotrexate dose of 400 mg/kg vs 270 mg/kg. Additionally, performance did not significantly differ by age at diagnosis or length of follow-up. Conclusions The results, indicating overall average to low-average neurocognitive functioning, are encouraging, though significant individual variability was noted. Those who were younger at diagnosis, received more intensive methotrexate, and were further out from treatment were not at significantly increased risk of cognitive decline within our sample, suggesting a strategy of using HDCTx and autologous hematopoietic progenitor cell rescue to reduce or eliminate irradiation may allow for continued CNS development in young children treated for a brain tumor.
41
Smith, David J. "4 Agrochemical Residues, Product Quality, and Safety of Beef Fed Cotton Ginning and Other Byproduct Feeds." Journal of Animal Science 98, Supplement_2 (November 1, 2020): 21. http://dx.doi.org/10.1093/jas/skz397.047.
Full textAbstract:
Abstract Most commodity crops undergo milling, husking, ginning or other processing procedures before use as human food or fiber. Byproduct nutrient density varies with the type of grain or oil seed processed and use typically varies with nutrient needs of specific production situations. Drought or high grain prices may increase the use of byproducts; regionally available, low-cost ingredients such as cotton ginning byproduct may be used extensively by beef producers to replace forage. Doubt associated with the use of such byproducts is not typically related to nutritional value but with uncertainties about the presence of residual pesticides, herbicides, or harvest-aid chemicals. Potential chemical residues in consumer products and the concomitant financial and reputational losses borne by the industry provide an impetus for concern. Negative experiences with contaminated Australian beef established a long-lived suspicion of “cotton trash” that continues to impact the industry today. The purpose of this review is to discuss sources, amounts, and risks of chemical residues associated with byproduct feeds used in the southern United States with cotton ginning byproducts as a major focus. The use patterns of specific crop protection and harvest-aid chemicals will be discussed in context with chemical tolerances established by the U.S. EPA. In addition, U.S. pesticide monitoring programs in beef will be discussed. Although data describing the transmission of chemical residues from byproduct feeds into beef products are limited, the available data suggest some best practices could be adopted to mitigate concerns and minimize possible agrochemical residue contamination of beef.
42
Shaw, C. A., J. S. Bains, B. A. Pasqualotto, and K. Curry. "Methionine sulfoximine shows excitotoxic actions in rat cortical slices." Canadian Journal of Physiology and Pharmacology 77, no. 11 (October 25, 1999): 871–77. http://dx.doi.org/10.1139/y99-097.
Full textAbstract:
Methionine sulfoximine (MSO) is a rare amino acid. It occurs in nature or as a by-product of some forms of food processing. A notable example of the latter was a former method for bleaching wheat flour, using nitrogen trichloride, the "agene process," in use for most of the first 50 years of this century. "Agenized" flour was found to be responsible for various neurological disorders in animals, and MSO was identified as the toxic factor. The agene process was subsequently discontinued in the United States and the United Kingdom circa 1950. MSO inhibits the synthesis of both glutathione and glutamine, and it is possible that its actions on the nervous system arise from alterations in the amount or distribution of these molecules. Structurally, MSO resembles glutamate, an observation that has also raised the possibility that it might have more direct glutamate-like actions on neurons. In the present investigation, we report excitatory and toxic actions of MSO in an in vitro preparation of adult rat cortex. Field potential recordings in this preparation show that MSO application evokes a sustained depolarization, which can be blocked by the N-methyl-D-aspartate (NMDA) antagonist L-(+)-2-amino-5-phosphonovalerate (AP5). However, competition assays using MSO on [3H]CGP-39653 (DL-(E)-2-amino-4-propyl-1-phosphono-3-pentenoate) binding in rat cortical homogenates show only 20% displacement of total binding, suggesting that MSO is acting indirectly, perhaps by releasing glutamate. To investigate this possibility, we measured glutamate release during MSO application. Time course and dose-response experiments with MSO showed significant [3H]glutamate release, which was partially attenuated by AP5. To assess cellular toxicity, we measured lactate dehydrogenase (LDH) release from cortical sections exposed to MSO. MSO treatment led to a rapid increase in LDH activity, which could be blocked by AP5. These data suggest that MSO acts by increasing glutamate release, which then activates NMDA receptors, leading to excitotoxic cell death. These data suggest the possibility that MSO in processed flour had excitotoxic actions that may have been contributing factors to some human neuronal disorders.Key words: agene process, glutamate release, lactate dehydrogenase, methionine sulfoximine, N-methyl-D-aspartate (NMDA) receptor, neurological disorders.
43
Ho, Jean K., Frank Moriarty, Jennifer J. Manly, Eric B. Larson, Denis A. Evans, Kumar B. Rajan, Elizabeth M. Hudak, et al. "Blood-Brain Barrier Crossing Renin-Angiotensin Drugs and Cognition in the Elderly: A Meta-Analysis." Hypertension 78, no. 3 (September 2021): 629–43. http://dx.doi.org/10.1161/hypertensionaha.121.17049.
Full textAbstract:
Hypertension is an established risk factor for cognitive decline and dementia in older adults, highlighting the potential importance of antihypertensive treatments in prevention efforts. Work surrounding antihypertensive treatments has suggested possible salutary effects on cognition and neuropathology. Several studies have specifically highlighted renin-angiotensin system drugs, including AT1-receptor blockers and angiotensin-converting-enzyme inhibitors, as potentially benefiting cognition in later life. A small number of studies have further suggested renin-angiotensin system drugs that cross the blood-brain barrier may be linked to lower dementia risk compared to their nonpenetrant counterparts. The present meta-analysis sought to evaluate the potential cognitive benefits of blood-brain barrier crossing renin-angiotensin system drugs relative to their nonpenetrant counterparts. We harmonized longitudinal participant data from 14 cohorts from 6 countries (Australia, Canada, Germany, Ireland, Japan, United States), for a total of 12 849 individuals at baseline, and assessed for blood-brain barrier crossing potential within antihypertensive medications used by cognitively normal participants. We analyzed 7 cognitive domains (attention, executive function, language, verbal memory learning, recall, mental status, and processing speed) using ANCOVA (adjusted for age, sex, and education) and meta-analyses. Older adults taking blood-brain barrier-crossing renin-angiotensin drugs exhibited better memory recall over up to 3 years of follow-up, relative to those taking nonpenetrant medications, despite their relatively higher vascular risk burden. Conversely, those taking nonblood-brain barrier-penetrant medications showed better attention over the same follow-up period, although their lower vascular risk burden may partially explain this result. Findings suggest links between blood-brain barrier crossing renin-angiotensin drugs and less memory decline.
44
Der-Martirosian, Claudia, Tara Strine, Mangwi Atia, Karen Chu, Michael N. Mitchell, and Aram Dobalian. "General Household Emergency Preparedness: A Comparison Between Veterans and Nonveterans." Prehospital and Disaster Medicine 29, no. 2 (March 19, 2014): 134–40. http://dx.doi.org/10.1017/s1049023x1400020x.
Full textAbstract:
AbstractBackgroundDespite federal and local efforts to educate the public to prepare for major emergencies, many US households remain unprepared for such occurrences. United States Armed Forces veterans are at particular risk during public health emergencies as they are more likely than the general population to have multiple health conditions.MethodsThis study compares general levels of household emergency preparedness between veterans and nonveterans by focusing on seven surrogate measures of household emergency preparedness (a 3-day supply of food, water, and prescription medications, a battery-operated radio and flashlight, a written evacuation plan, and an expressed willingness to leave the community during a mandatory evacuation). This study used data from the 2006 through 2010 Behavioral Risk Factor Surveillance System (BRFSS), a state representative, random sample of adults aged 18 and older living in 14 states.ResultsThe majority of veteran and nonveteran households had a 3-day supply of food (88% vs 82%, respectively) and prescription medications (95% vs 89%, respectively), access to a working, battery-operated radio (82% vs 77%, respectively) and flashlight (97% vs 95%, respectively), and were willing to leave the community during a mandatory evacuation (91% vs 96%, respectively). These populations were far less likely to have a 3-day supply of water (61% vs 52%, respectively) and a written evacuation plan (24% vs 21%, respectively). After adjusting for various sociodemographic covariates, general health status, and disability status, households with veterans were significantly more likely than households without veterans to have 3-day supplies of food, water, and prescription medications, and a written evacuation plan; less likely to indicate that they would leave their community during a mandatory evacuation; and equally likely to have a working, battery-operated radio and flashlight.ConclusionThese findings suggest that veteran households appear to be better prepared for emergencies than do nonveteran households, although the lower expressed likelihood of veterans households to evacuate when ordered to do so may place them at a somewhat greater risk of harm during such events. Further research should examine household preparedness among other vulnerable groups including subgroups of veteran populations and the reasons why their preparedness may differ from the general population.Der-MartirosianC, StrineT, AtiaM, ChuK, MitchellMN, DobalianA. General household emergency preparedness: a comparison between veterans and nonveterans. Prehosp Disaster Med. 2014;29(2):1-7.
45
Solano-Sandí, Luis Armando, Mónica Cambronero-Valverde, and Guadalupe Herrera-Watson. "Identification and analysis of ongoing registered clinical intervention trials on COVID-19." Medwave 20, no. 09 (October 31, 2020): e8051-e8051. http://dx.doi.org/10.5867/medwave.2020.09.8051.
Full textAbstract:
Introduction The World Health Organization declared the disease caused by the novel coronavirus (SARS-CoV-2), a pandemic on March 11, 2020. Several studies have been proposed and started since then, mainly covering prevention, diagnosis, management, and treatment. Objective To identify and categorize all intervention studies up to the end of May related to SARS-CoV-2 infection, according to population and geo-graphical location (emphasis in Latin America) and to verify if there is any correlation according to purpose, phase, and recruitment status. Methods One thousand six hundred seventy-two trials were selected from 1705 until May 24 on the World Health Organization clinical trials platform related to COVID-19. Jupyter and Python tools were used for data processing and cleaning. Results One thousand six hundred seventy-two intervention studies related to SARS-CoV-2 infection were found. China, The United States, Iran, France, and Spain are the countries participating in the largest number of studies, while only 4,1% are from Latin America (mostly Brazilian). 28 studies are focusing only on older adults, and ten studies are based exclusively on populations under 19 years of age. Conclusion The worldwide interest in this new disease is reflected in the increasing number of intervention studies that are being carried out to date. How-ever, the studies analyzed do not cover the most vulnerable age groups proportionally and do not have equitable participation of all the coun-tries. In Latin America, this problem is exacerbated by the region's social, economic, and political limitations. Because it is an emerging disease, there is still not enough information to establish strong correlations between the analyzed variables, and the standardization of protocols is not yet definite because most of the studies are in progress.
46
Spencer, Erin T., Emilie Richards, Blaire Steinwand, Juliette Clemons, Jessica Dahringer, Priya Desai, Morgan Fisher, et al. "A high proportion of red snapper sold in North Carolina is mislabeled." PeerJ 8 (June 25, 2020): e9218. http://dx.doi.org/10.7717/peerj.9218.
Full textAbstract:
Seafood mislabeling occurs when a market label is inaccurate, primarily in terms of species identity, but also regarding weight, geographic origin, or other characteristics. This widespread problem allows cheaper or illegally-caught species to be marketed as species desirable to consumers. Previous studies have identified red snapper (Lutjanus campechanus) as one of the most frequently mislabeled seafood species in the United States. To quantify how common mislabeling of red snapper is across North Carolina, the Seafood Forensics class at the University of North Carolina at Chapel Hill used DNA barcoding to analyze samples sold as “red snapper” from restaurants, seafood markets, and grocery stores purchased in ten counties. Of 43 samples successfully sequenced and identified, 90.7% were mislabeled. Only one grocery store chain (of four chains tested) accurately labeled red snapper. The mislabeling rate for restaurants and seafood markets was 100%. Vermilion snapper (Rhomboplites aurorubens) and tilapia (Oreochromis aureus and O. niloticus) were the species most frequently substituted for red snapper (13 of 39 mislabeled samples for both taxa, or 26 of 39 mislabeled total). This study builds on previous mislabeling research by collecting samples of a specific species in a confined geographic region, allowing local vendors and policy makers to better understand the scope of red snapper mislabeling in North Carolina. This methodology is also a model for other academic institutions to engage undergraduate researchers in mislabeling data collection, sample processing, and analysis.
47
Howanitz, Peter J., Stephen W. Renner, and Molly K. Walsh. "Continuous Wristband Monitoring Over 2 Years Decreases Identification Errors." Archives of Pathology & Laboratory Medicine 126, no. 7 (July 1, 2002): 809–15. http://dx.doi.org/10.5858/2002-126-0809-cwmoyd.
Full textAbstract:
Abstract Context.—Identification of patients is one of the first steps in ensuring the accuracy of laboratory results. In the United States, hospitalized patients wear wristbands to aid in their identification, but wristbands errors are frequently found. Objective.—To investigate if continuous monitoring of wristband errors by participants of the College of American Pathologists (CAP) Q-Tracks program results in lower wristband error rates. Setting.—A total of 217 institutions voluntarily participating in the CAP Q-Tracks interlaboratory quality improvement program in 1999 and 2000. Design.—Participants completed a demographic form, answered a questionnaire, collected wristband data, and at the end of the year, best and most improved performers answered another questionnaire seeking suggestions for improvement. Each institution's phlebotomists inspected wristbands for errors before performing phlebotomy and recorded the number of patients with wristband errors. On a monthly basis, participants submitted data to the CAP for data processing, and at the end of each quarter, participants received summarized comparisons. At the end of each year, participants also received a critique of the results along with suggestions for improvement. Main Outcome Measures.—The percentage of wristband errors by quarter, types of wristband errors, and suggestions for improvement. Results.—During 2 years, 1 757 730 wristbands were examined, and 45 197 wristband errors were found. The participants' mean wristband error rate for the first quarter in 1999 was 7.40%; by the eighth quarter, the mean wristband error rate had fallen to 3.05% (P < .001). Continuous improvement occurred in each quarter for participants in the 1999 and 2000 program and in 7 of 8 quarters for those who participated in both 1999 and 2000. Missing wristbands accounted for 71.6% of wristband errors, and best performers usually had wristband error rates under 1.0%. The suggestion for improvement provided by the largest number of best and most improved performers was that phlebotomists should refuse to perform phlebotomy on a patient when a wristband error is detected. Conclusions.—The wristband error rate decreased markedly when this rate was monitored continuously using the CAP Q-Tracks program. The Q-Tracks program provides a useful tool for improving the quality of services in anatomic pathology and laboratory medicine.
48
Miller, Ranee A., and William B. Smith. "406 Reduce Reuse Rerumen: Reduction of Eschericia coli, coliform bacteria, Enterobacteriaceae, and yeast and mold colonies in dried paunch manure." Journal of Animal Science 97, Supplement_3 (December 2019): 164–65. http://dx.doi.org/10.1093/jas/skz258.338.
Full textAbstract:
Abstract The discovery of novel by-product feeds for animals, especially cattle, supports an economically viable agricultural community and enhanced stability in the United States food chain. By-products of livestock processing (in this case, paunch manure, or rumen content) could provide the tools necessary to achieve this goal. Paunch manure, the material from ruminant stomachs at the time of harvest, is a waste product of the meat industry and represents a final loss due to cost of disposal. Our objective in this study was to determine the microbial content of fresh versus dried paunch manure in an effort to assess viability as a potential feed source. Fresh paunch manure was collected from cattle at a local abattoir and immediately homogenized for microbial plating. One milliliter of decanted paunch manure was plated on specialized film for determination of colony counts from Enterobacteriaceae, coliform-forming bacteria, Eschericia coli, Salmonella, and yeast and mold. Plates were incubated at 36°C for 24 ± 2 hours. Data were analyzed as a random effects model using PROC MIXED of SAS v. 9.4. In the wet paunch, E. coli had a mean colony count of 3, coliform bacteria of 53, yeast and mold of 0, and Enterobacteriaceae were too numerous to count. In the dry paunch, E. coli had a mean colony count of less than 1, coliform bacteria of 52, yeast and mold of 0, and Enterobacteriaceae less than 1. Source of paunch contributed a majority to the total variance in all instances of the random effects models. Results are interpreted to mean that, given the drastic reduction in microbial loads, paunch manure may represent a viable feedstock for further testing and development.
49
Saripan, Hartini, Nurus Sakinatul Fikriah Mohd Shith Putera, Sarah Munirah Abdullah, Rafizah Abu Hassan, and Zuhairah Ariff Abd Ghadas. "Liability Framework for Cognitive Computing in Healthcare: Standing at the Crossroad." Asian Journal of University Education 17, no. 2 (June 6, 2021): 183. http://dx.doi.org/10.24191/ajue.v17i2.13392.
Full textAbstract:
Abstract: Digitization across the healthcare industry has witnessed the advent of emerging Cognitive Computing (CC) healthcare technologies that improve diagnostic accuracy and efficiency, predict illnesses, automate routine healthcare tasks, and refine processes and care beyond human capabilities. Increased adoption of this technology can be attributed to its ability of processing enormous amounts of data promptly in addressing specific queries and producing customized intelligent recommendations. While CC’s transformative technologies offer profound benefits to the healthcare industry, it also carries an unpredictable burden of risk and mistakes with damaging consequences to patients. At this juncture, CC’s legal place in healthcare is largely undefined as the applicable liability framework is ambiguous. CC fits into the traditional liability rules in a piecemeal manner; however a single theory of recovery sufficiently addressing the potential liability questions arising from a computer system capable of practicing medicine and possessing the ability of parsing through enormous data for better patient outcomes is absent. The present research therefore sets out to chart the analysis of cases involving emerging medical technologies comparable to CC, in hope of examining ways in which the traditional theories of liability is projected to develop in adapting to this novel contrivance. A doctrinal and case study methods formed an integrated qualitative approach adopted by this research in opting the deployment of emerging medical technologies akin to CC and the bearing it has on the imposition of liability in the United States. CC’s potential contributions to healthcare are revolutionary, however its legal repercussions are just as alarming and therefore demands for more discussion in addressing the concerns.
Keywords: Cognitive computing and law, Cognitive computing and legal liability
50
Monico, Edward P., Valerie M. Allusson, Arthur Calise, and Valerie R. C. Allusson. "Understanding age-triggered cognitive assessments of late-career physicians." Journal of Hospital Administration 8, no. 5 (August 27, 2019): 26. http://dx.doi.org/10.5430/jha.v8n5p26.
Full textAbstract:
Late-career physicians now represent a significant part of the physician workforce in the United States. The American Medical Association Council on Medical Education tracks physician demographic data and found that in 1975 there were 50,993 practicing physicians 65 years or older, but by 2013, this number had risen to 241,641 physicians, a 374% increase. The AMA Council also concluded that aging was associated with decreased processing speed, increased difficulty inhibiting irrelevant information, reduced hearing and visual acuity, decreased manual dexterity and visuospatial ability. There is mounting concern that the effects of aging can adversely impact the practice of medicine by late-career physicians. Although results are mixed, studies suggest late-career physicians have a higher rate of disciplinary action, fail to acquire new knowledge and have greater variability in test scores and their patients experience higher mortality rates after complex surgical procedures. Hospital administrators in their efforts to assess cognition of their aging medical staff are limited by the absence of validated metrics when it comes to older individuals with above-average years of education. Also, attempts to curtail medical practice based on age are fraught with legal implications arising from the Americans with Disabilities Act of 1990 and the Age Discrimination in Employment Act of 1967. We examined the issues hospital administrators face when formulating policies regulating the medical practice of late-career physicians. Our review summarizes the state of the literature of late-career physicians, reviews the legal implications of policies regarding age and the practice of medicine and offers our experience in creating a late-career physician policy for a multi-disciplinary medical staff.