Space-based, operational instruments are in unique positions to monitor volcanic activity globally, especially in remote locations or where suborbital observing conditions are hazardous. The ...Multi-angle Imaging SpectroRadiometer (MISR) provides hyper-stereo imagery, from which the altitude and microphysical properties of suspended atmospheric aerosols can be derived. These capabilities are applied to plumes emitted at Karymsky volcano from 2000 to 2017. Observed plumes from Karymsky were emitted predominantly to an altitude of 2-4 km, with occasional events exceeding 6 km. MISR plume observations were most common when volcanic surface manifestations, such as lava flows, were identified by satellite-based thermal anomaly detection. The analyzed plumes predominantly contained large (1.28 µm effective radius), strongly absorbing particles indicative of ash-rich eruptions. Differences between the retrievals for Karymsky volcano's ash-rich plumes and the sulfur-rich plumes emitted during the 2014-2015 eruption of Holuhraun (Iceland) highlight the ability of MISR to distinguish particle types from such events. Observed plumes ranged from 30 to 220 km in length, and were imaged at a spatial resolution of 1.1 km. Retrieved particle properties display evidence of downwind particle fallout, particle aggregation and chemical evolution. In addition, changes in plume properties retrieved from the remote-sensing observations over time are interpreted in terms of shifts in eruption dynamics within the volcano itself, corroborated to the extent possible with suborbital data. Plumes emitted at Karymsky prior to 2010 display mixed emissions of ash and sulfate particles. After 2010, all plumes contain consistent particle components, indicative of entering an ash-dominated regime. Post-2010 event timing, relative to eruption phase, was found to influence the optical properties of observed plume particles, with light-absorption varying in a consistent sequence as each respective eruption phase progressed.
Spectral analyses of an uninterrupted 5.5-million-year (My)-long chronology of late Oligocene-early Miocene climate and ocean carbon chemistry from two deep-sea cores recovered in the western ...equatorial Atlantic reveal variance concentrated at all Milankovitch frequencies. Exceptional spectral power in climate is recorded at the 406-thousand-year (ky) period eccentricity band over a 3.4-million-year period 20 to 23.4 My ago (Ma) as well as in the 125- and 95-ky bands over a 1.3-million-year period (21.7 to 23.0 Ma) of suspected low greenhouse gas levels. Moreover, a major transient glaciation at the epoch boundary (~23 Ma), Mi-1, corresponds with a rare orbital congruence involving obliquity and eccentricity. The anomaly, which consists of low-amplitude variance in obliquity (a node) and a minimum in eccentricity, results in an extended period (~200 ky) of low seasonality orbits favorable to ice-sheet expansion on Antarctica.
Volcanic eruptions pose an ever-present threat to human populations around the globe, but many active volcanoes remain poorly monitored. In regions where ground-based monitoring is present the ...effects of volcanic eruptions can be moderated through observational alerts to both local populations and service providers, such as air traffic control. However, in regions where volcano monitoring is limited satellite-based remote sensing provides a global data source that can be utilised to provide near-real-time identification of volcanic activity. This paper details a volcanic plume detection method capable of identifying smaller eruptions than is currently feasible, which could potentially be incorporated into automated volcanic alert systems. This method utilises daily, global observations of sulfur dioxide (SO2) by the Ozone Monitoring Instrument (OMI) on NASA's Aura satellite. Following identification and classification of known volcanic eruptions in 2005–2009, the OMI SO2 data, analysed using a logistic regression analysis, permitted the correct classification of volcanic events with an overall accuracy of over 80 %. Accurate volcanic plume identification was possible when lower-tropospheric SO2 loading exceeded ∼ 400 t. The accuracy and minimal user input requirements of the developed procedure provide a basis for incorporation into automated SO2 alert systems.
Abstract Background and Objective Effective communication with primary care physicians is important yet incompletely understood for Spanish-speaking parents. We predicted lower satisfaction among ...Spanish-speaking compared to English-speaking Latino and non-Latino parents. Methods Cross-sectional analysis at 2-month well visits within the Greenlight study at 4 pediatric resident clinics. Parents reported satisfaction with 14 physician communication items using the validated Communication Assessment Tool (CAT). High satisfaction was defined as “excellent” on each CAT item. Mean estimations compared satisfaction for communication items among Spanish- and English-speaking Latinos and non-Latinos. We used generalized linear regression modeling, adjusted for parent age, education, income, and clinic site. Among Spanish-speaking parents, we compared visits conducted in Spanish with and without an interpreter, and in English. Results Compared to English-speaking Latino (n = 127) and non-Latino parents (n = 432), fewer Spanish-speaking parents (n = 303) reported satisfaction with 14 communication items. No significant differences were found between English-speaking Latinos and non-Latinos. Greatest differences were found in the use of a greeting that made the parent comfortable (59.4% of Spanish-speaking Latinos endorsing “excellent” vs 77.5% English-speaking Latinos, P < .01) and discussing follow-up (62.5% of Spanish-speaking Latinos vs 79.8% English-speaking Latinos, P < .01). After adjusting for parent age, education, income, and study site, Spanish-speaking Latinos were still less likely to report high satisfaction with these communication items. Satisfaction was not different among Spanish-speaking parents when the physician spoke Spanish versus used an interpreter. Conclusions Satisfaction with physician communication was associated with language but not ethnicity. Spanish-speaking parents less frequently report satisfaction with communication, and innovative solutions to enhance communication quality are needed.
Complicated intra-abdominal infections (cIAIs) are associated with significant morbidity and mortality. The aim of this study was to describe the clinical characteristics of patients with cIAI in a ...multicentre study and to develop clinical prediction models (CPMs) to help identify patients at risk of mortality or relapse.
A multicentre observational study was conducted from August 2016 to February 2017 in the UK. Adult patients diagnosed with cIAI were included. Multivariable logistic regression was performed to develop CPMs for mortality and cIAI relapse. The c-statistic was used to test model discrimination. Model calibration was tested using calibration slopes and calibration in the large (CITL). The CPMs were then presented as point scoring systems and validated further.
Overall, 417 patients from 31 surgical centres were included in the analysis. At 90 days after diagnosis, 17.3 per cent had a cIAI relapse and the mortality rate was 11.3 per cent. Predictors in the mortality model were age, cIAI aetiology, presence of a perforated viscus and source control procedure. Predictors of cIAI relapse included the presence of collections, outcome of initial management, and duration of antibiotic treatment. The c-statistic adjusted for model optimism was 0.79 (95 per cent c.i. 0.75 to 0.87) and 0.74 (0.73 to 0.85) for mortality and cIAI relapse CPMs. Adjusted calibration slopes were 0.88 (95 per cent c.i. 0.76 to 0.90) for the mortality model and 0.91 (0.88 to 0.94) for the relapse model; CITL was -0.19 (95 per cent c.i. -0.39 to -0.12) and - 0.01 (- 0.17 to -0.03) respectively.
Relapse of infection and death after complicated intra-abdominal infections are common. Clinical prediction models were developed to identify patients at increased risk of relapse or death after treatment, these now require external validation.
In Reply to Kang et al Flower, Kori B; Raffa, Brittany J; Lin, Jenny J
Academic medicine,
2024-Mar-01, 2024-3-00, 20240301, Letnik:
99, Številka:
3
Journal Article
Mineralogical and sedimentological records from the Gulf of Mexico (GOM) reveal major changes in the terrigenous particles provenance during the Marine Isotopic Stage 3 (MIS3) that likely resulted ...from modifications of the environmental conditions – including glacial activity and precipitation distribution – over the North American continent. The southeastern margin of the Laurentide Ice Sheet (LIS) was active throughout the entire MIS3, whereas the southwestern margin contributed to short-term meltwater events only during late MIS3. Some of the major mineralogical changes cannot be attributed to glacial activity but rather result from the changes in precipitation distribution. Combining sedimentological records from the GOM with previously published climate-related archives from the North American continent allows the reconstruction of two main schematic patterns of moisture inflow and precipitation distribution that may have prevailed during MIS3. Meltwater discharges contribute to modifying the LIS configuration and the GOM hydrological properties, ultimately affecting large-scale oceanic circulation and may have influenced atmospheric re-organizations although the insolation variation rate appears to be the main driver of the system.
•Drastic modifications of clay composition are evidenced in the GOM during MIS3.•Changes of detrital provenance are linked to LIS extension or rainfall patterns.•Different geographical areas of the LIS are active during major meltwater events.•Two distinct atmospheric patterns controlled rainfall distribution over the US.•Transitions between these configurations are likely driven by summer insolation.
Ocean Drilling Program (ODP) sites 984 and 983, located on North Atlantic sediment drifts, provide high-resolution records across the Matuyama-Brunhes boundary. At ODP site 984 (Bjorn Drift, Iceland ...Basin), the mean sedimentation rate in the 500-900 ka interval is ~12 cm kyr-1 based on an age model derived by matching the planktonic and benthic oxygen isotope records to an Ice Volume Model. The Matuyama-Brunhes polarity transition at site 984, as defined by virtual geomagnetic polar (VGP) latitudes <50°, has an apparent duration of ~7 kyr with a mid-point at 773.5 ka, compared with 772.5 ka at neighbouring site 983. Outside the polarity transition at both sites 984 and 983, excursions in VGP latitudes, to values <20°, at 540, 590 and 670 ka correspond to troughs in the palaeointensity record. New u-channel palaeomagnetic data across the Matuyama-Brunhes boundary, for working and archive halves of core sections from three holes at both sites 984 and 983, augment data published by Channell & Lehman (1997) and are compared with back-to-back 1 cm3 discrete samples. Clusters of VGPs in the South Atlantic and northeast Asia in both u-channel and discrete sample records imply that polarity transition fields have characteristics similar to the modern non-axial-dipole (NAD) field.
Despite increasing use of long-acting reversible contraception (LARC) among U.S. adolescents, there is limited literature on factors affecting intrauterine device (IUD) or subdermal implant use. This ...study aimed to describe statewide rates, and associated patient and provider factors of adolescent IUD or implant initiation and continuation.
This retrospective cohort study used N.C. Medicaid claims data. 10,408 adolescents were eligible (i.e., 13–19 years, female sex, continuous Medicaid enrollment, had an IUD or implant insertion or removal code from January 1, 2013, to October 1, 2015). Bivariate analyses assessed differences in adolescents using IUD versus implant. Kaplan-Meier curves were created to assess IUD or implant discontinuation through December 31, 2018.
Adolescents initiated 8,592 implants and 3,369 IUDs (N = 11,961). There were significant differences in nearly all provider and patient factors for those who initiated implants versus IUDs. 16% of implants and 53% of IUDs were removed in the first year. Younger (i.e., age <18 years old), Hispanic, and Black adolescents had higher adjusted continuation of implants compared with older and White adolescents, respectively (both p < .001). Those whose IUD was inserted by an obstetrician/gynecologist provider had lower continuation of IUDs compared with non-obstetrician/gynecologist providers (p < .001).
We found that age-related, racial, and ethnic disparities exist in both implant and IUD continuation. Practice changes to support positive adolescent experiences with implant and IUD insertion and removals are needed, including patient-centered health care provider training in contraception counseling, LARC initiation and removal training for adolescent-facing providers, and broader clinic capacity for LARC services.
PDF
