Jeppesenkamper9749

Ecological models are constrained by the availability of high-quality data at biologically appropriate resolutions and extents. Modeling a species' affinity or aversion with a particular land cover class requires data detailing that class across the full study area. Data sets with detailed legends (i.e., high thematic resolution) and/or high accuracy often sacrifice geographic extent, while large-area data sets often compromise on the number of classes and local accuracy. Consequently, ecologists must often restrict their study extent to match that of the more precise data set, or ignore potentially key land cover associations to study a larger area. We introduce a hierarchical Bayesian model to capitalize on the thematic resolution and accuracy of a regional land cover data set, and on the geographic breadth of a large area land cover data set. For the full extent (i.e., beyond the regional data set), the model predicts systematic discrepancies of the large-area data set with the regional data set, and divid NLCD based on the predicted distribution of white pine. This flexible statistical method helps ecologists leverage localized mapping efforts to expand models of species distributions, population dynamics, and management strategies beyond the political boundaries that frequently delineate land cover data sets.

To describe life experiences associated with patterns of medically treated and documented self-directed violence among youth who attempted suicide using highly lethal means to understand precipitating factors among youth using such lethal means.

Using data from a regional, level 1 Trauma center, we identified all youth suicide attempt survivors who received treatment from 2010 to 2018 for a suicide attempt with a firearm, hanging, or jump from height injury (n=42). We described differences in patient demographics and life experiences associated with patterns of self-directed violence by suicide attempt mechanism. We additionally assessed mechanisms used in any prior suicide attempts to identify potential increasing lethality of mechanism selection.

There were 42 eligible patients included, of whom 40.5% attempted suicide with a firearm, 26.2% with hanging, 33.3% with jumping injury. A greater proportion of patients with firearm injuries endorsed social support and had fewer preparatory acts, history of self-harming behavior, prior suicide behaviors, and fewer prior attempts compared to patients who attempted suicide with other mechanisms.

Given our findings, means safety should remain a key strategy to prevent highly lethal suicidal behavior among adolescents, especially with firearms, given that such attempts may occur prior to formal contact with mental health services.

Given our findings, means safety should remain a key strategy to prevent highly lethal suicidal behavior among adolescents, especially with firearms, given that such attempts may occur prior to formal contact with mental health services.

Appendicitis is the most common pediatric surgical emergency. Ultrasonography is recommended as first-line imaging for appendicitis in children; however, this is often followed by more advanced imaging. Our goal was to determine if point-of-care ultrasonography (POCUS) could reduce cost and length-of-stay (LOS) in suspected pediatric appendicitis.

We performed a chart review of patients presenting to our pediatric emergency department (ED) from August 1, 2017 to June 30, 2019 who had imaging for appendicitis. We compared cost and LOS for patients who received POCUS to those who had magnetic resonance imaging (MRI) as first-line imaging, which is standard at our institution.

We identified 695 visits of 685 unique patients. Patients who received POCUS (n = 209) had a significantly shorter mean LOS (274 minutes) in the ED compared to patients who did not (317 minutes, P <.001). This was true regardless of the month of their visit. The POCUS group was younger, less likely to have right lower quadrant pain/tenderness, less likely to be admitted, and less likely to have appendicitis than the MRI group. Average appendix imaging cost per patient was lower in the POCUS group at $1308 compared to the MRI group at $1371 (P <.001), although patients who had both POCUS and MRI (n = 102) had the highest average imaging costs ($2010).

POCUS can reduce LOS and imaging cost in suspected pediatric appendicitis. Further study is warranted to determine which patients benefit the most from POCUS and whether the results are applicable in other settings.

POCUS can reduce LOS and imaging cost in suspected pediatric appendicitis. Further study is warranted to determine which patients benefit the most from POCUS and whether the results are applicable in other settings.

Lung ultrasound (LUS) can accurately diagnose several pulmonary diseases, including pneumothorax, effusion, and pneumonia. LUS may be useful in the diagnosis and management of COVID-19.

This study was conducted at two United States hospitals from 3/21/2020 to 6/01/2020. Our inclusion criteria included hospitalized adults with COVID-19 (based on symptomatology and a confirmatory RT-PCR for SARS-CoV-2) who received a LUS. Providers used a 12-zone LUS scanning protocol. The images were interpreted by the researchers based on a pre-developed consensus document. Patients were stratified by clinical deterioration (defined as either ICU admission, invasive mechanical ventilation, or death within 28 days from the initial symptom onset) and time from symptom onset to their scan.

N = 22 patients (N = 36 scans) were included. Eleven (50%) patients experienced clinical deterioration. EHop-016 chemical structure Among N = 36 scans, only 3 (8%) were classified as normal. The remaining scans demonstrated B-lines (89%), consolidations (56%), pleuate the predictive utility of these findings on clinical outcomes.

To explore health-related quality of life (HRQoL) among subjects with hypothyroidism compared to subjects without hypothyroidism in the general population. HRQoL is important in clinical practice. Hypothyroidism is prevalent, mainly found in women, and increasing with age.

Cohort study of random population sample.

Women and men, n=414 (39-78years) from the WHO MONICA project, Gothenburg, Sweden, participated. Hypothyroidism was defined as subjects having levothyroxine supplementation or serum thyroid-stimulating hormone (S-TSH) >4.2mU/L.

Health-related quality of life was measured with Psychological General Well-Being Index (PGWB), Nottingham Health Profile (NHP), Short Form 36 Health Survey (SF-36) and a single item self-rated health scale (0-100), and stress was rated 1-6. The results were adjusted for age, sex and comorbidity using analysis of covariance (ANCOVA).

Hypothyroidism was found in 70 subjects (17%). They scored worse HRQoL than controls regarding Sleep (p<.001), Social isolation (p=.01) and Total NHP (p<.05), and had more medication in general 2.7±2.5 vs. 1.8±2.1, p<.05. Subjects with levothyroxine (n=40) showed similar results as the total hypothyroid group. Subjects unaware of their newly detected elevated STSH (n = 30) showed lower HRQoL in Sleep (p<.01) and Pain (p<.05) in NHP. HRQoL was similar in subjects with and without positive thyroperoxidase antibodies (TPO-Ab) either in those with hypothyroidism (44% TPO-Ab) or controls (9% TPO-Ab).

Men and women with hypothyroidism in the general population reported having more issues with Sleep and Social isolation than those without hypothyroidism irrespective of TPO-Ab. Scores were similar in all of the other HRQoL domains measuredAQ5.

Men and women with hypothyroidism in the general population reported having more issues with Sleep and Social isolation than those without hypothyroidism irrespective of TPO-Ab. Scores were similar in all of the other HRQoL domains measuredAQ5.Inverse probability of treatment weighting (IPTW), which has been used to estimate average treatment effects (ATE) using observational data, tenuously relies on the positivity assumption and the correct specification of the treatment assignment model, both of which are problematic assumptions in many observational studies. Various methods have been proposed to overcome these challenges, including truncation, covariate-balancing propensity scores, and stable balancing weights. Motivated by an observational study in spine surgery, in which positivity is violated and the true treatment assignment model is unknown, we present the use of optimal balancing by kernel optimal matching (KOM) to estimate ATE. By uniformly controlling the conditional mean squared error of a weighted estimator over a class of models, KOM simultaneously mitigates issues of possible misspecification of the treatment assignment model and is able to handle practical violations of the positivity assumption, as shown in our simulation study. Using data from a clinical registry, we apply KOM to compare two spine surgical interventions and demonstrate how the result matches the conclusions of clinical trials that IPTW estimates spuriously refute.

This validation study investigated a flow cytometric apoptosis assay according to good manufacturing practice (GMP).

Extracorporeal photopheresis (ECP) is a treatment for various immunological diseases and cutaneous T-cell lymphomas. It is based on the induction of apoptosis by 8-methoxypsoralene and ultraviolet A light. The quantification of apoptosis is therefore essential for ECP improvements. However, despite numerous publications on apoptosis, validated technical details are lacking.

Mononuclear cells were collected by apheresis and treated by ECP or camptothecin. Samples taken before and after ECP were cultured for 24, 48 and 72 h and analysed for apoptosis and viability of T cells and monocytes by flow cytometry with Annexin V and 7-AAD staining. Accuracy of the assay, intra- and inter-assay precision and the pre-analytical and analytical stability of the analytes were the investigated parameters.

Our data indicate that the median intra- and inter-assay precision coefficient of variation for T cells was 3.86% and 4.80%, respectively. Pre-analytical stability of T cells and monocytes was ensured during short-term storage for up to 2 h on ice. After staining, analytical stability was limited to 30 min, likely because of ongoing apoptosis and loss of monocytes due to plastic adhesion.

The results of this validation study show that the assay is GMP-compliant and that its reliability, accuracy and precision are acceptable. While pre-analytical stability of the cells was compatible with on-site procedures, our analytical stability data indicate that this assay is not suited for batch mode analysis of ECP products.

The results of this validation study show that the assay is GMP-compliant and that its reliability, accuracy and precision are acceptable. While pre-analytical stability of the cells was compatible with on-site procedures, our analytical stability data indicate that this assay is not suited for batch mode analysis of ECP products.

The purpose of this study was to investigate the diagnostic potential of the aortic closure (A2) signal length on Doppler echocardiography in distinguishing aortic patient-prosthesis mismatch (PPM) from prosthetic stenosis among patients with elevated gradients over bioprosthetic valves.

The A2 signal length was retrospectively measured for 150 patients with bioprosthetic aortic valves (50 with PPM, 50 with prosthetic stenosis, and 50 with normally functioning valves) from transthoracic echocardiograms performed at NYU Langone Health between 01/01/2012 and 08/01/2018.

Mean A2 signal length was shorter among patients with PPM (11.1 ms ± 5.2 ms), than among those with prosthetic stenosis (21.1 ms ± 6.0 ms), P < .001 and controls (21.7 ms ± 7.4 ms), P < .001. There was no difference in A2 signal length between prosthetic stenosis and controls. The A2 signal length yielded an AUC of 0.89 (95% CI 0.82-0.95) for predicting PPM over prosthetic stenosis.

Among patients with bioprosthetic aortic valves, the length of the A2 signal on Doppler echocardiography is shorter in PPM than in prosthetic stenosis and normally functioning valves.