Estimating uncertainty in the volume and carbon storage of downed coarse woody debris.

Downed coarse woody debris, also known as coarse woody detritus or downed dead wood, is challenging to estimate for many reasons, including irregular shapes, multiple stages of decay, and the difficulty of identifying species. In addition, some properties are commonly not measured, such as wood density and carbon concentration. As a result, there have been few previous evaluations of uncertainty in estimates of downed coarse woody debris, which are necessary for analysis and interpretation of the data. To address this shortcoming, we quantified uncertainties in estimates of downed coarse woody debris volume and carbon storage using data collected from permanent forest inventory plots in the northeastern United States by the Forest Inventory and Analysis program of the USDA Forest Service. Quality assurance data collected from blind remeasurement audits were used to quantify error in diameter measurements, hollowness of logs, species identification, and decay class determination. Uncertainty estimates for density, collapse ratio, and carbon concentration were taken from the literature. Estimates of individual sources of uncertainty were combined using Monte Carlo methods. Volume estimates were more reliable than carbon storage, with an average 95% confidence interval of 15.9 m3 /ha across the 79 plots evaluated, which was less than the mean of 31.2 m3 /ha. Estimates of carbon storage (and mass) were more uncertain, due to poorly constrained estimates of the density of wood. For carbon storage, the average 95% confidence interval was 11.1 Mg C/ha, which was larger than the mean of 4.6 Mg C/ha. Accounting for the collapse of dead wood as it decomposes would improve estimates of both volume and carbon storage. On the other hand, our analyses suggest that consideration of the hollowness of downed coarse woody debris pieces could be eliminated in this region, with little effect. This study demonstrates how uncertainty analysis can be used to quantify confidence in estimates and to help identify where best to allocate resources to improve monitoring designs.

A high-throughput antibody-based microarray typing platform.

Many rapid methods have been developed for screening foods for the presence of pathogenic microorganisms. Rapid methods that have the additional ability to identify microorganisms via multiplexed immunological recognition have the potential for classification or typing of microbial contaminants thus facilitating epidemiological investigations that aim to identify outbreaks and trace back the contamination to its source. This manuscript introduces a novel, high throughput typing platform that employs microarrayed multiwell plate substrates and laser-induced fluorescence of the nucleic acid intercalating dye/stain SYBR Gold for detection of antibody-captured bacteria. The aim of this study was to use this platform for comparison of different sets of antibodies raised against the same pathogens as well as demonstrate its potential effectiveness for serotyping. To that end, two sets of antibodies raised against each of the "Big Six" non-O157 Shiga toxin-producing E. coli (STEC) as well as E. coli O157:H7 were array-printed into microtiter plates, and serial dilutions of the bacteria were added and subsequently detected. Though antibody specificity was not sufficient for the development of an STEC serotyping method, the STEC antibody sets performed reasonably well exhibiting that specificity increased at lower capture antibody concentrations or, conversely, at lower bacterial target concentrations. The favorable results indicated that with sufficiently selective and ideally concentrated sets of biorecognition elements (e.g., antibodies or aptamers), this high-throughput platform can be used to rapidly type microbial isolates derived from food samples within ca. 80 min of total assay time. It can also potentially be used to detect the pathogens from food enrichments and at least serve as a platform for testing antibodies.

The Ascension Health journey to zero: lessons learned and leadership.

BACKGROUND: In 2002, Ascension Health, a 65-hospital nonprofit health care system, articulated a call to action to provide Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind. The goal is to provide excellent clinical care with no preventable injuries or deaths by July 2008. Just months from this target date, substantial reductions in events related to eight priorities for action have been documented, and at the current rate more than 2,000 lives a year are being saved compared to the baseline mortality rate. BUILDING THE AGENDA FOR CHANGE: Progress toward the goal of zero preventable injuries or deaths required transformational change. Key steps toward this change included establishing a sense of urgency, creating a guiding coalition (the clinical excellence team), and developing the Destination Statement II. Other key factors in our early success included methods of process and outcomes measurement, the formation of appropriate and diverse leadership groups comprised of primary stakeholders, methods of knowledge transfer, and the involvement and leadership of the Ascension Health Quality Committee and individual health ministry Boards. THE JOURNEY CONTINUES: An ongoing discussion of what "zero preventable deaths and injuries" really means has led to the identification of additional interventions to further reduce preventable injuries and deaths.

Prevalence of osteoporosis in men in a VA rehabilitation center.

OBJECTIVE: To evaluate the prevalence of previously unrecognized osteoporosis in men admitted for long-term rehabilitation nursing home care. DESIGN: Cross-sectional study. METHODS: A total of 1179 consecutive admissions to a VA rehabilitation center were reviewed. Men who were already diagnosed with osteoporosis, had confounding medical illness, were unable to complete the study, or who declined to participate were excluded. A total of 153 patients were enrolled and 106 were evaluated. Measurements included dual-energy X-ray absorptiometry of the hip and lumbar spine, biochemical and hormonal studies, and functional evaluation. RESULTS: A total of 33 patients (31.1%) had osteoporosis (T-score at any site lumbar spine, total hip, or femoral neck <-2.5). Patients with osteoporosis were significantly older than those without: 68.4 +/- 13.2 years versus 62.7 +/- 12.1 years (P <.05), respectively. Body mass index (BMI) and weight were lower in men with osteoporosis: 23.4 +/- 3.9 kg/m2 versus 28.7 +/- 7.08 kg/m2 and 72.6 +/- 14.4 kg versus 90.3 +/- 23.8 kg, respectively (both, P <.001). There were no differences in use of medications thought to affect bone metabolism or functional status, or in hormonal and metabolic measurements. Hip and spine bone density were correlated (r = 0.3, P <.05). Multivariate analysis showed that hip bone density was independently associated with BMI. CONCLUSION: Hip osteoporosis is common in this unscreened population, suggesting that screening should be more widely performed in veterans admitted to rehabilitation units. These data suggest that nutritional status could impact osteoporosis risk.

Stereochemistry of C-6 nucleophilic displacements on 1,1-difluorocyclopropyldibenzosuberanyl substrates. An improved synthesis of multidrug resistance modulator LY335979 trihydrochloride.

Studies of the displacement chemistry of 1,1-difluorocyclopropyldibenzosuberanyl alcohol 4 and its activated bromide derivative 6 have led to an improved approach to anti-2, a key precursor to LY335979 3HCl (1). Bromination of either syn-4 or anti-4 gave anti-oriented 6, indicating thermodynamically controlled product stereochemistry via a stabilized 1,1-difluorohomotropylium ion intermediate. Reaction of 6 with piperazine proceeded irreversibly to provide an isomeric mixture of piperazine products, with the syn:anti product ratio increased by solvent effects. Reaction of 6 with pyridine and pyrazine, on the other hand, gave anti-pyridinium and pyrazinium salts, respectively, apparently via equilibration of initially formed syn products. Reduction of pyrazinium salt 11 with lithium borohydride/TFA provided anti-2 unaccompanied by its syn isomer. A practical and expeditious approach to 1 was derived from these new results.