ABSTRACT
Northern Indigenous communities are experiencing rapid climate change and disrupted seasonal transitions. The Teetl'it Gwich'in use a five-season calendar to measure the year, indicating the timing of seasonal events and associated cultural practices. From trapping in the spring, to fishing in the summer and fall, and hunting in the fall and winter, the Gwich'in have moved upon the land with the changing seasons. However, disrupted seasonal synchrony can disconnect cultural practices from suitable conditions, creating risks to self and culture. With warming temperatures, communities have observed slower river freeze-up in the fall and faster spring thaw, which has impacted the timing of when fishers can safely set their nets under river ice. Historically, freeze-up occurred in October, providing several weeks when fishers could set nets under ice while luk dagaii (broad whitefish, Coregonus nasus) traveled downriver. Today, freeze-up often begins in November, and fishing during the luk dagaii migration requires setting nets while the ice is thinner and the river is not completely frozen. This presents risks to individuals working to maintain a fundamental cultural practice. Here, Arlyn Charlie, a Teetl'it Gwich'in artist whose career focuses on culture and language, uses personal narrative to explore impacts of climate change on Gwich'in culture. Arlyn notes how these changes are making the traditional seasonal calendar unreliable, and explores how changing patterns among animals and the landscape no longer provide consistent, safe harvesting conditions. With a growing risk of working on thin ice, ongoing cultural practices are threatened.
ABSTRACT
Background. In South Africa (SA), intensive care is faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low- to middle-income countries experience daily the consequences of limited resources. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are frequently necessary in SA, particularly in the publicly funded health sector. Purpose. The purpose of this consensus statement is to examine key questions that arise when considering the status of ICU resources in SA, and more specifically ICU admission, rationing and triage decisions. The accompanying guideline in this issue is intended to guide frontline triage policy and ensure the best utilisation of intensive care in SA, while maintaining a fair distribution of available resources. Fair and efficient triage is important to ensure the ongoing provision of high-quality care to adult patients referred for intensive care. Recommendations. In response to 14 key questions developed using a modified Delphi technique, 29 recommendations were formulated and graded using an adapted GRADE score. The 14 key questions addressed the status of the provision of ICU services in SA, the degree of resource restriction, the efficiency of resource management, the need for triage, and how triage could be most justly implemented. Important recommendations included the need to formally recognise and accurately quantify the provision of ICU services in SA by national audit; actively seek additional resources from governmental bodies; consider methods to maximise the efficiency of ICU care; evaluate lower level of care alternatives; develop a triage guideline to assist policy-makers and frontline practitioners to implement triage decisions in an efficient and fair way; measure and audit the consequence of triage; and promote research to improve the accuracy and consistency of triage decisions. The consensus document and guideline should be reviewed and revised appropriately within 5 years. Conclusion. In recognition of the absolute need to limit patient access to ICU because of the lack of sufficient intensive care resources in public hospitals, recommendations and a guideline have been developed to guide policy-making and assist frontline triage decision-making in SA. These documents are not a complete plan for quality practice but rather the beginning of a long-term initiative to engage clinicians, the public and administrators in appropriate triage decision-making, and promote systems that will ultimately maximise the efficient and fair use of available ICU resources.
Subject(s)
Critical Care/standards , Health Care Rationing/standards , Intensive Care Units/standards , Patient Admission/standards , Triage/standards , Adult , Consensus , Humans , South AfricaABSTRACT
Background. In South Africa (SA), administrators and intensive care practitioners are faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low- to middle-income countries experience the consequences of limited resources daily. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are routinely necessary in SA, particularly in the publicly funded health sector. Purpose. The purpose of this guideline is to utilise the relevant recommendations of the associated consensus meeting document and other internationally accepted principles to develop a guideline to inform frontline triage policy and ensure the best utilisation of adult intensive care in SA, while maintaining the fair distribution of available resources. Recommendations. An overall conceptual framework for the triage process was developed. The components of the framework were developed on the basis that patients should be admitted preferentially when the likely incremental medical benefit derived from ICU admission justifies admission. An estimate of likely resource use should also form part of the triage decision, with those patients requiring relatively less resources to achieve substantial benefit receiving priority for admission. Thus, the triage system should maximise the benefits obtained from ICU resources available for the community. Where possible, practical examples of what the consensus group agreed would be considered appropriate practice under specified South African circumstances were provided, to assist clinicians with practical decision-making. It must be stressed that this guideline is not intended to be prescriptive for individual hospital or regional practice, and hospitals and regions are encouraged to develop specified local guidelines with locally relevant examples. The guideline should be reviewed and revised if appropriate within 5 years. Conclusion. In recognition of the absolute need to limit patient access to ICU because of the lack of sufficient intensive care resources in public hospitals, this guideline has been developed to guide policy-making and assist frontline triage decision-making in SA. This document is not a complete plan for quality practice, but rather a template to support frontline clinicians, guide administrators and inform the public regarding appropriate triage decision-making.
Subject(s)
Critical Care/standards , Health Care Rationing/standards , Intensive Care Units/standards , Patient Admission/standards , Triage/standards , Adult , Consensus , Humans , South AfricaABSTRACT
Background: In South Africa (SA), intensive care is faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low- to middle-income countries experience daily the consequences of limited resources. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are frequently necessary in SA, particularly in the publicly funded health sector. Purpose: The purpose of this consensus statement is to examine key questions that arise when considering the status of ICU resources in SA, and more specifically ICU admission, rationing and triage decisions. The accompanying guideline in this issue is intended to guide frontline triage policy and ensure the best utilisation of intensive care in SA, while maintaining a fair distribution of available resources. Fair and efficient triage is important to ensure the ongoing provision of high-quality care to adult patients referred for intensive care. Recommendations: In response to 14 key questions developed using a modified Delphi technique, 29 recommendations were formulated and graded using an adapted GRADE score. The 14 key questions addressed the status of the provision of ICU services in SA, the degree of resource restriction, the efficiency of resource management, the need for triage, and how triage could be most justly implemented. Important recommendations included the need to formally recognise and accurately quantify the provision of ICU services in SA by national audit; actively seek additional resources from governmental bodies; consider methods to maximise the efficiency of ICU care; evaluate lower level of care alternatives; develop a triage guideline to assist policy-makers and frontline practitioners to implement triage decisions in an efficient and fair way; measure and audit the consequence of triage; and promote research to improve the accuracy and consistency of triage decisions. The consensus document and guideline should be reviewed and revised appropriately within 5 years. Conclusion: In recognition of the absolute need to limit patient access to ICU because of the lack of sufficient intensive care resources in public hospitals, recommendations and a guideline have been developed to guide policy-making and assist frontline triage decision-making in SA. These documents are not a complete plan for quality practice but rather the beginning of a long-term initiative to engage clinicians, the public and administrators in appropriate triage decision-making, and promote systems that will ultimately maximise the efficient and fair use of available ICU resources.
ABSTRACT
Background: In South Africa (SA), administrators and intensive care practitioners are faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low- to middle-income countries experience the consequences of limited resources daily. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are routinely necessary in SA, particularly in the publicly funded health sector. Purpose: The purpose of this guideline is to utilise the relevant recommendations of the associated consensus meeting document and other internationally accepted principles to develop a guideline to inform frontline triage policy and ensure the best utilisation of adult intensive care in SA, while maintaining the fair distribution of available resources. Recommendations: An overall conceptual framework for the triage process was developed. The components of the framework were developed on the basis that patients should be admitted preferentially when the likely incremental medical benefit derived from ICU admission justifies admission. An estimate of likely resource use should also form part of the triage decision, with those patients requiring relatively less resources to achieve substantial benefit receiving priority for admission. Thus, the triage system should maximise the benefits obtained from ICU resources available for the community. Where possible, practical examples of what the consensus group agreed would be considered appropriate practice under specified South African circumstances were provided, to assist clinicians with practical decision-making. It must be stressed that this guideline is not intended to be prescriptive for individual hospital or regional practice, and hospitals and regions are encouraged to develop specified local guidelines with locally relevant examples. The guideline should be reviewed and revised if appropriate within 5 years. Conclusion: In recognition of the absolute need to limit patient access to ICU because of the lack of sufficient intensive care resources in public hospitals, this guideline has been developed to guide policy-making and assist frontline triage decision-making in SA. This document is not a complete plan for quality practice, but rather a template to support frontline clinicians, guide administrators and inform the public regarding appropriate triage decision-making.
ABSTRACT
BACKGROUND: Energy crops including Miscanthus provide a storable, portable energy source which can be used to complement a wide range of products and energy generation systems. Miscanthus is predominantly used in Europe as a combustion material for electricity generation but also has the potential for biochemical conversion due to its high yield and low-nutrient requirements. The ratio of holocellulose (hemicellulose and cellulose combined) to acid detergent lignin (H:L) within the senesced material has previously been shown to indicate the relative suitability of Miscanthus accessions for thermochemical conversion. In this study, the ratio was assessed to examine its use as a selection aid for biochemical conversion. 20 highly-characterised Miscanthus accessions were saccharified using an enzyme mix to determine optimum sugar release. Nine of these accessions spanning high, medium and low H:L ratios were then autoclaved with dilute acid, alkali or water, and enzymically hydrolysed and fermented to produce ethanol. Samples taken throughout the process allowed assessments of released sugars. RESULTS: Enzymic degradation of the biomass showed a relationship between H:L ratio and glucose release, with high glucose release for high H:L ratio accessions and vice versa. Xylose release showed no such relationship. This relationship was maintained following pretreatments and enzyme saccharification, where compound analysis showed that following all pretreatments, accessions with high H:L ratios repeatedly had the highest releases of glucose, xylose and arabinose, and produced more ethanol. Release of all measured compounds increased with the pretreatment severity and ethanol yields from each pretreatment correlated with the respective glucose yield, providing assurance that any inhibitory compounds generated were tolerated by the fermentation yeast. Strong correlations were also seen between glucose release, ethanol and cell wall components, with cellulose showing the highest correlations with ethanol yields for some treatments and H:L ratio with others. CONCLUSIONS: The H:L ratio is a good predictor of ethanol yields and sugar release from Miscanthus in this study but individual components lignin and cellulose also correlate well, especially for hot water and mild acid pretreatments. In conclusion, use of the H:L ratio does not provide any advantages over the concentration of individual cell wall components for predicting sugar release and ethanol yields.
ABSTRACT
Since the discovery of Aphis glycines Matsumura (Hemiptera: Aphididae) in the United States, the primary management tactic has been foliar insecticides. Alternative management options such as host plant resistance to A. glycines have been developed and their effectiveness proved. However, the use of host plant resistance was complicated by the discovery of multiple, virulent biotypes of A. glycines in the United States that are capable of overcoming single Rag genes, Rag1 and Rag2, as well as a two-gene pyramid of Rag1+Rag2. However, current models predict that the virulent allele frequency of A. glycines decreases in response to the use of pyramided Rag genes, suggesting that pyramids represent a more sustainable use of these traits. Previous research has demonstrated that virulent biotypes can be effectively managed using a three-gene pyramid of Rag1+Rag2+Rag3. Additional Rag-genes have been discovered (Rag4 and Rag5), but whether the incorporation of these genes into novel three-gene pyramids will improve efficacy is not known. We tested single-gene (Rag1 and Rag2) and pyramid cultivars (Rag1+Rag2, Rag1+Rag2+Rag3, Rag1+Rag2+Rag4) to multiple biotypes in laboratory assays. Our results confirm that the Rag1+Rag2+Rag3 pyramid effectively manages all known A. glycines biotypes when compared with cultivars that are overcome by the associated biotype. Our results indicate that Rag1+Rag2+Rag4 would be an effective management option for biotype-1, biotype-2, and biotype-3 A. glycines, but had a negligible impact on biotype-4.
Subject(s)
Aphids/physiology , Glycine max/genetics , Herbivory , Pest Control, Biological/methods , Animals , Phenotype , Plant Breeding , Glycine max/growth & developmentABSTRACT
Waste biomass is generated during the conservation management of semi-natural habitats, and represents an unused resource and potential bioenergy feedstock that does not compete with food production. Thermogravimetric analysis was used to characterise a representative range of biomass generated during conservation management in Wales. Of the biomass types assessed, those dominated by rush (Juncus effuses) and bracken (Pteridium aquilinum) exhibited the highest and lowest volatile compositions respectively and were selected for bench scale conversion via fast pyrolysis. Each biomass type was ensiled and a sub-sample of silage was washed and pressed. Demineralization of conservation biomass through washing and pressing was associated with higher oil yields following fast pyrolysis. The oil yields were within the published range established for the dedicated energy crops miscanthus and willow. In order to examine the potential a multiple output energy system was developed with gross power production estimates following valorisation of the press fluid, char and oil. If used in multi fuel industrial burners the char and oil alone would displace 3.9 × 105 tonnes per year of No. 2 light oil using Welsh biomass from conservation management. Bioenergy and product development using these feedstocks could simultaneously support biodiversity management and displace fossil fuels, thereby reducing GHG emissions. Gross power generation predictions show good potential.
ABSTRACT
The objective of this work was to identify biomass feedstocks and optimum pyrolysis process conditions to produce a biochar capable of adsorbing metals from polluted groundwater. Taguchi experimental design was used to determine the effects of slow-pyrolysis process conditions on char yield and zinc adsorption. Treatments were repeated using six candidate feedstocks (Lolium perenne, Lolium perenne fibre, Miscanthus x giganteus, Salix viminalis, Fraxinus excelsior and Picea sitchensis) and the resultant chars were tested for metal adsorption performance. Chars produced from L. perenne and its extracted fibre displayed the greatest zinc adsorption performance and removed 83.27-92.96% respectively. Optimum process conditions in terms of both char yield and zinc adsorption performance were achieved from slow-pyrolysis at 300°C for 2h using a feedstock with a particle size of less than 1mm.
Subject(s)
Charcoal/chemistry , Metals, Heavy/chemistry , Adsorption , Biomass , Bioreactors , Environmental Pollution , Environmental Restoration and Remediation/methods , Fraxinus/metabolism , Groundwater/chemistry , Hot Temperature , Lolium/metabolism , Picea/metabolism , Salix/metabolism , Water Pollutants/chemistry , ZincABSTRACT
Pure trigeminal motor neuropathy is rare and characterised by weakness of the mandibular motor branch with no signs of involvement of the trigeminal sensory or other cranial nerve. Its aetiology is unclear but it has been hypothesised that a viral infection may be a cause. Magnetic resonance imaging is useful in its diagnosis and typically shows loss of volume of the affected masticatory muscles and infiltration of fat. We describe the case of a 29-year-old woman who presented with a 12-year history of progressive facial asymmetry, which was later shown on imaging to be caused by unilateral atrophy of the masseter with compensatory contralateral hypertrophy.
Subject(s)
Masticatory Muscles , Trigeminal Nerve Diseases , Adult , Atrophy , Facial Asymmetry , Female , Humans , Magnetic Resonance Imaging/adverse effects , Masseter Muscle , Trigeminal Nerve Diseases/diagnosisABSTRACT
Why sexual reproduction has evolved to be such a widespread mode of reproduction remains a major question in evolutionary biology. Although previous studies have shown that increased sex and recombination can evolve in the presence of host-parasite interactions (the 'Red Queen hypothesis' for sex), many of these studies have assumed that multiple loci mediate infection vs. resistance. Data suggest, however, that a major locus is typically involved in antigen presentation and recognition. Here, we explore a model where only one locus mediates host-parasite interactions, but a second locus is subject to directional selection. Even though the effects of these genes on fitness are independent, we show that increased rates of sex and recombination are favoured at a modifier gene that alters the rate of genetic mixing. This result occurs because of selective interference in finite populations (the 'Hill-Robertson effect'), which also favours sex. These results suggest that the Red Queen hypothesis may help to explain the evolution of sex by contributing a form of persistent selection, which interferes with directional selection at other loci and thereby favours sex and recombination.
Subject(s)
Biological Evolution , Host-Parasite Interactions , Reproduction , Sexual BehaviorABSTRACT
To avoid negative impacts on food production, novel non-food biofuel feedstocks need to be identified and utilised. One option is to utilise marine biomass, notably fast-growing, large marine 'plants' such as the macroalgal kelps. This paper reports on the changing composition of Laminaria digitata throughout it growth cycle as determined by new technologies. The potential of Laminaria sp. as a feedstock for biofuel production and future biorefining possibilities was assessed through proximate and ultimate analysis, initial pyrolysis rates using thermo-gravimetric analysis (TGA), metals content and pyrolysis gas chromatography-mass spectrometry. Samples harvested in March contained the lowest proportion of carbohydrate and the highest ash and alkali metal content, whereas samples harvested in July contained the highest proportions of carbohydrate, lowest alkali metals and ash content. July was therefore considered the most suitable month for harvesting kelp biomass for thermochemical conversion to biofuels.
Subject(s)
Animal Feed/analysis , Biotechnology/methods , Laminaria/growth & development , Seasons , Bioelectric Energy Sources , Biofuels , Biomass , Gas Chromatography-Mass Spectrometry , Kelp/growth & development , Metals/analysis , Seawater/analysis , Thermogravimetry , Time FactorsABSTRACT
Different species and genotypes of Miscanthus were analysed to determine the influence of genotypic variation and harvest time on cell wall composition and the products which may be refined via pyrolysis. Wet chemical, thermo-gravimetric (TGA) and pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) methods were used to identify the main pyrolysis products and determine the extent to which genotypic differences in cell wall composition influence the range and yield of pyrolysis products. Significant genotypic variation in composition was identified between species and genotypes, and a clear relationship was observed between the biomass composition, yields of pyrolysis products, and the composition of the volatile fraction. Results indicated that genotypes other than the commercially cultivated Miscanthus x giganteus may have greater potential for use in bio-refining of fuels and chemicals and several genotypes were identified as excellent candidates for the generation of genetic mapping families and the breeding of new genotypes with improved conversion quality characteristics.
Subject(s)
Andropogon/chemistry , Andropogon/classification , Biofuels/analysis , Hot Temperature , Species SpecificityABSTRACT
The objectives of the experiment were to assess the impact of nitrogen (N) and potassium (K) fertiliser application on the cell wall composition and fast-pyrolysis conversion quality of the commercially cultivated hybrid Miscanthus x giganteus. Five different fertiliser treatments were applied to mature Miscanthus plants which were sampled at five intervals over a growing season. The different fertiliser treatments produced significant variation in concentrations of cell wall components and ash within the biomass and affected the composition and quality of the resulting fast-pyrolysis liquids. The results indicated that application of high rates of N fertiliser had a negative effect on feedstock quality for this conversion pathway: reducing the proportion of cell wall components and increasing accumulation of ash in the harvested biomass. No exclusive effect of potassium fertiliser was observed. The low-N fertiliser treatment produced high quality, low ash-high lignin biomass most suitable as a feedstock for thermo-chemical conversion.
Subject(s)
Fertilizers , Poaceae/drug effects , Poaceae/physiology , Agriculture/methods , Hot TemperatureABSTRACT
OBJECTIVE: To determine the relationship between presence of amniotic fluid (AF) biomarkers characteristic of inflammation (defensins 2 and 1 and calgranulins C and A) and fetal inflammatory status at birth. DESIGN: Prospective observational cohort. SETTING: Tertiary referral University hospital. POPULATION: One hundred and thirty-two consecutive mothers (gestational age, median [interquartile range]: 29.6 [24.1-33.1] weeks) who had a clinically indicated amniocentesis to rule out infection and their newborns. METHODS: Intra-amniotic inflammation was diagnosed by mass spectrometry surface-enhanced-laser-desorption-ionization time of flight (SELDI-TOF). The AF proteomic fingerprint (mass-restricted [MR] score) ranges from 0-4 (none to all biomarkers present). The intensity of intra-amniotic inflammation was graded based on the number of proteomic biomarkers: MR score 0: 'no' inflammation, MR score 1-2: 'minimal' inflammation and MR score 3-4: 'severe' inflammation. At birth, cord blood was obtained for all women. Severity of histological chorioamnionitis and early-onset neonatal sepsis (EONS) was based on established histological and haematological criteria. Interleukin-6 (IL-6) levels were measured by sensitive immunoassays. The cord blood-to-AF IL-6 ratio was used as an indicator of the differential inflammatory response in the fetal versus the AF compartment. MAIN OUTCOME MEASURES: To relate proteomic biomarkers of intra-amniotic infection to cord blood IL-6 and to use the latter as the primary marker of fetal inflammatory response. RESULTS: Women with intra-amniotic inflammation delivered at an earlier gestational age (analysis of variance, P<0.001) and had higher AF IL-6 levels (P<0.001). At birth, neonates of women with severe intra-amniotic inflammation had higher cord blood IL-6 levels (P=0.002) and a higher frequency of EONS (P=0.002). EONS was characterised by significantly elevated cord blood IL-6 levels (P<0.001). Of the 39 neonates delivered by mothers with minimal intra-amniotic inflammation, 15 (39%) neonates had umbilical cord blood IL-6 levels above the mean for the group and 2 neonates had confirmed sepsis. The severity of the neutrophilic infiltrate in the chorionic plate (P<0.001), choriodecidua (P=0.002), umbilical cord (P<0.001) but not in the amnion (P>0.05) was an independent predictor of the cord blood-to-AF IL-6 ratio. Relationships were maintained following correction for gestational age, birthweight, amniocentesis-to-delivery interval, caesarean delivery, status of the membranes, race, MR score and antibiotics and steroid exposure. CONCLUSIONS: We provide evidence that presence of proteomic biomarkers characteristic of inflammation in the AF is associated with an increased inflammatory status of the fetus at birth. Neonates mount an increased inflammatory status and have positive blood cultures even in the context of minimal intra-amniotic inflammation.
Subject(s)
Chorioamnionitis/diagnosis , Pregnancy Complications, Infectious/diagnosis , Premature Birth/immunology , Adult , Amniotic Fluid/immunology , Analysis of Variance , Biomarkers/analysis , Female , Fetal Blood/chemistry , Humans , Interleukin-6/analysis , Pregnancy , Prospective Studies , Proteome/analysis , Regression AnalysisABSTRACT
The next generation of large scale fusion devices--ITER/LMJ/NIF--will require diagnostic components to operate in environments far more severe than those encountered in present facilities. This harsh environment is the result of high fluxes of neutrons, gamma rays, energetic ions, electromagnetic radiation, and in some cases, debris and shrapnel, at levels several orders of magnitude higher than those experienced in today's devices. The similarities and dissimilarities between environmental effects on diagnostic components for the inertial confinement and magnetic confinement fusion fields have been assessed. Areas in which considerable overlap have been identified are optical transmission materials and optical fibers in particular, neutron detection systems and electronics needs. Although both fields extensively use cables in the hostile environment, there is little overlap because the environments and requirements are very different.
ABSTRACT
BACKGROUND: The incidence of postoperative delirium (PD) in the elderly ranges between 3-60% but has never been examined in gynecologic oncology. Our goal was to identify pre, intra, and postoperative risk factors associated with the development of PD. METHODS: English speaking women of 60 years and above undergoing major surgery for suspected gynecologic malignancies were invited to participate. Enrolled patients were administered a pre and postoperative Mini-Mental State Exam (MMSE), and the postoperative Confusion Assessment Method was used to diagnosis PD. Pre, intra, and postoperative clinicopathology parameters were collected. Statistics included the Pearson chi-squared tests and multivariate logistic regression. RESULTS: Eighteen of a total of 103 patients (17.5%) developed PD. Univariate analysis revealed significant associations (p<0.05) between the development of delirium and age, albumin level, Charlson comorbidity index, performance status, dementia, level of education, number of pre and postoperative medications, prolonged oxygen or Foley catheter usage (>2 d), increased narcotic use (above standard regimens), postoperative transfusion, bed restriction and change in MMSE scores (pre vs. post). Using multivariate logistic regression analysis, older patients (p=0.0002), on multiple medications (p=0.008), given additional narcotic doses (p<0.0001) were at highest risk for the development of delirium. Intraoperative parameters were not correlated with outcome. CONCLUSIONS: PD is a common complication in older women undergoing major gynecologic surgery. Increased narcotics, age, and preoperative medications were strongly associated with this adverse event. Prevention needs to focus on i) identifying patients at higher risk for PD based on preoperative parameters, and ii) eliminating known postoperative risk factors.
Subject(s)
Genital Neoplasms, Female/surgery , Gynecologic Surgical Procedures , Parkinson Disease/epidemiology , Parkinson Disease/etiology , Postoperative Complications , Age Factors , Aged , Aged, 80 and over , Dose-Response Relationship, Drug , Drug Prescriptions/statistics & numerical data , Female , Humans , Incidence , Logistic Models , Middle Aged , Narcotics/administration & dosage , Narcotics/adverse effects , Risk Assessment , Risk FactorsSubject(s)
Athletic Injuries , Baseball , Tooth Injuries/classification , Female , Humans , Sex FactorsABSTRACT
Soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), reached damaging levels in 2003 and 2005 in soybean, Glycine max (L.) Merrill, in most northern U.S. states and Canadian provinces, and it has become one of the most important pests of soybean throughout the North Central region. A common experimental protocol was adopted by participants in six states who provided data from 19 yield-loss experiments conducted over a 3-yr period. Population doubling times for field populations of soybean aphid averaged 6.8 d +/- 0.8 d (mean +/- SEM). The average economic threshold (ET) over all control costs, market values, and yield was 273 +/- 38 (mean +/- 95% confidence interval [CI], range 111-567) aphids per plant. This ET provides a 7-d lead time before aphid populations are expected to exceed the economic injury level (EIL) of 674 +/- 95 (mean +/- 95% CI, range 275-1,399) aphids per plant. Peak aphid density in 18 of the 19 location-years occurred during soybean growth stages R3 (beginning pod formation) to R5 (full size pod) with a single data set having aphid populations peaking at R6 (full size green seed). The ET developed here is strongly supported through soybean growth stage R5. Setting an ET at lower aphid densities increases the risk to producers by treating an aphid population that is growing too slowly to exceed the EIL in 7 d, eliminates generalist predators, and exposes a larger portion of the soybean aphid population to selection by insecticides, which could lead to development of insecticide resistance.