Mapping the yearly extent of surface coal mining in Central Appalachia using Landsat and Google Earth Engine.

Surface mining for coal has taken place in the Central Appalachian region of the United States for well over a century, with a notable increase since the 1970s. Researchers have quantified the ecosystem and health impacts stemming from mining, relying in part on a geospatial dataset defining surface mining's extent at a decadal interval. This dataset, however, does not deliver the temporal resolution necessary to support research that could establish causal links between mining activity and environmental or public health and safety outcomes, nor has it been updated since 2005. Here we use Google Earth Engine and Landsat imagery to map the yearly extent of surface coal mining in Central Appalachia from 1985 through 2015, making our processing models and output data publicly available. We find that 2,900 km2 of land has been newly mined over this 31-year period. Adding this more-recent mining to surface mines constructed prior to 1985, we calculate a cumulative mining footprint of 5,900 km2. Over the study period, correlating active mine area with historical surface mine coal production shows that each metric ton of coal is associated with 12 m2 of actively mined land. Our automated, open-source model can be regularly updated as new surface mining occurs in the region and can be refined to capture mining reclamation activity into the future. We freely and openly offer the data for use in a range of environmental, health, and economic studies; moreover, we demonstrate the capability of using tools like Earth Engine to analyze years of remotely sensed imagery over spatially large areas to quantify land use change.

Use of clinical practice guidelines by executive directors of optometric associations.

BACKGROUND: The process of developing the American Optometric Association's (AOA) Optometric Clinical Practice Guidelines began in 1989 under the direction of John F. Amos, O.D., M.S., then chair of the AOA's Clinical Care Center. The guideline development process used by the AOA was modeled after the recommendations established by the Agency for Health Care Policy and Research in response to the federal government encouraging health care groups to develop clinical guidelines to enhance the quality, appropriateness, and effectiveness of health care. The guideline topics were chosen for their importance in the education of members, health care payers, and state legislators. A principal author and a consensus panel of experts then were chosen for each subject area. This group was responsible for transforming the latest scientific research and expert judgment into a document that would apply to everyday optometric practice. Thirteen guidelines were developed and mailed to AOA members in 1994 and 1995. Additional guidelines were mailed as they were approved. Currently, there are 20 guidelines available. METHODS: A survey was mailed to the executive director of the optometric association of each state and the District of Columbia and to the chief of optometry of each of the federal services. Telephone follow-up was made to nonrespondents, and an additional copy of the survey was mailed to them with telephone follow-up again taking place for those who did not respond. RESULT: Forty-three of the surveys were returned for a response rate of 78%. Seventy-six percent of the respondents stated that they had received the guidelines. The sections that were found most useful to the respondents were those related to Description and Classification, Basis of Treatment, and Treatment Options. The guidelines were most often used by these groups to improve the quality of eye care, expand optometric involvement in health programs, affect public policy, and overcome problems with insurance groups. DISCUSSION: Optometric organizations have found the clinical practice guidelines useful beyond their primary goal of enhancing the quality of patient care. They have been used effectively to help educate other parties about optometry and its role as a primary health care profession.

Auditory response to a photic stimulus.

BACKGROUND: The photic sneeze response is a well-established clinical phenomenon in which patients respond by sneezing in an uncontrolled manner. This paroxysm of sneezing is evoked by a sudden exposure to an intense or bright light source. The pathogenesis of this response is apparently quite complex. Sudden exposure to bright light involves the optic, oculomotor, and trigeminal nerves, the autonomic nervous system and central brainstem functions. Anecdotal reports have suggested the photic sneezing response may occur as an autosomal dominantly inherited condition. However, such a familial pattern is not always present. METHODS: This article presents a descriptive report of a case in which a patient sought comprehensive eye care and, during the course of the examination, reported a relationship between light and a predictable auditory response. The mechanism for this involuntary auditory response to a bright light may be similar to that involved with photic sneeze response. RESULTS: This patient's history, specific features of the auditory response, and ophthalmic findings as a result of the comprehensive eye examination are reported. CONCLUSION: The photic sneeze response is not an uncommon phenomenon. A similar mechanism may explain the auditory response to a photic stimulus reported in this article.